Common Causes of End-stage Kidney Disease
Common causes of end-stage kidney disease include:
1- Diabetes
2- Chronic and uncontrolled blood pressure
3- Chronic glomerulonephritis – inflammation and possible small scarring inside your kidneys (glomerular)
4- Polycystic kidney disease
People who have 90% of all kidney failure must purify their blood through a device called dialysis to survive. At specialist clinics, health care professionals are trained to help you experience a successful kidney transplant.
What is Glomerulonephritis?
Glomerulonephritis is an inflammation of the small parts (glomerular) of your kidneys that are responsible for purifying the blood. Glomeruli remove fluids, electrolytes, and waste materials from the bloodstream and transfer them into the urine. Glomerulonephritis can occur suddenly (acutely) or gradually (chronically). Glomerulonephritis occurs alone or as part of another condition such as lupus or diabetes. Severe or prolonged inflammation associated with glomerulonephritis can damage the kidneys. Treatment depends on your type of glomerulonephritis. Signs and symptoms of glomerulonephritis depend on the form of the disease (i.e. acute or chronic) and the cause.
Signs and symptoms of glomerulonephritis include:
1- Bloody urine
2- Urine foam due to excessive protein (proteinuria)
3- High blood pressure
4- Swelling in your face, hands, feet, and abdomen
What is Polycystic?
Polycystic ovary syndrome (PCOS) is a hormonal disorder that is common among women during fertility. Women with polycystic ovary syndrome may have a short or prolonged menstrual cycle. The exact cause (PCOS) is unknown. Early diagnosis and treatment, along with weight loss, may reduce the risk of long-term complications such as type 2 diabetes and heart disease.
Why is a Kidney Transplant Performed?
In most cases, kidney transplantation is a treatment of choice for kidney failure that is performed instead of a lifetime of dialysis. Kidney transplantation can cure chronic kidney disease and help you feel better and live longer. Compared to dialysis, kidney transplantation has the following benefits:
1- Better quality of life
2- Less risk of death
3- Less dietary restrictions
4- Lower treatment cost
Some people may also use kidneys and transplants before they need dialysis. This method is known as preventive kidney transplantation. But for certain people with kidney failure, kidney transplantation may be more dangerous than dialysis. Conditions that may disqualify individuals from having kidney transplantation include:
1. Old Age
2- Severe heart disease
3- Active cancer or recently treated cancer.
4- Dementia or poor mental illness
5- Alcohol or drug abuse
6. Any other factor that affects the safety of kidney transplantation. If a living donor cannot donate all of their blood (e.g. your blood type does not match), you will have to wait to receive another one that is compatible with your body and blood type from the deceased donor. How long you have to wait for the donor depends on the degree of compatibility between you and the donor, the time of dialysis, and the transplant waiting list. Some people have a kidney transplant in a few months, and others may wait several years.
Potential Risks of Kidney Transplantation
Kidney transplantation can treat advanced kidney disease and kidney failure, but this is not a complete treatment for these diseases. Because some of the conditions and symptoms of kidney disease may occur again, even after a kidney transplant. Possible risks of kidney transplantation include those directly associated with the surgery itself. For example, rejection of new organs and side effects of taking medications (immunosuppressive drugs to prevent organ rejection by the body) are possible risks of kidney transplantation. Deciding whether a kidney transplant is right for you is a personal decision that you should consider the side effects and benefits of.
Possible Complications of Kidney Transplantation
Kidney transplant surgery poses some significant risks and complications, including:
1- Blood clots and bleeding
2- Leakage or obstruction of the tube (ureter) that connects the kidney to the bladder.
3- Infection
4. Failure or rejection of all donations
5- Infection or cancer that can be transmitted with the donated organ.
6. Death
7- Heart attack and stroke
Side effects of anti-rejection drugs (drugs used to suppress the immune system to prevent organ rejection by the body). After a kidney transplant, you will use medications to prevent your immune system from rejecting the donated organ. These drugs can cause various side effects. Including:
1- Osteoporosis and bone damage (osteonecrosis)
2- Diabetes
3- Excessive hair growth or hair loss
4- High blood pressure
5- High cholesterol
Other side effects may include:
1- Increased risk of cancer (especially skin cancer and lymphoma)
2- Infection
3- Swelling
4- Weight gain
5- Acne
Steps to Prepare for a Kidney Transplant
In the continuation of this article, we will explain the stages of kidney transplantation.
1- Choosing a transplantation center
If your doctor recommends a kidney transplant, he or she will refer you to a medical center. You can also choose a kidney transplant center according to your personal preference or choose a center from the list of kidney transplant centers that are contracted with the insurance companies you are covered by.
It is better to pay attention to the following points before choosing a center:
1- Get information about the number and type of transplantations your center makes every year.
2- Ask about the survival rate of people who have had a kidney transplant at your kidney transplant center.
3- Compare the statistics of different kidney transplant centers.
4. Choose a center for a kidney transplant where you have a better chance of being a priority (on the kidney waiting list).
5- Investigate the costs you have to pay before, during, and after the link. These costs include tests, organ preparation (kidneys), surgery, hospitalization, as well as transportation to the center where you want to complete kidney transplant procedures.
2- Your Qualification
Once you have selected a kidney transplant center, you will be evaluated to see if you are eligible for a kidney transplant. The kidney transplant center team will check if you:
1- Are you healthy enough for surgery?
2- Do you have the necessary tolerance (e.g. does your body tolerate the use of the drugs you want?) to use the lifelong medications you should take after a kidney transplant?
3- Do you have a specific medical condition that can impair the success of transplantation?
Your evaluation process may take several days and may include the following:
1- A complete physical examination
2- Imaging such as X-ray (MRI) or CT scan
3- Blood test
4- Mental health assessment
5. Any other necessary tests prescribed by the doctor.
After your assessment, the kidney transplant center team will talk to you about the results of the tests and tell you whether you have been accepted as a kidney transplant candidate. Each kidney transplant center meets its assessment criteria. If you are not admitted to a kidney transplant center, you can go to another center.
Preoperative Procedures for Kidney Transplantation
The kidney donor can be alive or deceased and can also be a relative of yours or a stranger. Before the operation, you should do some necessary tests, including:
1- Blood type determination test
It is advisable to get a kidney transplant from someone whose kidneys match your blood type. Although you can get a kidney from someone who does not have the same blood type as you, in this case, the body is more likely to reject the new organ. You will need to take various actions to reduce the likelihood of this happening.
2- Test to determine body tissue
If your blood type is compatible with the donor, the next step is to test tissue typing called human leukocyte antigen (HLA). This test compares your genetic markers and that of the donor.
This test increases the possibility of finding a kidney that is more likely to match your body well. Good adaptation at this point means your body will not reject the organ.
3- In the last trial, a small sample of your blood is mixed with donor blood. This test determines whether antibodies in your blood react to specific antigens in the donor’s blood. The negative result of this test means that these antigens are compatible and your body is not likely to reject the new kidney. Other factors that will be evaluated before a kidney transplant include the age and size of the kidney.
Alive Donor
Most likely, family members will be a good option for a kidney transplant. But that doesn’t mean you can’t get new ones from other people like your friend or colleague. If for any reason you find someone who wants to donate a kidney but the kidney does not meet the requirements of your body, you can try placental donation. In a placenta donation, the person wishing to donate will donate his or her kidney to the person whose tissue is the same as yours. In this type of donation, the second person will donate his or her kidney to you. If you do not find a living donor who is fully compatible with your body, your name will be placed on a waiting list to receive a kidney from a deceased donor. The waiting time to receive a kidney from a deceased donor is usually several years.
Take Care of Yourself
If you have to stay on the waiting list to receive a kidney or it is your turn, you should know that you should try to maintain your health. Having good physical health increases the chances of successful surgery. In addition, staying physically fit will shorten your treatment period. To maintain your health, follow the tips below.
1- Take your medications as prescribed.
2. Have a healthy diet.
3- Do not smoke. If you smoke you should quit smoking. You can get help from your doctor in this case.
4. Get enough rest.
Procedures During Kidney Transplantation
Kidney transplantation is performed under general anesthesia. So you are not conscious during the operation. The surgical team monitors your heart rate, blood pressure, and oxygen levels at all stages.
During surgery, the surgeon makes an incision in your lower abdomen and places the donated kidney in your body. The blood vessels of the new kidney are connected to the blood vessels in the lower abdomen, just above one of the legs. The ureter is the tube that connects the new kidney to the bladder.
Life After Kidney Transplant Surgery
You will spend a few days to a week in the hospital after having a kidney transplant. Doctors and nurses will monitor your condition in the hospital to control any possible symptoms and complications. You may need temporary dialysis even after surgery so that new kidneys start functioning properly. When recovering, expect pain around the incision site. Most kidney recipients can resume their daily activities and other normal activities eight weeks after transplantation. Avoid lifting heavy objects and strenuous exercise after the operation. Talk to your doctor regularly during recovery. After leaving the hospital, for a few weeks, careful monitoring of your recovery process is required. This monitoring will help you and your doctor to make sure your body doesn’t reject the new kidney. You may need to take several blood tests during a week and have to take your medication even during the weeks after a kidney transplant (you should only use some medications within a specified period and use some medications permanently). It is advisable to accommodate near the clinic where you have undergone a kidney transplant (or choose a clinic for your kidney transplant that is close to where you live) so that you can visit specialists immediately in case of any problems. You will take medication during your lifetime.
Kidney Transplant Result
After a successful kidney transplant, the new one will purify your blood and you will no longer need dialysis. To prevent the body from rejecting the kidney, you need medications to suppress your immune system. Since used painkillers make your body vulnerable to infection, your doctor may also prescribe antibacterial, antiviral, and antifungal medications. It is important to take all of your medications as prescribed by your doctor. Even if you do not take your medication for a short time, your body may reject your new kidney. If you experience any side effects that prevent you from continuing to take the prescribed medication (for example, if you are allergic to the prescribed medication), contact your kidney transplant center medical team immediately.
Success Rate for Kidney Transplantation
The success rate among kidney recipients in Iranian transplant centers can be checked online on official websites. If the new kidney also fails, you can resume dialysis or have a second transplant. You can also stop treatment. If you decide to stop treatment, your doctor may prescribe medication to relieve your symptoms. Your decision depends on your current health, ability to withstand surgery, and your expectations for maintaining a quality of life.
Kidney Transplantation in Iran
Iran is one of the countries where you can travel safely for a kidney transplant (if you live in Iran, it will be easier for you). The success rate of kidney transplantation in Iran is high. Because skilled surgeons perform this operation. You will be completely anesthetized for a kidney transplant in Iran. After the kidney transplant, you will be hospitalized for 7 to 10 days. Generally, you can resume your daily activities 8 weeks after your kidney transplant. Iranian doctors perform kidney transplants in two or three hours. To have a kidney transplant in Iran, you will stay in this beautiful country for at least ten days.
