Transplant or Dialysis: Which is Best for Me?

You know you have Chronic Kidney Disease (CKD), though you may not know when you’ll be approaching the need for a transplant or dialysis.  It’s not uncommon to be overwhelmed by your diagnosis and looming health concerns—or confused about your options.

No doubt you’ve been provided information on transplant and dialysis, but is it enough to give you the clarity you need?

Are you able to answer the tough questions, like “Should I try to get a transplant before I need dialysis?” Another question might be, “Is it even possible to get a transplant before I would have to start dialysis?”  Download PDF 1-Sheet

Common Misconceptions: Kidney patients often believe that they must be on dialysis before getting a transplant and that planning for transplant before dialysis doesn’t make a lot of sense. Yet, this line of thinking couldn’t be further from the truth for proactive patients with interested living kidney donors.

Another misconception is thinking life on dialysis is easier (or better) than getting a transplant, or that they could live forever on dialysis. While dialysis is a lifesaving treatment, it can only perform about 10 percent of the work of a functioning kidney. Over time, the harsh process of dialyzing often causes additional health issues like anemia, bone disease, high blood pressure, heart disease, nerve damage and a high propensity for Infection. 

Likewise, dialysis is extremely demanding on the patient’s schedule. The process itself can cause muscle cramping, itchy skin, low blood pressure and it tends to leave patients feeling exhausted long after their sessions.  

Hidden Benefits: The average life expectancy for a patient on dialysis is generally five years. Patients who can avoid dialysis or minimize how long they will require dialysis, can generally expect to live a longer and less cumbersome life after transplant. For example, patients who get a kidney transplant before dialysis (known as a preemptive kidney transplant) live an average of 10 to 15 years longer1 than if they had stayed on dialysis.

Another quality of life misconception points to age. While younger adults tend to benefit more than older adults, a 75-year old kidney transplant recipient can gain four additional years on average, when they choose to secure a transplant instead of staying on dialysis. 1   

The most undervalued misconception about transplant has to do with the timing of when to secure a transplant. Without question, a preemptive (before dialysis) transplant offers the best outcome, yet when a patient needs to be on dialysis while waiting for a donated kidney, the less time a patient is on dialysis the fewer health problems they’ll have long-term. For example, a transplanted kidney will work longer in patients who were transplanted before dialysis was required. (Patients who wait for a transplant on dialysis for two years are three times more likely to lose their transplanted kidney than those patients who wait less than six months on dialysis). 1

Download PDF 1-Sheet

1. https://www.bidmc.org/centers-and-departments/transplant-institute/kidney-transplant