Those with CKD - please consider a Preemptive Kidney Transplant

The normal course of events for someone with CKD is to wait till the kidneys have failed completely, create an access in the meantime, and when the symptoms and numbers start getting bad, start dialysis. Then, start thinking of a transplant. Either a cadaver or a live-related donor.

There is another path that is not commonly looked at (though, that is changing these days) is that of a pre-emptive kidney transplant. This is a kidney transplant when the kidneys have not yet failed fully but we know for sure that they are on the way to complete failure.

This has the advantage of not having to get on to dialysis at all.

Few people opt for this though. For some, it is because of denial that their kidney disease is permanent and irreversible. They have a hope that the kidneys are going to recover their function. For some, it is inertia. They just go with the flow and do not want to take any major proactive steps. Others don't even know this can be done.

There are several advantages of a pre-emptive kidney transplant. Since you are doing it before the kidneys have failed, you have time on your side. By planning well-ahead, you can do this by thinking through every aspect, including the donor, the hospital, the surgeon and so on.

Physiologically as well, this is a better solution. You have got fully functioning kidneys before your old kidneys have failed completely. So, your body would not have to withstand the stress of a life without functioning kidneys.

If the transplant doesn't work due to whatever reason, then dialysis is always there as a backup. One problem could be the lack of an access. But that is not an insurmountable problem.

So, if you're currently in CKD and have crossed Stage 3 or so, start thinking of a pre-emptive kidney transplant. Talk to your doctor if you are a candidate. See if you have a willing and able donor. A proactive approach to your health has many advantages. Stop going with the flow. 


Anonymous said…
We have 2 people in our family who have had a transplant. I’m the donor for one of them. Both times, I had asked the nephrologist if we can go for a preemptive transplant, and both times he said no. His reasoning was, nothing can come close to the native kidneys, so why meddle with it before time. So on both occasions we waited till Cr was around 9, and then started the dialysis, ultimately a transplant. But yes, I agree with you about going in for a preemptive transplant, especially if there’s a donor.