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Living Day to Day with Kidney Dialysis

Dialysis in the Future continued...

Still, dialysis is not a cure. If a person's kidneys are temporarily damaged, dialysis can give them a rest and a chance to recover. But for chronic, end-stage renal disease, a kidney transplant is the only long-term solution that frees a patient from dialysis.

Living relatives can donate a kidney if their remaining organ is healthy. Even with a kidney from a close relative, however, a transplant recipient must take drugs to suppress the immune system from rejecting the organ. There are about three times as many people waiting for transplants as there are kidneys available.

Some dialysis patients are not well enough for the rigors of a transplant operation and the drugs that follow, according to Robinson of the American Association of Kidney Patients. In fact, 20 percent of dialysis patients are over 65. More than half suffer from other illnesses, such as diabetes and high blood pressure. Some patients receive transplants only to have them rejected by their immune system later. Some patients refuse transplants. For them, says Robinson, dialysis may be something of a social gathering and a way to be monitored and cared for by a group of health-care providers that become like friends.

Dialysis survival in the United States after one year is 77 percent, according to the National Center for Health Statistics. After five years it is 28 percent, and after 10 years it is about 10 percent. Transplant survival rates are higher: 77 percent of patients survive 10 years after a living-relative donor. Many experts point out there is room for improvement in the survival rate and quality of life for American dialysis patients.

"I think everything will be different in the future," predicts Eknoyan of the National Kidney Foundation. "People are working on fine-tuning dialysis and improving the technology. For instance, they are trying to develop ways to put essential substances back into the blood while taking the impurities out."

Perhaps kidney transplants, always in shortage, will become easier to get if animals such as pigs are used as donors, Eknoyan adds. But the best treatment, of course, is to protect healthy kidneys in the first place. Diabetes and high blood pressure account for more than half of all cases of end-stage renal disease. Both of these conditions usually can be managed with proper medical care (see article below, "Take Care of Your Kidneys").

Says Eknoyan, "Prevention is going to be a big part of the answer."

To report a problem with dialysis equipment, call MedWatch at 1-800-FDA-1088.

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