For most people with mild CKD (stages 1-3) treatment will consist of adopting a healthy lifestyle and taking some medications to control their blood pressure and prevent their kidneys from getting worse.
If your CKD progresses to stage 4-5 you will need to start thinking about the treatment options available for kidney failure.
Read our guide to living with early stage chronic kidney disease (PDF 4Mb)
Choosing the treatment option that's right for you
Anyone can consider making a kidney donation.
Kidney donation is the removal of a healthy kidney from a living person, or one who is recently deceased, for the purposes of transplanting. There are different ways that a kidney can be donated and matched to a recipient.
What are the different types of kidney transplant?
Living donor transplant - This is when someone (the donor) chooses to donate a kidney to another person (the recipient) who needs a transplant. The donor is often a family member who is related by blood but it may also be a spouse, partner or friend who is not related by blood.
Your country will have its own regulations for living donors. You can ask your healthcare team about these. In the United Kingdom the options include:
- Paired or pooled donations – When a donor and recipient are incompatible or mismatched with each other, either by blood group or by tissue type, it may be possible for them to be matched with another donor and recipient pair in the same situation and for the kidneys to be exchanged or swapped. This is called paired kidney donation. Each recipient benefits from a transplant that he or she would otherwise not have had. When more than two pairs are involved in the swap it is known as pooled kidney donation.
- Altruistic donation - This is used only in kidney transplantation. It is where a person volunteers to donate a kidney to an unknown recipient; someone they have never met before. The benefit of this type of donation is that a person in the national transplant pool receives a living donor kidney transplant and the number of patients waiting is reduced overall. This increases the chance of other potential recipients receiving a kidney.
- ABO and HLA incompatible transplantation - an ABO (blood group) incompatible transplant is where the living donor and recipient have different blood groups. An HLA (human leukocyte antigen) incompatible transplant is where the living donor and the recipient have different tissue types. It has only recently become possible to do these types of transplants and these options are usually considered when other transplant options are not possible.
There are several advantages to having a living donor transplant, including the chance to plan the transplant before the need for dialysis (a pre-emptive transplant). A living donor kidney transplant before you start dialysis offers you, the recipient, the best chance of long-term transplant survival and freedom from dialysis. Although all operations carry some risk, once the donor has recovered from the surgery, he/she can usually live a normal and healthy life with no impact on their long-term health.
Deceased donor transplant - This is when you receive a kidney from someone who has died . There is a national pool of people waiting for this type of transplant.
Kidney and pancreas transplant - This may be an option if you have diabetes mellitus and kidney failure. Your kidney care team can tell you more about the kidney and pancreas transplant options.
What if my donor is not compatible with me?
Blood tests will show whether your donor(s) is compatible. If the donor is not compatible with you this means that you, the recipient, have antibodies in your blood against your potential donor´s blood group or tissue type.
It might be possible to remove the antibodies from your blood by a process similar to haemodialysis. This involves ´washing´ the blood plasma to make it safe to go ahead with the transplant. Or you might want to consider paired donation.
How can I find out if someone is a suitable donor?
Anyone wishing to consider living kidney donation, donor or recipient, should contact their local kidney unit. Anyone wanting to donate a kidney will need to have a thorough assessment to make sure that they are fit and healthy enough to donate a kidney.