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
A transplanted kidney occupies a new position in your body.
A kidney transplant operation is when a kidney from one person is placed in the body of another person. A kidney can either be donated by someone who has died or from a living person.
How do you know if you can have a transplant?
You will need to discuss the choices open to you with your kidney care team as early as possible. Then you can make the best decision for you and your family. If you feel you need more information at any time, ask your team. You will also need a series of tests to make sure that you are fit and healthy enough to have a transplant.
Why you might be suitable for a transplant
For many patients with chronic kidney disease (CKD) a transplant is the best treatment choice. It will give you the best chance of having a lifestyle similar to the time before you became ill. A transplant is also the treatment choice that is most likely to improve your long-term health.
Why you might not be suitable for a transplant
If you have other conditions as well as CKD, such as significant heart or lung disease you may not be fit enough for a transplant operation because the risks would be much greater than the potential gains. If you are obese the risks of having a transplant operation may be too great and technically difficult. Your healthcare team can give you support to lose weight.
What is tissue typing and cross matching?
If you have a kidney transplant you will need to take anti-rejection medication. This stops your body´s immune system from recognising the kidney as foreign and destroying it. Your body recognises the kidney as foreign partly because of characteristics called the tissue type. If your tissue type is similar to the person donating the kidney then your body is less likely to reject the kidney. The cross match is the final blood test before a transplant operation happens. It checks if you have any antibodies to the donor kidney, which could damage or destroy it. The operation can only go ahead if the result of the cross match is negative.
Is any surgery involved?
The operation takes between two and four hours. Your own kidneys are not usually removed. The transplant kidney is usually put in on the right side of your groin/pelvic area, but it can also be transplanted on the left side. The exact positioning varies according to the individual patient. The blood vessels of the donor kidney are attached to your blood supply and the ureter (the tube which connects the kidney and the bladder) is joined to your bladder. The operation will leave you with a small scar which will fade over time.A small tube called a stent is put down the ureter to ensure you can pass urine and to protect the join with your bladder. Once you have healed, you will need a small procedure about three months after your transplant to take the stent out. Your own kidneys are not usually removed.
What are the benefits of having a transplant?
- Having a transplant means that you do not have to dialyse.
- You might find you have more energy, making you feel better able to cope with everyday life, including work or studies.
- Your sex life and fertility will probably improve (if it has been affected by CKD).
- If you have Type 1 diabetes and have a kidney and pancreas transplant you should no longer need to take insulin or tablets to control your blood sugar.
- You will not need to travel to hospital for dialysis. However, you will need to come to hospital for regular clinic appointments for up to six months after your transplant. After this time you will need to come to clinic around three to four times a year depending on your needs.
- You will have a less restrictive diet than if you are on dialysis, although you will need to follow a low fat diet after a transplant.
- You do not need space at home to store equipment.
- You will be able to restart any sport or exercise after the transplant, although if you play contact sports please discuss this with your kidney doctor or nurse first. You must be a healthy weight for the operation so exercise is important while you are waiting for a transplant.
What are the risks in having a transplant?
- There are the general risks associated with having surgery and a general anaesthetic, including the risk of infection.
- There is always a risk your body will reject the new kidney. This means the body´s immune system recognises a transplanted kidney as foreign and tries to attack it. You will need to take anti-rejection medication for the rest of the time the kidney is working. You may have side-effects with this medication such as excess weight gain, hair growth and an increased risk of some cancers, including skin cancer. Many of these can be prevented by carefully following the advice of the healthcare team. It is especially important that you do not stop taking any medication without first talking to your kidney doctor or nurse.
- You are also more susceptible to infection after a transplant because of the medication.
- You will need to have a detailed discussion with your kidney consultant and / or surgeon before deciding to have a transplant, this discussion will include more information on potential risks.
How do I know if I'm in the transplant pool?
Ask your kidney care team if you are in the transplant pool.
What is a pre-emptive transplant?
This means having a transplant before you need dialysis. This is usually from a living donor because it is possible to plan ahead so you receive a kidney when you need it.
Can I have another transplant if the first one fails?
Sometimes a kidney transplant fails. Most people can have further transplants if this happens. If your transplant fails you might need to have an operation to remove the failed kidney. The success rate for subsequent transplants is generally as good as for the first. However, you are likely to wait longer. You will also need to go through the same tests again to make sure you are fit and healthy enough to have another kidney