Kidney Disease and Transplant: Frequently Asked Questions

Keeping Kidneys Healthy

What can we do to take better care of our kidneys?
The most important thing to do is make sure your blood pressure is under control by having it measured once a year. Also, it is important to maintain good control of your blood sugar level.
How do you know if you are at risk for kidney disease?
There are some basic things that we monitor for risk of kidney disease:
  • Blood pressure, which should be checked at least once a year
  • Urine analysis, to check protein levels
  • Creatinine level in your blood
How long can you live with one kidney?
As long as one kidney is healthy, it should not affect a lifespan.
What is serum creatinine?
Serum creatinine is a blood test that your doctor uses to measure how well your kidneys are filtering.
If you only have one kidney, how do you know when the other one is going bad?
The most important thing to do is measure blood pressure and proteins to ensure that the remaining kidney is still healthy. In most cases, when one kidney goes bad, the other will go bad as well.
Why are African-Americans more prone to kidney disease?
African-Americans tend to have a higher incidence of high blood pressure and diabetes. Additionally, there is a tendency for African-Americans to scar their kidneys more severely than other people. Given a certain kidney injury, an African-American may scar in the area and lose function where someone else might heal the injury with no loss of function.

When Kidneys Fail

What causes kidney failure, and what can be done to prevent it from happening?
There are four major causes of kidney failure, listed from most common to least common in the United States:
  1. Diabetes
  2. High blood pressure
  3. Special kidney diseases known as glomeronephritis
  4. Hereditary kidney diseases, such as polycystic kidney disease
When a kidney shuts down, is it removed?
It is usually not necessary to remove a kidney that shuts down.
Is kidney disease hereditary?
Around 10 percent of kidney failures are caused by hereditary factors.
What can be done for fatigue when you have kidney disease?
Fatigue is a common symptom of kidney failure and there are medications that treat this symptom. If the fatigue is too severe, the best way to manage this might be with dialysis.
Can kidney disease cause back pain?
Kidney infections and certain obstructions can cause back pain. However, most back pain is unrelated to kidney problems.
What can be done for swelling and fluid?
Many patients with kidney failure have swelling, which is something we can treat with medicine. Another way patients can keep from swelling is avoiding salt in their diets.

Dialysis

What is the process of dialysis?
The major function of your kidneys is to filter out impurities from your blood. When kidneys don’t work, we use a dialysis machine to filter out the impurities since your kidneys aren't able to do so.
When is there a concern about dialysis?
After kidney failure begins, we monitor the serum creatine levels. If they reach a certain point, we consider dialysis.
How often does dialysis need to be done?
Most patients get dialysis three times a week.
How long can you stay on dialysis while waiting for a transplant?
Some patients remain on dialysis for more than 25 years so there is no upper limit to the amount of time spent on dialysis. However, the survival rate of a patient increases when they get a transplant instead.
I have heard that some patients can do dialysis themselves at home. When and how can this be done?
Yes, this can be done, and around 25 percent of our patients are dialyzed this way. This possibility should be discussed with a doctor when considering dialysis as an option. Most patients who do dialysis at home would often have to travel a long distance to get to a dialysis center.
Is being on dialysis that bad? People say it is horrible.
The experience varies from patient to patient. Some do well on dialysis and some do not do well. Dialysis is always better than the alternative of death, but it is not as good as getting a transplant.

Kidney Transplants

Who qualifies for a transplant? Is there an order of qualifications?
There are rules that determine who is the highest on the transplant waiting list. These are based on expected survival, time on dialysis, and other factors.
How long can one expect the kidney transplant to last?
On average, transplanted kidneys last between 10 and 12 years.
What is the recovery time after a kidney transplant? What kind of lifestyle changes do you need to make?
Two weeks after the surgery, you should start to feel much better, however, you need to take drugs to prevent rejection for the rest of your life. Beyond that, the only other lifestyle change we encourage is for transplant patients not to be involved in contact sports. We recommend that you stay active, avoid smoking and alcohol, and stick to a healthy diet.
Can competitive athletics continue after a kidney transplant?
We recommend that people avoid contact sports: football, basketball, wrestling, soccer, and certain other sports that could result in injury to the area of the body where the transplanted kidney has been placed.
What causes rejection after a kidney transplant?
Rejection is due to the same immune response that protects yourself against colds and other viruses. Though we run tests to indicate how likely rejection will be, there is no way to be sure about whether rejection will happen or not.
What is the percentage of rejection in kidney transplantation?
Early rejection happens in about 15 percent of patients, which is the lowest it has ever been. However, most people will not lose their kidneys from this kind of rejection.
Where do kidneys come from for transplantation?
Around 30 percent of transplanted kidneys come from relatives or friends of the person with kidney failure who volunteer to donate a kidney (living donation). The other 70 percent come from patients who have died suddenly and are organ donors
What are the advantages of living donation?
There are three advantages to living donations versus getting a deceased donor kidney:
  1. There are not enough deceased donor kidneys, so getting a kidney from a friend or relative is often quicker than waiting on the transplant list for a deceased donor kidney.
  2. A kidney from a living donor is completely healthy. They are known to work better and longer than deceased donor kidneys.
  3. If the kidney is donated from a relative, the tissue may be a closer match and lower the chance of rejection.
Can someone who is not a close relative be a living donor?
Yes, a kidney from someone who is not a relative can work very well.
How does living donation affect the donor?
The risk of serious injury from a donation is low, around 1 in 10,000. Patients who donate a kidney may also be sore for some period of time, as after any major surgery.
What does the operation involve?
The operation is different depending on whether it is an “open” surgery or by “laparoscopy.” Both start with an incision made in the person’s side, the blood vessels to the kidney get tied off, and the ureter (the tube from the kidney to the bladder) is tied off and the kidney is taken out. Typically donors recover from laparoscopic surgery within a week and from the open surgery within a couple of weeks.

Conditions that Affect Your Kidneys

What effect does diabetes have on the kidneys?
Diabetes is now the most common cause of kidney failure in America. About one third of patients with kidney failure have it because of diabetes. There are three main things that can be done to reduce the likelihood of kidney failure in diabetics:
  1. Have tight control over blood sugar.
  2. Reduce blood pressure, by weight loss or other means.
  3. Take blood pressure medicines that are designed to protect against the progression of kidney disease.
Is the kidney regularly "monitored" in diabetic patients and if so how?
Yes. In diabetic patients we monitor both blood pressure and protein in their urine. These tests are done at least once a year.
Do recurrent kidney stones lead to kidney disease?
Kidney stones don’t lead to kidney failure often. However, if they cause long-term obstruction of the kidney, they may lead to kidney failure.
Can the non-functioning kidney cause recurrent UTI's (urinary tract infections)?
No, generally speaking, patients do not get urinary tract infections because of a non-functioning kidney.
What does blood in the urine typically mean?
There are many causes for blood in urine. Please consult our blood in urine page for more information.
Are alcoholics at risk for kidney disease?
No, excessive alcohol consumption does not cause kidney disease.
When the kidneys are echogenicity what does that mean?
Typically it means there is scarring or cysts within the kidney that we see with a special kind of x-ray.
Can being overweight cause kidneys to fail?
Being overweight is a major contributor to high blood pressure, which often has a relationship with kidney failure. Patients who are seriously overweight should try to get their weight and blood pressure down.
Can people with kidney failure still eat sweets? I've heard that they can't.
There is no relation between sweets and kidney failure, only sweets and diabetes.
Can kidney and urinary tract abnormalities be detected before birth?
The most common urinary tract problems affecting babies are often diagnosed by ultrasound before birth. Sometimes these can be repaired before the baby is born.

Department of Internal Medicine

Transplant Center Resources

Contact Us

For Kidney, Pancreas or Liver Transplant:
Surgery Specialty Clinic, 1400 JCP, First Floor, Colloton Pavilion
Elevator F, Level 1
319-353-7704
For Lung Transplant:
Heart and Vascular Center, Roy Carver Pavilion (RCP)
Elevator E, Level 4
(319) 384-8357
UI Health Access Line: (800) 777-8442
Ask for the Lung Transplant Coordinator
For Heart Transplant:
Heart and Vascular Center, Roy Carver Pavilion
Elevator E, Level 4
(319) 356-1028
UI Health Access Line: (800)-777-8442
Pager 3711 for Heart Transplant Coordinator