Program touts kidney transplants over dialysis

Program touts kidney transplants over dialysis
By Cynthia Billhartz Gregorian
ST. LOUIS POST-DISPATCH
Thursday, Dec. 24 2009
Several years ago, Amy Waterman, assistant professor of medicine and a social
psychologist at Washington University, realized that most people with kidney
failure go on dialysis and stay on it until they die.

She studied more than 1,000 renal patients and living donors and found that
they're often so overwhelmed with information about dialysis, including
necessary lifestyle changes, that they're given little or no information on
kidney transplants in the crucial months after being diagnosed.

This didn't sit right with Waterman.

Dialysis patients, she notes, retain only about 10 percent to 15 percent of
normal kidney function, even though they spend about 10 hours a week hooked to
dialysis machines.

"With a transplant, they get more than 50 percent of normal kidney function, so
they feel better, have fewer restrictions on what they can eat and drink, don't
have to do dialysis and can return to work and to a more normal life," she says.

But time is of the essence because patients spend an average of four years on
transplant waiting lists, yet only about a third of all dialysis patients live
more than five years after diagnosis, Waterman says. In comparison, 70 percent
to 80 percent of those who get kidney transplants live more than five years.

"What would it be like if you were sitting in a less desirable health care
option, and no one told you there was something that could return you to your
normal life?" Waterman asks. "It became clear that people were making decisions
without having knowledge. A lot of patients are scared of transplants and the
pain; they wonder what if it doesn't work and what if they can't find a donor."

In 2004, Waterman founded the Explore Transplants program and began counseling
250 renal patients in 20 area dialysis centers. Today, nurses and social
workers are trained to talk to about 20,000 patients in 200 dialysis centers in
Missouri, Iowa, Kansas and Nebraska.

They visit each patient four times to learn about their lives, how dialysis
would fit in and whether they'd be interested in a transplant. They leave
brochures and videos with the patients to share with family and friends.

"Patients are often scared to talk to family and friends,'' about donating a
kidney, she says. "They don't know how to bring it up or what would happen if
they do and the answer is no. How will family dinners be after that?"

Waterman estimates she saves taxpayers about $1 million for every five Medicare
patients she convinces to get a kidney transplant.

http://www.stltoday.com/stltoday/lifestyle/stories.nsf/healthfitness/story/1A61191C58F2C25686257695007626FE?OpenDocument