More kidney patients avoiding dialysis on path to transplant10/28/2009
More and more people with failing kidneys are skipping dialysis and going directly to transplant, new national data shows.
These “pre-emptive” kidney transplants still represent a fraction of the total number of kidney transplants performed every year. But new data from the U.S. Renal Data System show that fraction is growing. Fifteen percent of all transplants performed in the U.S. in 2007 were pre-emptive, according to USRDS’s 2009 annual report. That’s up from 9 to 10% in the early 1990s.
“This is a big step up in pre-emptive transplants and speaks to efforts that have been undertaken by all parties within the transplant community to address early transplantation,” said Bryan Becker, MD, National Kidney Foundation President. “There has really been a big shift in making pre-emptive transplantation a much greater reality for patients in the U.S.”
Kidney specialists have known for years that patients with chronic kidney disease will do better if they have transplants before they need to go on dialysis, or after only a short period on dialysis (typically six months or less). Analysis of large datasets from the early 2000s shows that the shorter the amount of time a patient is on dialysis before transplant, the better the prognosis for the transplanted organ—and the patient.
When a patient can go directly to transplant and avoid dialysis, the transplanted organ is more likely to start working fast, and to function well. Pre-emptive transplantation can also slash medical costs; Medicare spends about a third less on patients who go straight to transplant.
“More and more, the entire health care community is recognizing dialysis and transplantation as treatments for kidney failure, but not necessarily ones that have to be done in sequence,” said Becker. Efforts must continue to promote awareness of pre-emptive transplantation among people with kidney disease and potential living donors, he said.
“It is important to make the public aware of this improvement in transplant efficiency,” Becker said. “We should continue to examine factors that led to this trend and work to enhance them further.”
http://www.nephronline.com/news.asp?N_ID=3258
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