kidney transplant is the only option because dialysis is making things worse

[john]

Has anyone had any experiences where their doctor opted for an immediate kidney transplant because dialysis was causing too many problems?

What causes a doctor to take a patient off dialysis and opt for an immediate kidney transplant? (the kidney transplant is the only option cause the dialysis is not helping or making things worse). I have heard that after years of dialysis some people's health declines and there can be a call for immediate surgery  (one examples is  former washington dc mayor Marion Barry)

Some of the side effects of dialysis that I have found  are:
High blood pressure, Infection, Anemia, Bone Disease, nerve damage, and heart disease.

What dialysis side effect would cause a doctor to stop dialysis and push to set up surgery?
For example, has anyone had a doctor tell them...we should focus on a transplant asap because dialysis is causing ....?  or we shouldn't continue dialysis much longer because of another side effect.  If so, what was the side effect that made the doctor push for finding a donor soon?

Any answers are greatly appreciated.   Thank you for your time.

[paris]

I can understand a doctor pushing for a transplant as soon as possible, but even with a living donor, it isn't immediate.  And can't imagine a doctor saying not to continue dialysis because that is your life support.   All the things you listed are part of the kidney disease.  Most nephrologist will recommend a transplant, if possible.   I hope to hear more of what you are going through.  Take care, and keep asking questions   

[okarol]

Dialysis is not perfect. Sometimes patients are not getting adequate toxin removal, so they have a worse time. As mentioned, those symptoms are all part of kidney disease. Our daughter's nephrologist recommended a kidney transplant for her, partly because she was so young, but also because he felt she would do better with a kidney as she was always fatigued and confused on dialysis (which she had for 3 years before getting a kidney from a living donor.)

[jbeany]

I'm with paris - there's no such thing as immediate.  Barry had a live donor, so he was able to get one faster, but there is still a long process of testing to go through.  All of those side effects are possible, but can usually be controlled with meds, and carefully following the renal diet and fluid restrictions.  The longer you are on, the more chance you are going to get some serious side effects.  Dialysis is a life support system, not a cure for kidney failure, and even the best dialysis options don't completely replace a healthy kidney. Everyone reacts to the treatment differently, so yes, some patients are going to do worse than others, no matter how good the treatment.

Another thing to remember - transplants are no cure either.  There's an equally long list of side effects from transplant meds.  It's certainly easier to have a "normal" life while taking pills twice a day instead of going to D, but there's no guarantee that the transplant will work (Check out Otto's story on here.), and there are plenty of risks with transplant surgery, too. (Like the two months I spent in the hospital, and the multiple surgeries I had for complications.)

There aren't any side effects that would cause a doc to stop D - if you have ESRD, you have to have it to live, no matter how many side effects you have.  Only the patient can make that decision - and the end result is usually death in a matter of weeks.  Kidneys are in far too short supply for any doc to just insist that their patient get one.  They can recommend that you do all you can to find a live donor, but wait time is a given on the cadaver list, unless you are willing to go overseas to buy one, and risk the legal and moral quagmire that goes with that option.

[tyefly]

     I agree with what everyone has said.....   I have only been on Dialysis for a short time  and  I have a living donor but it takes time to get everything done  to move forward  with transplantation.....  I dont like going to Dialysis  but I do feel better than I did before Dialysis  but I dont like the fluid restrictions  ( I would rather drink my dinner that eat.... I love to drink....) .       I thought I would be able to wait for the transplant  but I couldnt  so I needed to start Dialysis  to keep me healthy to get a transplant.....and I still have alot to do before that..... 

             

[RightSide]

What dialysis side effect would cause a doctor to stop dialysis and push to set up surgery?

One possibility is amyloid bone disease. 

This disease is caused by the gradual deposition of a protein, beta-2 microglobulin, in the bones and tissues.  A healthy kidney removes this substance. But some dialyzers don't do a good job of removing it.  In that case, the remedy is a kidney transplant; the new healthy kidney will go to work removing the beta-2-microglobulin from the patient's body.

Another possibility is a bad reaction, either inflammatory or allergic, to the dialysis process.  Either a reaction to the dialyzer materials, or to the cleaning agents used to clean the dialysis equipment.  In that case, the patient will continue to suffer as long as dialysis continues.

Those are just guesses; you should definitely get clarification from your doctor.

[girliekick]

i imagine access problems would be cause for faster' tx recommendation. Both my fistulas failed, and i had to have perma caths changed almost every two weeks. I do pd now, grin and bear its side effects, but if that would have been as diff as hemo. I can only hope they would help the process along.
Girl

[tyefly]

  I agree.....  access problems should put you at the head of the list......   with both of your fistulas failing you need a transplant soon.....   

   Have you talked about access in your leg..... I know someone who has that .....says it works fine, but also says that she could never get the fistulas to work in either arm.......

  PD is good.... I would of choose that   instead of Hemo....but  I cant do PD...   

[Goofy]

As jbeany said, just because you get a transplant, doesn't mean you are out of the woods.  You could reject the new kidney and then you have to be on dialysis again.

That happend to me.  I had the transplant and 24 hours later, they took it out because of complications.  Obviously you need some type of solution.  Have you thought about getting a 2nd opinion?

[girliekick]

i am doing fine on pd, i would think, and was told that should it become a problem to get enough dialysis then we should start talking to people about getting me moved up on the list.
Idk if that is even possible, i was just speculating.
 Just encase there was any confusion i have adjusted well to pd
girl