Chronic Kidney Disease (CKD) affects about 10 percent of the population of the United States, but only approximately two percent of the population has a diagnosis of kidney disease. CKD is diagnosed in five stages. In the early stages of the disease, many people have no symptoms. Therefore, they do not realize that they have kidney damage. Stage five kidney disease is also called End Stage Renal Disease (ESRD). Over a half million people in the United States are suffering from ESRD.
Kidney disease ranks at number nine for causes of death in the United States, where ESRD is growing at a rate of about five percent per year. Hispanics and Native Americans, when compared to Caucasians, are about one and a half times more likely to experience ESRD. African-Americans are about three and a half times more likely to be diagnosed with ESRD than Caucasians. The top two causes of CKD are uncontrolled diabetes and high blood pressure.
Dialysis can prolong life for patients in total renal failure, but the prognosis for survival at five years is only at 35 percent. A successful kidney transplant increases the five-year survival rate up to 80 percent. The problem is the need for transplant organs far exceeds the supply. One year of statistics indicated that there were over 100,000 people with ESRD waiting for a kidney transplant with less than 20,000 kidneys available for transplant.
Transplant recipients can have living donors. Healthy people can live just as healthy for their normal lifespan with one kidney as they can with two. This makes living kidney donation possible. The closest possible matches may come from one’s closest relatives. Choosing to donate kidneys at death gives hope of life for two people with total kidney failure.
There are types of artificial means of reproducing some of the work kidneys do. The National Institutes of Health indicates that there were 398,861 kidney patients in 2009 on dialysis. Peritoneal dialysis uses a flexible tube surgically inserted into the abdomen to act as a catheter to fill a patient’s abdominal cavity with a sterile solution called dialysate. Both of the two types of peritoneal dialysis are done at home.
Continuous Ambulatory Peritoneal Dialysis (CAPD) is manual where the patient connects disposable plastic bags to the catheter to place the fluid and exchanges it with fresh fluid a few hours later all day, every day. Automated Peritoneal Dialysis (APD) handles the fluid with a machine that the patient connects at home, usually at bedtime. Hemodialysis is also controlled by machine, but it is done in dialysis facilities. Patients have surgery to strengthen blood vessels, usually in the forearm, to make the multiple weekly connections to the dialysis machine easier. The patient’s blood is pumped through a machine that filters it through permeable membranes surrounded by dialysate. Toxins and fluid can flow through the membranes, but red blood cells cannot.
Before dialysis and kidney transplantation, patients faced a slow decline of health as kidney function diminished, only to face death once ESRD was reached. Carefully managing diabetes and high blood pressure can reduce the chances of getting CKD. Thankfully, there is hope for patients who do progress to stage five of this insidious disease.