One of the greatest things about being a kidney donor is that by donating your kidney, you can prevent somebody with kidney disease from ever having to go through dialysis. If you donate a kidney to somebody who is already in dialysis, once they have a healthy kidney they will no longer need dialysis. Dialysis is not a long term solution to cure kidney disease, but transplant IS a long term solution in most cases. This graph shows the survival rates of dialysis patients and transplant patients side by side.
“Dialysis patients have a 25% chance of death after being on dialysis for one year; their chance of death increases to 65% after five years. Although dialysis extends patients’ lives, it comes with a large swath of side effects that range from anemia and muscle cramps to bone diseases. It’s much better, therefore, to get a kidney transplant, if possible.”
Getting a living donor before your kidney disease progresses to the point where you need dialysis produces the best possible long term outcome. This is because there are better outcomes from kidney transplant when the kidney comes from a living donor vs a deceased donor. Here is a graph from the National Kidney Foundation that illustrates this.
Strangely, this is really easy information to find online, but over and over again, we meet people in the transplant community who don’t understand their options when it comes to deciding between dialysis and transplant. So where is the disconnect?
John Oliver tackles this topic this week on Last Week Tonight, and the information he spotlights, is pretty disturbing. As Oliver explains, “kidney dialysis occurs in centers outside of hospitals, and roughly 70% of these are run by two private, for-profit companies: DaVita and Fresenius. These companies have fairly loose laws about quality control measures. For example, only one nurse and no doctors need to be present at a center at any given time.”
“Companies like DaVita and Fresenius legally have to tell patients that getting themselves on the kidney transplants list is another option, but they’ve built entire business models on keeping as many patients coming through as possible. They don’t do a lot to advertise this other option, and instead —like any self-respecting business—do all they can to maximize their own profits. In 2009, the CEO of DaVita, Kent Thiry, told University of California, Los Angeles business students that “if [he] had 1,400 Taco Bells and 32,000 people who worked in them [he] would be doing all the same stuff.”
If you know somebody with kidney disease who is facing decisions regarding transplant and dialysis, this episode is a must watch! Be your own health advocate. If you won’t, who will?