This is a virtual education series in partnership with Columbia New York Presbyterian, sponsored by Veloxis Pharmaceuticals, that will address key topics of living through late-stage disease through the transplantation process and beyond.

Living with Chronic Kidney Disease: What are My Options?

This session discusses end-stage renal disease management before dialysis and transplant. Other topics include what it’s like living with kidney disease, what can be done to prevent further progression, and treating the patient in the disease journey.  

Kidney Function

The kidneys have several roles – one is regulating fluid balance. The human body takes in extra salt and water. Whatever is not utilized is excreted in the form of urine. The kidneys also regulate mineral content in the blood such as potassium, phosphorus, and calcium. They also clear waste products of metabolisms like proteins and nitrogen. Lastly, it regulates blood counts preventing someone from becoming anemic. If any of these functions can’t be regulated, a person has some degree of kidney disease.

Causes of Kidney Disease

In adults, the cause of kidney disease is primarily diabetes, high blood pressure (hypertension), or other autoimmune diseases that cause nephritis (inflammation of the kidney). Function can be preserved by maintaining blood pressure, blood glucose levels, and monitoring other body functions. In children, the primary cause of kidney disease is congenital issues. These are primarily determined before birth or in infancy due to infections, proteins, or blood found in the urine. A kidney biopsy is the best way to determine the presence and source of kidney disease. Sometimes an ultrasound or a CAT scan can determine it as well. 

When is it time for a kidney transplant?

If the patient is showing symptoms of severe kidney disease such as nausea and severe fatigue, and medications and diet have been modified with no improvement, then proceeding with dialysis until a kidney transplant can occur is the appropriate course of action. 

Evaluation for transplant begins when kidney function (GFR) is around 15 or 20% of normal kidney function. Most people receive a transplant with around 10 to 15% of GFR. 

A kidney transplant can either come from a deceased or living donor. In 2019, 41,000 people in the United States were newly placed on the waiting list for kidney transplants. That year, there were only about 23,000 kidney transplants done. This means 20,000 individuals do not get transplants per year. The wait time for a deceased donor can be years, and there is a great need for living donors.

Advancements in Transplantation Research

In the last few years, research into genetically engineered organs from animals is advancing. In the first of its kind, a pig kidney was recently successfully transplanted into a human. This was a temporary experiment, however, and there is still much to learn and advance in this field. Regardless of the technology, clinicians and researchers are focused on moving toward research advancements where transplants can be more accessible to patients and the success of transplanted kidneys and other organs is significantly improved.

Listen to the webinar and learn more about innovations and research involving dialysis and kidney transplants. This and future webinars can be found on transplantLyfe.com. 

Panelist and Moderators

Panelists:

David J. Cohen, MD, MA – medical director of transplantation at Columbia
Hilda Fernandez, MD – associate professor at Columbia and a pediatric and adult nephrologist
Lloyd E. Ratner, MD, MPH, FACS, FICS (Hon) – professor and chief of the renal pancreas transplantation service at Columbia

Moderators:

Mark A. Hardy, MD, PhD (Hon), FACS – professor of surgery at Columbia University
Carly Rebecca McNulty, RN, BSN, CCTC – senior coordinator at the Columbia transplant program
Karin Hehenberger, MD, PhD – CEO of Lyfebulb and visiting associate researcher at Columbia