The kidney is an essential organ in the human body. The kidney not only purifies the blood and eliminates toxins from the body, but it also regulates water balance, maintains electrolyte balance, controls blood pressure, activates vitamin D, and performs many other activities.

For optimal kidney function, it's important to have a healthy lifestyle and eat a balanced diet. Even though each of our two kidneys is essential for our bodily functions, some individuals are born without one kidney or have chronic renal disease that causes either kidney to fail. In this blog, we are layering down the best 

Can one kidney function as a substitute for survival? 

Yes, it is possible to not only survive but also strive to have a normal life with one kidney. The person with two kidneys will have a much healthier life as compared to the person with one. 

To have a healthy life with one kidney, a patient has to maintain a balanced diet, engage in regular exercise, avoid excessive alcohol consumption and do many other things. Regular check-ups with healthcare providers are required to monitor kidney function. 

What happens when both the kidneys fail? 

When renal illness advances to its final stage, it is known as end-stage renal disease (ESRD). Kidney failure is characterized by several symptoms and diseases.

  • Severe conditions can occur when both kidneys fail, causing waste product accumulation and fluid retention. Resulting in decreased urine output, fluid retention, electrolyte imbalance, uremia, high blood pressure, anemia, bone disease, and cardiovascular complications.

What are the treatments available for end-stage renal disease (ESRD)? 

The final stage of renal disease, known as end-stage renal failure, occurs when the kidney can no longer function normally. Typically, doctors perform a blood test to measure the glomerular filtration rate (GFR) and determine the blood filtration rate. Kidney failure occurs when the parameters fall below 15 GFR (mL/min).

There are two treatments for kidney failure: dialysis and kidney transplantation. Let us see how both treatments work.

Dialysis 

Artificial methods filter the blood and flush out toxins from the body when the kidney is unable to perform its function naturally. This process is known as dialysis. It is an alternate treatment for kidney transplants.

Dialysis is done in two ways, depending on the patient’s condition and the feasibility of the treatment. 

1. Hemodialysis 

Hemodialysis is performed through a special dialysis machine known as a hemodialyzer, which filters the blood by removing the waste, and again, the filtered blood is passed into the body. A filtering membrane, similar to an artificial kidney, is inside the dialysis machine. This membrane allows the passage of waste products, toxins, and excess fluids. A clean dialysis solution, called dialysate, moves sequentially with blood flow to remove waste products and maintain electrolyte balance.

Depending on the patient's medical condition, they may go under dialysis multiple times a week in a hospital or a dialysis centre.

2. Peritoneal dialysis

Peritoneal dialysis is another dialysis technique in which patients don’t need a dialysis machine and dialysis can be done at home by a healthcare professional. Peritoneal dialysis involves inserting a catheter or a tube into the abdomen, which is flexible and placed below the belly button.

The procedure involves infusing a sterile dialysate solution, similar to hemodialysis, containing electrolytes and a sugar solution into the abdominal hole. After a certain amount of time has passed, the solution leaves the abdomen, and the peritoneum may drain any extra fluids or waste. After a certain amount of time, the catheter empties the solution. Peritoneal dialysis usually involves cycles with different exchanges, depending on the patient's specific requirements. 

Recommendation 

Patients with significant cardiovascular disease, unstable blood pressure, or vascular access issues who require intensive dialysis treatments should consider hemodialysis. Patients with stable blood pressure, good residual kidney function, no significant cardiovascular disease, and difficulty visiting a dialysis centre regularly should consider peritoneal dialysis. 

Kidney Transplant 

Instead of dialysis, the other way of treating end-stage renal disease is a kidney transplant.

A kidney transplant is a surgical procedure where a healthy kidney of a living or dead individual is planted in the required patient’s body by replacing the non-working one. It may look simple, but organ transplantation is a very complex procedure. It involves a thorough evaluation process for both the recipient and potential donors, including medical tests, imaging studies, and consultations with healthcare providers. Most donors are family members, friends, or individuals who voluntarily donate one of their kidneys. 

The surgery usually takes several hours to complete. After the surgery, both the recipient and donor require a specific period of recovery in the hospital, with the recipient staying for several days to a week or longer depending on their recovery progress and any complications. 

Kidney transplant or dialysis? 

Both procedures have their own advantages and disadvantages and sometimes it is not an option. Regardless of which is available, patients have to go with that procedure. 

  • Kidney transplants offer better quality of life, a longer life expectancy, and improved kidney function compared to dialysis. However, they require lifelong immune-related medications, a risk of rejection, and surgical risks. These complications can lead to additional treatment or transplant loss. Successful transplants eliminate the need for ongoing dialysis, allowing recipients to return to a normal lifestyle. 

 

  • Dialysis offers immediate relief from kidney failure symptoms and complications, without the need for surgery or donor organs. Patients can perform it at home or in a centre, enabling them to maintain a normal lifestyle. However, it can reduce quality of life, increase mortality rates, require ongoing treatments, and increase the risk of complications like infection, vascular access issues, fluid overload, and cardiovascular disease. 

In summary, in conclusion, for eligible patients, kidney transplantation often provides superior results and quality of life over dialysis. However, there are a lot of people who have renal failure and aren't good transplant candidates because of things like medical contraindications or a lack of organ donors. Healthcare practitioners should carefully evaluate the patient's medical history, personal preferences, and treatment objectives before making decisions about dialysis or a kidney transplant.