Pros and cons of dialysis vs a kidney transplant
In advanced CKD (CKD5; kidney failure) there are three options: dialysis, kidney transplantation, or supportive care (not having either). In this article we will describe the pros and cons of dialysis or a kidney transplant.
It would seen obvious that a kidney transplant is ‘better’ than dialysis. And it is, for many patients, much of the time. But for some patients a transplant is not a good option (see below). Also a small number of patients – especially if they have had a transplant that failed after a relatively short time, or had a lot of problems with a transplant – actually prefer to stay on dialysis.
So. Let’s go through the pros and cons of dialysis vs a kidney transplant.
Dialysis
Pros
- Dialysis is widely available and can help extend the lives of individuals with kidney failure
- Dialysis treatment can start right away
- Patients do not need to take immunosuppressant (anti-rejection) medication
- Potential donors (who may be love ones) do not need to undergo major surgery
- Less invasive than a transplant.
Cons
- Time-consuming and requires regular visits to a dialysis unit (if on haemodialysis)
- Physically and emotionally draining
- Side effects such as fatigue, muscle cramps, and low blood pressure on haemodialysis.
Kidney transplant
It is important to note not everyone is suitable for a kidney transplant. And those that are suitable, are not suitable all the time. There are certain medical conditions and behaviours that can disqualify a person from receiving a transplant, such as: active cancer (any pre-existing cancer need not to have recurred for at least 5 years to be considered for a transplant), bad heart or lung disease, advanced brain disease (e.g. dementia), uncontrolled infections, substance abuse, or a history of noncompliance with dialysis or medication.
Pros
- Increases life expectancy
- Improves quality of life (including sex life)
- Allows for greater independence, and travel – as individuals do not need to undergo regular dialysis treatment
- Greater flexibility in terms of food and water intake.
Cons
- Lack of availability of a suitable donor. The average wait for a deceased donor kidney transplant in the UK is about 18 months; with most people transplanted by 3 years on the waiting list
- Transplant kidneys do not last forever. 3 in 20 from deceased donors and and 1 in 20 from living donors, are not working a year after the transplant. They last on average 10 and 15 years respectively
- Have to take immunosuppressant (anti-rejection) medication for the life of the kidney
- Carry risks, such as:
- Rejection of the transplanted kidney
- Infections (due to the immunosuppression)
- Complications related to the surgery
- Cancer (especially skin and anogenital cancer and lymphoma).
Summary
We have described the pros and cons of dialysis vs a kidney transplant. We hope it has been helpful.
Last Reviewed on 30 April 2024