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Rising Kashmir > Blog > Viewpoint > Which is Best treatment for Stage 5 CKD: Dialysis or Kidney Transplant?
Viewpoint

Which is Best treatment for Stage 5 CKD: Dialysis or Kidney Transplant?

DR. SANJEEV GULATI
Last updated: March 13, 2024 7:22 pm
DR. SANJEEV GULATI
Published: March 13, 2024
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 WORLD KIDNEY DAY

 

World Kidney Day is a global campaign aimed at increasing awareness amongst the general public of the role of kidneys in maintaining optimal health and also about various aspects of kidney diseases. It is being celebrated on 14th March this year and the theme for 2024 is “Kidney Health for All”

 

Chronic kidney disease (CKD) has become a common but under diagnosed problem. Inspite of recent advances in diagnosis and management, kidney disease related mortality continues to increase yearly and is projected to be the 5th leading cause of death by 2040.

 

Recent studies have shown that the prevalence of CKD is increasing. A screening study was conducted in 165000 people all over the country by Indian Society of nephrology along with Astra Zeneca. This shows that currently 20-30 out of 100 people are having CKD and most of it is undiagnosed. This shows alarming increase in prevalence of CKD to 20-30%.

 

CKD a progressive disease starting form stage 1 and it progresses to Stage 5 CKD. If diagnosed early we can slow down the progression and prolong the life of the kidneys. In stage 5 CKD there are only 2 treatments available: dialysis and kidney transplant. There is no other treatment that allows patient to survive and all other treatments that you may see on social media are unscientific and unvalidated therapies being prescribed by quacks.

 

There is also no doubt that kidney transplant is better than dialysis both in terms of cost as well as long term outcomes. The 1 year survival of dialysis is about 75% and 5 year survival is 20%. Also these patients have to continue coming for dialysis indefinitely. They often require admissions at hospitals because of infections or cardiac problems.

 

In contrast 1 year survival for kidney transplant is >99% and successful kidney survival is 95 %. At 5 years the kidney survival is 80% and patient survival 95 % .This is more than 4 times better than dialysis and at a much lower cost. Moreover kidney transplant is the only treatment that allows a person to get back to his normal lifestyle and work.

 

A transplant patient can complete his studies, work and support himself as well as his family and have very satisfying family and social life. Recent studies have proven that cognitive function and mental health of Transplant patients is also better than those on Dialysis.

 

Hence every patient of Stage 5 CKD should plan for a kidney transplant preferable get a pre-emptive transplant (transplant without dialysis). This not only has better outcomes but also at a lower cost.

 

(The Author is Principal Director Nephrology and Kidney Transplant, Fortis Hospitals and Member Governing Body, Indian Society of Nephrology)

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