Dialysis and Transplantation
Dialysis
Before dialysis was available, total kidney failure meant death. Today, people with kidney failure can live because of treatments such as dialysis and kidney transplant. Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs.

When is Dialysis Needed?
You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function.

What Does Dialysis Do?
Like healthy kidneys, dialysis keeps your body in balance. Dialysis does the following:

• Removes waste, salt and extra water to prevent them from building up in the body.
• Keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate.
• Helps to control blood pressure.

Where is Dialysis Done?
Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition and your wishes.

Are There Different Types of Dialysis?
Yes, there are two types of dialysis: hemodialysis and peritoneal dialysis.

What is Hemodialysis?
In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg. Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula. However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft. Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment. Usually, each hemodialysis treatment lasts about four hours and is done three times per week. A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.

What is Peritoneal Dialysis?
In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. There are two major kinds of peritoneal dialysis.

Will Dialysis Help Cure the Kidney Disease?
No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.

How Long Can You Live on Dialysis?
We do not yet know how long patients on dialysis will live. We think that some dialysis patients may live as long as people without kidney failure.

Can Dialysis Patients Continue to Work?
Many dialysis patients can go back to work after they have gotten used to dialysis. If your job has a lot of physical labor (heavy lifting, digging, etc.), you may need to get a different job.

Do Dialysis Patients Feel Normal?
Many patients live normal lives except for the time needed for treatments. Dialysis usually makes you feel better because it helps many of the problems caused by kidney failure. You and your family will need time to get used to dialysis.

Do Dialysis Patients Have to Control their Diets?
Yes. You may be on a special diet. You may not be able to eat everything you like, and you may need to limit how much you drink. Your diet may vary according to the type of dialysis.

Can Dialysis Patients Travel?
Yes. Dialysis centers are located in every part of the United States and in many foreign countries. The treatment is standardized. You must make an appointment for dialysis treatments at another center before you go. The staff at your center may help you make the appointment.

Kidney Disease Outcome Quality Initiative (K/DOQI):

K/DOQI: Expands the Dialysis Outcomes Initiative or DOQI, a project begun by the National Kidney Foundation in 1997 and recognized throughout the world for improving the care of dialysis patients. For more information on D/OQI click here and go directly to our national site.

Kidney Transplantation

• More than 1,800 Michigan residents are currently waiting for a kidney transplant.
• Kidney transplantation can be from a living donor or a cadaver donor (someone who has recently died).
• Living donors are most often parents, siblings, sons or daughters of the person with kidney disease.
• Only 20 percent of the people in Michigan who need a transplant have an eligible related donor. The rest must wait on the Transplantation Society of Michigan's waiting list for a kidney from a cadaver donor.
• In 1999, there were 479 kidney transplants performed in Michigan, including 168 from living-related donors, 47 from living-unrelated donors and 264 from cadavers.
• Many Michigan residents lead productive lives after kidney transplant surgery. As of December 31, 1999 there were 3,784 living kidney transplant patients in Michigan.
• Informing your family of your decision to donate and signing a donor label could mean a "gift of life" for several people.
• Inform your family of your decision to donate as their consent is no longer necessary but the hospital will want to have it.

• Organ and tissue donation is supported by all major religions.
• Kidneys, hearts, livers, lungs, pancreas, bones, eyes, skin and other soft tissues can be transplanted.
• There is no charge to you or your family for donation.
• Donation involves a surgical procedure to remove the needed organs and tissues.
• Donation will not interfere with customary funeral arrangements or alter your body's appearance.
• Transplant recipients are selected on the basis of medical criteria, urgency of need and length of waiting time.
• If you are 18 years of age or under, you must have your parent or legal guardian sign as a witness on the donor label.
• If you change your mind, you simply have to inform your family and peel the label off of your driver's license.
• Up to 80 people in need can benefit from one person's decision to be an organ and tissue donor.