26 million Americans have kidney disease. THAT'S
ONE IN NINE ADULT AMERICANS!Millions
more are at
risk. To bring this even closer to home…
Mississippi ranks among
the top in the nation in incidences of kidney
disease.
African Americans are four times more likely to
develop kidney disease than white Americans.
Jackson has a 26% higher prevalence of kidney
failure than the national average.
Jackson has a 7% higher rate of newly diagnosed
cases of kidney failure than the national average.
More than 75% of African Americans in Jackson who
have kidney failure also have diabetes or hypertension.
The Silent Disease
As with cancer or heart
disease, kidney disease can be a silent killer. Many
people are not diagnosed until too late in this
progressive disease. With kidney disease, there may be
little or no symptoms, so many people are not diagnosed
until too late in this progressive disease.
Are You at Risk?
If you have diabetes, high
blood pressure, or a family history of kidney disease,
you are considered at risk. Ask your doctor for two
tests, 1) a urine test to check for protein in the urine, and
2) a blood test to check your creatinine level. From
this, your GFR (glomerular
filtration rate) can be calculated. If you do not have a doctor, please
call the Mississippi Kidney Foundation to find when the
next free screening will be offered in your area.
FREE KIDNEY SCREENING
REAP (Renal
Evaluation and Assessment Program) Through
our free screenings for kidney disease, we are trying to
detect kidney disease in its earliest stages. With
early diagnosis and early treatment, kidney disease is
treatable.
If you have diabetes, high blood pressure, or a relative with kidney
disease, call the Mississippi Kidney Foundation at (601) 981-3611
and register for the next free REAP screening. Partnering with Quest
Diagnostics, tests include a full renal panel, complete
blood count and cholesterol check. Additional tests
include blood pressure, blood sugar and urinalysis. Lab
results are available the next day. Approximately 12
screenings are held each year throughout the state,
including Jackson, Biloxi, Meridian, Oxford and the
Delta. Warning Signs of Kidney Disease:
High blood pressure
Pain in small of back
Puffy eyes, swollen hands and feet
Bloody urine
Burning during urination
More frequent urination
Kidney Disease: The "Silent" Disease...Are You
at Risk?
The Mississippi Kidney
Foundation has printed 80,000 brochures designed
to target those at risk of kidney disease. These
brochures have been sent to over 100 nurse
practitioners and medical clinics across the
state. If you would like to order some of these
free brochures, please call the MS Kidney
Foundation at (601) 981-3611. Grants were
received from Centocor Ortho Biotech and Genzyme
to assist with the cost of the printing.
Nurse Practitioners,
Family Physicians, Congregational
Care Nurses...please
call our office, toll free, 1-800-232-1592, and
ask for these free brochures to be sent to you.
The brochures
come shrink-wrapped in packages of 50.
Five Stages of Kidney
Disease
Stages 1 and 2 ...
Stages 1 and 2 usually have no
symptoms to indicate that the kidneys are damaged.
People are usually diagnosed through being tested for
other conditions such as high blood pressure or
diabetes, which are the two leading causes of kidney
disease.
Stage 3 ...
Symptoms may develop in Stage 3,
such as puffy eyes or swollen hands and feet. Changes in
urination (more frequent urination, burning during
urination, or bloody urination) may also be a sign of
Stage 3, along with pain in the small of back and
fatigue. It is
recommended that you see a kidney specialist (nephrologist)
at Stage 3.
Stage 4 ...
Stage 4 patients have advanced
kidney damage. Additional symptoms from Stage 3 may
include nausea, difficulty in concentrating, loss of
appetite or metallic taste in mouth.
Stage 5 ...
Stage 5 patients are in kidney
failure. Treatment includes dialysis or transplantation.
Kidney
Transplantation
Mississippi's only
transplant center is
University Transplant, a
part of the University of Mississippi Health Care,
located in Jackson, Mississippi. For more information,
please call (601) 984-5065.
Is a Kidney
Transplant an Option For You?
Step One: Your Doctor’s Recommendation
Step Two: Medical Evaluation at a Transplant Center
Step Three: If You Pass the Medical Evaluation, You
Will be Placed on the Waiting List
(or do you have a
family member or friend
who is willing to donate a kidney?) The following information is provided by the
National Institute of Health. Please read, ask questions
and determine if a kidney transplant is an option for
you. If you have advanced
and permanent kidney failure, kidney transplantation may
be the treatment option that allows you to live much
like you lived before your kidneys failed. Since the
1950s, when the first kidney transplants were performed,
much has been learned about how to prevent rejection and
minimize the side effects of medicines.
But transplantation is not a cure; it’s an ongoing
treatment that requires you to take medicines for the
rest of your life. And the wait for a donated kidney can
be years long.
A successful transplant takes a coordinated effort from
your whole health care team, including your nephrologist,
transplant surgeon, transplant coordinator, pharmacist,
dietitian, and social worker. But the most important
members of your health care team are you and your
family. By learning about your treatment, you can work
with your health care team to give yourself the best
possible results, and you can lead a full, active life.
When Your Kidneys Fail
Healthy kidneys clean your
blood by removing excess fluid, minerals, and wastes.
They also make hormones that keep your bones strong and
your blood healthy. When your kidneys fail, harmful
wastes build up in your body, your blood pressure may
rise, and your body may retain excess fluid and not make
enough red blood cells. When this happens, you need
treatment to replace the work of your failed kidneys.
How Transplantation Works
Kidney transplantation is a
procedure that places a healthy kidney from another
person into your body. This one new kidney takes over
the work of your two failed kidneys.
A surgeon places the new kidney inside your lower
abdomen and connects the artery and vein of the new
kidney to your artery and vein. Your blood flows through
the new kidney, which makes urine, just like your own
kidneys did when they were healthy. Unless they are
causing infection or high blood pressure, your own
kidneys are left in
place.
The Transplant Process
Step One: Your Doctor’s
Recommendation
The transplantation process begins when you learn that
your kidneys are failing and you must start to consider
your treatment options. Whether transplantation is to be
among your options will depend on your specific
situation. Transplantation isn’t for everyone. Your
doctor may tell you that you have a condition that would
make transplantation dangerous or unlikely to succeed.
Step Two: Medical
Evaluation at a Transplant Center
If your doctor sees transplantation as an option, the
next step is a thorough medical evaluation at a
transplant hospital. The pretransplant evaluation may
require several visits over the course of several weeks
or even months. You’ll need to have blood drawn and x
rays taken. You’ll be tested for blood type and other
matching factors that determine whether your body will
accept an available kidney.
The medical team will want to see whether you’re healthy
enough for surgery. Cancer, a serious infection, or
significant cardiovascular disease would make
transplantation unlikely to succeed. In addition, the
medical team will want to make sure that you can
understand and follow the schedule for taking medicines.
If a family member or friend wants to donate a kidney,
he or she will need to be evaluated for general health
and to see whether the kidney is a good match.
Step Three: If you Pass the
Medical Evaluation, You Will Be Placed on the Waiting
List
If the medical evaluation shows that you’re a good
candidate for a transplant but you don’t have a family
member or friend who can donate a kidney, you’ll be put
on the transplant program’s waiting list to receive a
kidney from a deceased donor—someone who has just died.
Waiting Period
How long you’ll have to wait depends on many things but
is primarily determined by the degree of matching
between you and the donor. Some people wait several
years for a good match, while others get matched within
a few months.
While you’re on the waiting list, notify the transplant
center of changes in your health. Also, let the
transplant center know if you move or change telephone
numbers. The center will need to find you immediately
when a kidney becomes available.
When a deceased donor kidney becomes available, a
computer-generated list of suitable recipients is
created. Suitability is initially based on two factors:
Blood Type...
Your blood type (A, B, AB, or O) must be compatible with
the
donor’s blood type.
HLA Factors...
HLA stands for human leukocyte antigen, a genetic marker
located
on the surface of your white blood cells. You inherit a
set of three antigens from your mother and three from
your father. A higher number of matching antigens
increases the chance that your kidney will last for a
long time.
If you’re selected on the basis of the first two
factors, a third is evaluated:
Antibodies...
Your immune system may produce antibodies that act
specifically
against something in the donor’s tissues. To see whether
this is the case, a small sample of your blood will be
mixed with a small sample of the donor’s blood in a
tube. If no reaction occurs, you should be able to
accept the kidney. Your transplant team might use the
term negative cross-match to describe this lack of
reaction.
Transplant Operation
If you have a living donor, you’ll schedule the
operation in advance. You and your donor will be
operated on at the same time, usually in side-by-side
rooms. One team of surgeons will perform the nephrectomy—that
is, the removal of the kidney from the donor—while
another prepares the recipient for placement of the
donated kidney.
If you’re on a waiting list for a deceased donor kidney,
you must be ready to hurry to the hospital as soon as a
kidney becomes available. Once there, you’ll give a
blood sample for the antibody cross-match test. If you
have a negative cross-match, it means that your
antibodies don’t react and the transplantation can
proceed.
You’ll be given a general anesthetic to make you sleep
during the operation, which usually takes 3 or 4 hours.
The surgeon will make a small cut in your lower abdomen.
The artery and vein from the new kidney will be attached
to your artery and vein. The ureter from the new kidney
will be connected to your bladder.
Often, the new kidney will start making urine as soon as
your blood starts flowing through it, but sometimes a
few weeks pass before it starts working.
Recovery From Surgery
As after any major surgery, you’ll probably feel sore
and groggy when you wake up. However, many transplant
recipients report feeling much better immediately after
surgery. Even if you wake up feeling great, you’ll need
to stay in the hospital for about a week to recover from
surgery, and longer if you have any complications.
Post-Transplant Care
Your body’s immune system is designed to keep you
healthy by sensing “foreign invaders,” such as bacteria,
and rejecting them. But your immune system will also
sense that your new kidney is foreign. To keep your body
from rejecting it, you’ll have to take drugs that turn
off, or suppress, your immune response. You may have to
take two or more of these immunosuppressant medicines,
as well as medications to treat other health problems.
Your health care team will help you learn what each pill
is for and when to take it. Be sure that you understand
the instructions for taking your medicines before you
leave the hospital.
If you’ve been on hemodialysis, you’ll find that your
posttransplant diet is much less restrictive. You can
drink more fluids and eat many of the fruits and
vegetables you were previously told to avoid. You may
even need to gain a little weight, but be careful not to
gain weight too quickly and avoid salty foods that can
lead to high blood pressure
Rejection
You can help prevent rejection by taking your medicines
and following your diet, but watching for signs of
rejection—like fever or soreness in the area of the new
kidney or a change in the amount of urine you make—is
important. Report any such changes to your health care
team.
Even if you do everything you’re supposed to do, your
body may still reject the new kidney and you may need to
go back on dialysis. Unless your health care team
determines that you’re no longer a good candidate for
transplantation, you can go back on the waiting list for
another kidney.
Side Effects of
Immunosuppressants
Immunosuppressants can weaken your immune system, which
can lead to infections. Some drugs may also change your
appearance. Your face may get fuller; you may gain
weight or develop acne or facial hair. Not all patients
have these problems, though, and diet and makeup can
help.
Immunosuppressants work by diminishing the ability of
immune cells to function. In some patients, over long
periods of time, this diminished immunity can increase
the risk of developing cancer. Some immunosuppressants
cause cataracts, diabetes, extra stomach acid, high
blood pressure, and bone disease. When used over time,
these drugs may also cause liver or kidney damage in a
few patients.
Financial Issues
Treatment for kidney failure is expensive, but Federal
health insurance plans pay much of the cost, usually up
to 80 percent. Often, private insurance or state
programs pay the rest. Your social worker can help you
locate resources for financial assistance.
Organ Donation
Deceased Donor
Most transplanted kidneys
come from people who have died. However, the number of
people waiting for kidneys has increased in recent
years, while the number of kidneys available from
deceased donors has remained constant. The result is a
shortage of kidneys and a longer waiting time for people
with kidney failure.
Many suitable kidneys go unused because family members
of potential donors don’t know their loved one’s wishes.
People who wish to donate their organs should talk about
this issue with their families. Several organizations
provide organ donor cards for people who wish to make
this life-preserving gift when they die. A properly
completed organ donor card notifies medical officials
that you’ve decided to donate your organs. In most
states, you can indicate your desire to be an organ
donor on your driver’s license.
Living Donor
A growing number of
transplanted kidneys are donated by living family
members or friends. Potential donors need to be tested
to make sure that donating a kidney won’t endanger their
health, as well as for matching factors. Most people,
however, can donate a kidney with little risk.
A kidney from a living donor often has advantages over a
deceased donor kidney:
People who receive a kidney
from a family member or friend don’t have to wait until
a kidney becomes available. Living donation allows for
greater preparation and for the operation to be
scheduled at a convenient time.
Kidneys from family members are more likely to be good
matches, although there’s no guarantee.
Kidneys from living donors
don’t need to be transported from one site to another,
so the kidney is in better condition when it’s
transplanted.
Living donation helps people waiting for kidneys from
deceased donors by lowering the number of people on the
waiting list.
Minority Donation
Diseases of the kidney are found more frequently in
racial and ethnic minority populations in the United
States than in the general population. African
Americans, Asian Americans, Hispanics/Latinos, and
Pacific Islander Americans are three times more likely
to suffer from kidney failure than Americans of European
descent. Successful transplantation is often enhanced if
organs are matched between members of the same ethnic
and racial group. A shortage of organs donated by
minorities can contribute to longer waiting periods for
transplants for minorities.
