Know Your Stage of Kidney Disease Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQI™) has guidelines and commentaries that help your doctor and healthcare team make important decisions about your medical treatment? The information in this booklet is based on the NKF-KDOQI recommended guidelines and commentaries. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment. STAGES OF KIDNEY DISEASE Stage Description Glomerular Filtration Rate (GFR)* 1 Kidney damage (e.g., protein in the urine) with normal GFR 90 or above 2 Kidney damage with mild decrease in GFR 60 to 89 3 Moderate decrease in GFR 30 to 59 4 Severe reduction in GFR 15 to 29 5 Kidney failure Less than 15 *Your GFR number tells your doctor how much kidney function you have. As chronic kidney disease progresses, your GFR number decreases. WWW.KIDNEY.ORG 3 What's Inside •Kidney transplantation •Living and deceased donation •“Preemptive” and early transplant •The process of getting a kidney transplant •What the transplant operation involves •What to expect after receiving a transplant •Other transplant issues •Personal and financial concerns •Resources 4 NATIONAL KIDNEY FOUNDATION When a person’s kidneys fail, kidney transplant and dialysis are the two types of treatment available to replace many of the functions of healthy kidneys. Many people feel that a successful kidney transplant offers a better quality of life than dialysis. This is because a transplant allows for considerably greater freedom (no need to spend time on dialysis), increased energy levels, and a less restricted diet. In addition, studies have shown that people who receive kidney transplants live longer than those who remain on dialysis. This brochure provides information on kidney transplantation. It was written to help you decide if transplantation is the best treatment for you. You will likely have many new questions after reading this booklet. You may find it helpful to talk to people who have already had a kidney transplant. Feel free to speak to your doctor, nurse, and family members about your options for kidney transplant. If you use the Internet, there are helpful online resources listed at the end of this booklet. WWW.KIDNEY.ORG 5 What is a kidney transplant? A kidney transplant allows a person whose own kidneys have failed to receive a new kidney from another person. A successful kidney transplant can improve many of the complications of kidney failure. A kidney may come from a living donor or from an individual who has died (deceased donor). A living donor may be someone in your immediate or extended family, or it may be your spouse or a close friend. In some cases, a living donor may even be a stranger who wishes to donate a kidney to someone in need of a transplant. A deceased donor is someone who has consented to donating his or her organs upon death. In situations where the wishes of the deceased donor are not known, family members may consent to organ donation. 6 NATIONAL KIDNEY FOUNDATION What are the advantages and disadvantages of a transplant from a living donor? One advantage of receiving a kidney from a living donor is that this type of kidney has been shown to last longer than a kidney from a deceased donor. Another advantage is that the operation can be planned to suit your schedule, since it is not necessary to wait for a kidney to become available from a deceased donor. Some research shows that an early kidney transplant, with little or no time spent on dialysis, can lead to better longterm health. WWW.KIDNEY.ORG 7 A disadvantage of living donation is that a healthy person must undergo surgery to remove a healthy kidney. The donor will need some recovery time before returning to work and other activities. However, recent advances in surgical techniques for kidney removal allow for very small incisions (often called minimally invasive surgery). This may offer shorter hospital stays and recovery time for donors. Living donors usually experience positive feelings about their courageous gift. What are the financial costs to the living donor? The living donor should have no financial responsibility for the surgical costs of kidney donation. The living donor evaluation and surgery is covered by Medicare or the recipient’s insurance. However, insurance does not cover time off from work, travel, lodging expenses, and incidental expenses. Travel and lodging costs may be covered by the recipient, or the National Living Donor Assistance Program (www.livingdonorassistance.org) or other programs. 8 NATIONAL KIDNEY FOUNDATION Donors may be eligible for sick leave, state disability, and benefits under the federal Family Medical Leave Act. In addition, federal employees, some state employees, and certain other workers may be eligible for 30 days paid leave. The transplant team may be able to provide more information. What are the advantages and disadvantages of a transplant from a deceased donor? Technical advances and more choices for antirejection