Which is Best treatment for Stage 5 CKD? Dialysis or Kidney Transplant- a question often asked by many
Chronic kidney disease (CKD) has become a common but underdiagnosed problem in spite 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 and it 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%.
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 to 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.
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