In the Spotlight
By Anthony J. Langone, MD
Medical Director of Renal Transplantation
VA Tennessee Valley Health Care System, Nashville, TN
Assistant Professor of Medicine, Division of Nephrology
Vanderbilt University Medical School
End Stage Renal Disease (ESRD) has reached epidemic proportions in the United States. Almost one in six hundred adults has ESRD. Diabetes is the number one cause of ESRD. It is estimated that more than half of all new dialysis patients last year needed help because of damage caused by diabetes. Death rates for dialysis patients have fallen over time. However, patients with type 2 diabetes who are dialysis-dependent have a higher death rate than 85% of those with cancer. The best hope for these patients is a kidney transplant.
A kidney transplant improves patient survival regardless of age, race, and gender. Unfortunately, more than 80,000 patients are waiting for a kidney transplant in the United States. The average wait time now is greater than five years. In some regions, patients are dying at a greater rate while waiting for a kidney transplant than are actually receiving them. Public awareness can improve the organ supply for patients on wait lists. It is important that people willing to donate their kidneys or other organs share their beliefs with their family members. This way their wishes to donate can be honored.
Not all transplants are successful. Nearly half of all kidneys transplanted and lost in the first year are related to patients who do not follow their new health care routine. Medicare only covers 80% of the patient's post-transplant medication for 36 months. With an average monthly cost greater than $3,000, Medicare coverage alone leaves a major gap in payments. The patient must pay these costs. Many patients are not able to afford their medications and health care visits after the kidney transplant. However, patients who are eligible for coverage with Department of Veteran Affairs can receive a kidney transplant with fully covered medications for the life of their transplant. The VA National Transplant Program now has four hospitals in the United States. This program has performed kidney transplants for nearly fifty years with excellent outcomes. We urge all veterans who require kidney transplantation to consider this option.
Kidney Diseases (Medline Plus)
Enfermedades de los riñones (Medline Plus) (en Español)
Kidney Transplantation (Medline Plus)
Trasplante de riñón (Medline Plus) (en Español)
Diabetes and Kidney Disease (Veterans Health Library)
Updated January 11, 2016