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What I learned When My Kidneys Failed, Part IV

September 30, 2013

Last Installment-The Big Show

By the Numbers

The researchers at UCSF estimate that 40 million Americans are in some stage of renal failure. Most people in this group do not know it. The major factors contributing to this are diabetes and high blood pressure.

Diabetes can lead to high blood pressure as well as renal failure. High blood pressure is a contributing factor for renal failure, and renal failure is a contributing factor for high blood pressure.

90% to 95% of all diagnosed diabetes are Type II. 79 Million Americans have undiagnosed diabetes or pre-diabetes.

These conditions, undiagnosed or treated, sets up a downward spiral that just feeds on itself. While many of these people go on to die of renal failure or diabetes outright, many more go on to die of heart disease.

Demographically speaking, it is easy to see that there is trouble coming.

There are about 5,000 people waiting for kidney transplants at UCSF alone. UCSF does, on average, 315 transplant surgeries a year. That makes an average wait time about 14 years, assuming that everyone lives long enough to receive a transplant.

The average wait time to receive a kidney is three-to five years. The difference between 14 years and 5 years is the number of people who will die waiting for a kidney transplant. About 5,000 people per year die while on kidney transplant list.

The annual costs of treating patients in the US with End Stage Renal Disease (ESRD) was $40 billion as of 2009. The individual cost of a kidney transplant, including pre-surgery prep, the actual surgery, and the first 180 days of post operative care are about $263,000.

For people like myself, who are lucky enough to have excellent employer-provided health care insurance, these costs are of very little concern. However, those less fortunate who need to rely on Medicare, the gaps in coverage can be not only a real burden, but financially devastating.

ESRD will continue to grow as our population ages. This will place increasing upward pressure on our health care costs. New programs, such as the Affordable Care Act, will help. However, no program or combination of programs will come close to matching the growing need. We are rapidly approaching a state where only the affluent will be able to afford this treatment. We can expect to see the annual mortality rate of people waiting for transplants to increase, perhaps dramatically, in the coming years.

What to do? First of all, we need to realize that the very best treatment is prevention. We need to aggressively control the conditions that lead to renal failure, especially diabetes.

Much, although not all, Type II diabetes is controllable, if not preventable. If you know someone with Type II diabetes or is at risk for it, for God’s sake, intervene. This may be uncomfortable, but take it from someone who has walked this path—renal failure is no joke. Save a life.

Be aware of, and control other behaviors that can lead to renal failure, Including hypertension. Control dietary choices—including a low sodium diet, avoid high fructose corn syrup, most processed foods. Make good nutritional decisions, including fresh vegetables, and reduce red meat consumption. Renal failure is no joke. Save a life.

Consider becoming a living donor. You do not have to be an exact match, but can paired with another in need through the national Kidney Registery. A healthy and long life can be experienced with one kidney. I was on the transplant list for about a year, not the 3-5 year average. The difference? I was lucky to have living donors. Renal failure is no joke. Save a life.

To the extent you can, support advanced kidney disease research, like the implantable artificial kidney being developed at UCSF. Renal failure is no joke. Save a life.

I know this last part became a little preachy, but the need is great, and the resources to meet that need are shockingly inadequate. Renal failure is an especially bad way to die. Everyone who can should do their part.

Renal failure is no joke. Save a life.

Next Installment-Lessons Learned and Closing Observations

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3 Comments
  1. not_Anonymous permalink

    Type II diabetes is largely a lifestyle disease. Three years ago I went to the doctor for a physical. I had an HA1C of 5+ and was significantly overweight with high triglycerides. I knew that I would be leaving my employment in 2-3 years and realized that a diabetes diagnosis would doom me to no insurance. I asked the doctor to omit the diagnosis for 6 months and I went on a diet. I lost 70 pounds (have kept 50 off and am at about 22% body fat ) and reduced the HA1C and triglycerides to normal levels. The financial incentive scared me straight. I know that I have only postponed the disease. Even the best diet can only hold it at bay but it will get me to retirement. I will do my best to maintain my health for as long as possible but when its time to go I will go happily. Frankly, the only way to cure Type II diabetes is to make everyone responsible for their own health including taking financial responsibility. One cannot willfully live a life of excess and expect others to pay for it.

  2. I am glad to know that you responded responsibly to your warning signs. I wish others would do the same. You are living proof that we are not hostage to unhealthy lifestyles–we have the power to to make the changes that we need to.

    What I find most astonishing is an unhealthy way of living affects not only the person making bad choices. It affects the family, extended family and the broader circle of friends as well. We all have what I consider to be a sacred obligation to those who care for us to take care of ourselves. Slipping away to soon, due to factors we could have controlled, is a crime against all who love us.

  3. Keeping the weight off is a continuing challenge. I have relatives and friends that will not do it. Our society has an obligation to allow them to experience the consequences of their choices.

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