FOR PEOPLE WILLING TO BE DONORS, WHAT SHOULD THEY DO?
For people considering of becoming a living kidney donor, they should first visit their primary care provider and have a general physical examination to screen for high blood pressure and/or diabetes, obesity, heart disease, kidney disease, protein in the urine, high cholesterol and lipids, Hepatitis C or other conditions as well as determination if they have two normal kidneys with a kidney ultrasound.
Likewise, if a patient in need of a kidney transplant is already undergoing a pre-kidney transplant evaluation at a kidney transplant center, that center can evaluate a prospective living kidney donor at no charge to the person willing to donate one of their kidneys for transplantation.
For people interested in registering on the organ donor registry to donate their organs after their death, one can register online at the National Kidney Foundation website or other website, at their local bureau of motor vehicles or at their local organ donor procurement agency or by calling any transplant center or in other ways.
ARE THERE DIFFERENT TYPES OF KIDNEY DISEASE?
Yes, there are different types of kidney disease. There is kidney disease caused by “medical causes”, such as diabetes and/or high blood pressure or heredity causes such as a variety of “glomerulonephritis” causes.
In addition, there are “Urological” causes or structural causes that cause kidney disease as a result of bladder outlet obstruction as a result of having a benign, noncancerous enlarged prostate, prostate cancer, stroke and urinary retention, chronic kidney reflux, chronic kidney stones or chronic recurrent urinary tract infections.
Patients can also be bore with kidney disease or kidney anomalies which can progress to chronic kidney disease and the need for dialysis and/or kidney transplantation.
WHY DOES KIDNEY DISEASE IN AFRICAN AMERICANS GO UNDETECTED UNTIL THE LAST STAGES?
African-Americans most commonly develop kidney disease from high blood pressure and/or diabetes. Diabetes and high blood pressure in early stages often present with no signs or symptoms and many African-Americans do not undergo routine physical examinations or health screenings.
Many African-Americans are not aware that they need to undergo such routine examinations or health screenings and many do not access to care due to lack of health insurance or because of poverty and other social determinants of health.
Therefore, due to relative lack of routine preventive health screenings, African-Americans often are not diagnosed with chronic kidney disease until they are in the very late or advanced stages of chronic kidney disease.
WHAT’S YOUR RECOMMENDATION FOR THOSE NEEDING TO BE EVALUATED, LISTED AND TRANSPLANTED?
My recommendation for those who have been diagnosed with chronic kidney disease that they seek early evaluation for a kidney transplant at more than one kidney transplant center.
I advise that if their own primary care physician, urologist or nephrologist has not discussed with them their options to receive a kidney transplant that they proactively contact the kidney transplant centers themselves and self-refer themselves to undergo pre-kidney transplant evaluation.
Additionally, those with chronic kidney disease, I advise that they avoid undergoing routine blood transfusion (unless in an emergency situation) because blood transfusions can interfere and prevent them receiving a kidney transplant.
In addition and very importantly, I advise that anyone considering to undergo a kidney transplant actively seek to identify several potential living individuals to agree to undergo an evaluation to be considered as a potential living kidney donor.
Proactively provide potential living donors with information regarding living kidney donation and provide them with the phone numbers of the living kidney donor offices of their kidney transplant centers.
Also, note that for potential living donors who are not compatible with the person to whom they wish to donate their kidney to, there are paired donor exchange programs that allow such prospective donors to donate to others and in turn the incompatible donors of others can donate to the person they had wised to donate to.
I encourage individuals who need kidney transplants to start their pre-kidney transplant evaluation as early as possible, even before they require starting dialysis. I advise also that people become creative and even use their social media, churches, community connections and other networks to let others know of their need for a kidney transplant. Doing so may result in them finding a prospective living donor whom they may have never considered. I have seen this happen numerous times.
Dr. Modlin answers your ‘Text Tom’ questions on the next page.
