Fans were shocked when world-renowned singer and entertainer Stevie Wonder announced on July 6 that he is taking a break from touring to have a kidney transplant in September. Former NFL football player Albert Haynesworth recently took to social media to plea for a donor for a kidney transplant, which reportedly generated significant interest. The plight of these high-profile individuals puts the spotlight on kidney failure, which can affect the life of anyone.
It is estimated that 1 in 7 adults in the United States have chronic kidney disease. That’s 30 million people – and the Centers for Disease Control and Prevention reports that most are undiagnosed and half of those with severely reduced kidney function who need dialysis don’t even know it. Part of the problem is that there are no early signs or symptoms of chronic kidney disease, which gets worse over time, although treatment can slow progression. Kidney diseases are the ninth leading cause of death in the U.S.
Kidney disease can be genetic, as with polycystic kidney disease, or caused by autoimmune disorders, such as lupus. However, in the U.S., the most likely culprits causing kidney failure (End Stage Renal Disease) are diabetes and high blood pressure, which account for 3 out of 4 new cases.
“The arteries throughout the body get destroyed by high blood pressure – they become thickened where the blood pressure can become worse and the arteries inside the kidney become thickened, and they decrease the blood flow through the kidney, causing scarring,” said transplant specialist Henry Randall, M.D., executive director and professor of Surgery at SSM Health Saint Louis University Hospital.
“The same thing occurs in diabetes, but it’s more than just the arteries – it’s the functional unit of the kidney, called glomeruli. So you get glomerular thickening or scarring; you can get arterial thickening and fibrosis [excess fibrous connective tissue] in the kidney.”
As kidneys weaken over time, the organs cannot clean the blood as well. Health issues that chronic kidney disease can cause include fatigue and weakness from anemia or low red blood cell count; bone problems due to low calcium and high phosphorus in the blood; abnormal heart beats from high potassium; nausea; appetite loss; fluid retention in the body which can cause high blood pressure, leg swelling and shortness of breath; infections due to a weakened immune system; and depression.
To lower the risk of kidney failure and to manage chronic kidney disease, experts recommend management of blood sugar and blood pressure and making lifestyle changes – eating healthy and exercising – to reduce further damage. A dietician can create an eating plan that is low in salt, fat and has the proper amount of protein for a kidney-healthy diet. Other actions include eliminating smoking, preventing bladder and kidney infections, and avoiding over-the-counter pain medication like ibuprofen and naproxen, which can worsen kidney function. Your doctor can suggest other actions to protect your kidneys, which could include avoiding certain antibiotics and herbal supplements.
While patients can wait months, years or even die while waiting on an organ transplant list, a donation by a living donor allows fortunate transplant recipients like Wonder time to advance schedule his kidney transplant.
“There is no such thing as a new kidney, except from a newborn baby. These are used organs,” Randall said. “I tell people, ‘You are getting a used car. Our job is to find the ones that you’re going to get quite a bit of mileage with, and you’re going to be able to drive off the car lot and they don’t fall apart on you soon as you leave the lot, and you get years of function out of them.’”
Most organs donated for kidney transplants come from deceased donors. Belleville, Illinois resident Nikki Love-McIntyre was diagnosed with type 1 diabetes after her pancreas no longer produced insulin. For many years, she checked her blood sugar four times a day and took insulin injections to stay alive. Over the years, diabetes caused her kidneys to fail. By the time she started having related health problems, she was in the third stage of kidney failure, which quickly moved to stage four of five for End Stage Renal Disease.
The idea of dialysis terrified her, and after doing some research, she asked her doctor, Dr. Randall, if a double transplant – of a kidney and a pancreas – was an option for her. A double transplant would resolve Love-McIntyre’s diabetes and the kidney failure.
“They say the shelf life for a kidney is 10 years. In half of that time, I would have needed another kidney and the same thing would have kept happening,” Love-McIntyre said. “Because of my needing dual organs, when I got on the list I was placed at the top of the list.” Her transplant surgery took place almost four years ago, and she will be on antirejection medication for the rest of her life.
Dr. Randall said surgeons typically don’t use live donor kidney donations from persons with diabetes and high blood pressure – “because if they are headed down a road where they are going to have or realize End Stage Kidney Disease, then we don’t want to expedite or speed up the process for them.” However, Randall did say that persons with type 2 diabetes can be candidates for a kidney and pancreas transplant, if they have lost kidney function.
“Both type 1 and type 2 diabetics have to have End Stage Renal Disease to the point where they are either going to end up on dialysis or they currently are on dialysis.” Randall said. “Most type 2 diabetics aren’t at the point where they need insulin. So we are looking for people who have End Stage Renal Disease and are already on insulin. Just because you are a diabetic, which many people are, doesn’t qualify you for a kidney-pancreas transplant.”
About her double-organ donor, Love-McIntyre is both grateful and emotional. She knows his age (23), where he was from and how he died. And she wrote letters to her donor’s family to let them know what his gift of life means to her and her family. Love-McIntyre said she had written several letters to the family after her transplant and decided to write her last letter on the one-year anniversary of the surgery.
“I just wanted to let them know that I appreciate it and I pray for them every day and he lives within me now,” she said, tearfully. “I don’t know what he was able to accomplish in those 23 years, but anything that I do – he’s doing. And I’m going to do my best to take care of him.”
The donor’s aunt responded and wrote back to her.
“If you are interested in helping out the general public,” Dr. Randall said, “designate yourself as a donor and have that important conversation with your family members.”
Love-McIntyre said, “Let your last act of selflessness be to donate.”