Kidney Transplantation

Rebecca P. Winsett, FNP, PhD, Judy Martin, FNP, PhD, Laura Reed, FNP, Carey Bateman, FNP

Organ Transplant

Introduction

Chronic kidney disease (CKD) is a global public health problem of immense proportions. The adverse sequelae of CKD include cardiovascular disease and kidney failure. CKD is defined as kidney damage for ≥ 3 months, as defined by structural or functional abnormalities of the kidney, with or without decreased glomerular filtration rate (GFR), or GFR <60 mL/min/1.73m² for ≥ 3 months, with or without kidney damage.^[1] Unfortunately, CKD is underdiagnosed and undertreated in the United States, which has important implications for kidney transplantation.

References

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Cite this: Rebecca P. Winsett, Judy C. Martin, Laura Reed. Kidney Transplantation - Medscape - Oct 01, 2002.

Table 1. Sociodemographic and Medical Characteristics of Treated Medicare End-Stage Renal Disease Patients in the U.S., 1997 ^[4]
Patient Characteristics	Incidence (1997)	Percentage
Race White Black Asian/Pacific Islander Native American Other	51,171 22,926 2,383 928 1,694	64.69% 28.98% 3.01% 1.18% 2.14%
Sex Male Female	42,129 36,973	53.26% 46.74%
Primary Diagnosis Diabetes mellitus Hypertension Glomerulonephritis Polycystic disease Urologic diseases Other known causes Unknown cause	33,096 20,066 7,390 1,772 1,388 8,284 2,920	41.8% 25.4% 9.3% 2.2% 1.76% 10.47% 3.69%

Table 2. 1-, 2-, 5- and 10-Year Survival Rates and Causes of Death for Patients with end-Stage Renal Disease Receiving Renal Replacement Therapy ^[4]
Treatment Type	1-Year^a	2-Year^b	5-Year^c	10-Year^d
	Survival Rates (%)
Living-related donor transplant	97.79	95.82	90.21	74.84
Cadaveric donor transplant	94.68	91.96	78.93	55.07
Dialysis	77.96	62.39	27.96	8.49

Table 3. Contraindications to Kidney Transplantation
Contraindication	Absolute	Relative
Cancer	X
HIV positive/AIDS	X
HCV infection		X
HBV infection		X
Morbid obesity		X
Atherosclerosis		X
Cardiac Disease		X
Uncontrolled hypertension		X
Smoking		X
Unresolved psychosocial issues		X
Active UTI	X
Active tuberculosis	X
Irreversible heart failure	X
Irreversible lung failure	X
Irreversible liver failure	X
Active systemic disease (ie, lupus, sickle cell disease, Wegener's disease)	X

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Kidney Transplantation

Introduction

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Author(s)

Rebecca P. Winsett, RN, PhD

Judy C. Martin, PhD, APRN

Laura Reed, MSN

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