Info on outpatient Dialysis

Weebil · Mar 12, 2009

Hello, my character is morbidly obese, smoker, waiting for a kidney transplant. As I have it set up, he is on dialysis, but will not be eligible for a kidney transplant until he stops smoking. Viable? At this point, he is also a diabetic (which I understand can lead to kidney failure), and I just have him going out of the house several times a week for treatment. Anyone that can tell me expected time of each dialysis, etc, whether he could even be considered for a kidney if he smoked, age restrictions...
Oh, and then he dies of heart failure. (he's not a major character)
Any help is appreciated.
Thank you!

ColoradoGuy · Mar 12, 2009

You've got the frequency of dialysis about right -- usually it takes a half day or so. I think most centers would still list him for transplant while trying to get him to quit smoking. (For comparison, they won't list someone for liver transplant who is still drinking.) Also, about half of kidney transplants are from living donors, usually family. The United Network for Organ Sharing (UNOS) site is here with lots of information. UNOS sets most of the rules.

citymouse · Mar 12, 2009

His age would be the deciding factor. After age 55 most people are not eligible for transplants unless they have a boat load of $$$$$$$ to bypass younger recipients. Life expectancy for a dialysis patient who will never get a transplant is on average 5 years. Dialysis is extremely hard of the heart.

You also need to consider the reason for the transplant. A person suffering an aortic aneurysm at the kidney juncture would not be a candidate for a transplant because there would be no blood vessels left to connect the kidney.
C

Weebil · Mar 12, 2009

Thanks for all the advice! There hasn't been any indication of a previous heart problem, only the dialysis. I read somewhere about the burden on the heart, so it seemed a good way to get rid of him (necessary for the plot, I'm afraid)

DamaNegra · Mar 13, 2009

You can also have the dyalisis at home, during the night. You're plugged in to the machine when yo go to sleep, by the time you wake up voila! the dyalisis is done and no time wasted.

I think it's rather expensive to do that, but not at all impossible. The machine isn't that big, it can fit any table you have lying around the house.

citymouse · Mar 13, 2009

DN is correct. Home dialysis is an option. It is expensive but I believe a far better way to go. All you need is a reclining chair and a water source near by, a bathroom for example. A dialysis nurse stays with the patient from start to finish (usually 4 hours). The biggest concern is infection at the shunt site. This can be a killer.
C

Dale Emery · Mar 13, 2009

My father-in-law did peritoneal dialysis at home overnight (every night, I think). He also did something called an "exchange" in the early afternoon. That took 30 minutes or so.

My wife (who is current on these things) says that age is not a direct factor for either getting on the transplant list or receiving a kidney once you're on the list. A key factor (if there's a match) is health. Of course, age affects health, but age per se is not a factor.

Dale

citymouse · Mar 13, 2009

Dale, Your wife is correct that age is not direct factor in getting on the list for a transplant and especially getting dialysis treatment because that would be discriminatory and illegal.
However, say a 72 year old man needs a kidney transplant. The chances of him getting on the list are slim and even if he does he may get bumped around. Dialysis was not invented to keep people alive indefinitely. It was / is as therapy to prolong life until a kidney can be found. Thanks to donor programs kidneys and other organs are far more plentiful than they were twenty years ago.

best of luck to your wife and you.
C

Kathie Freeman · Mar 20, 2009

citymouse said:
Dialysis was not invented to keep people alive indefinitely. It was / is as therapy to prolong life until a kidney can be found.

Actually the dialysis machine was invented in 1944 by Dr. Willem Kolff as a way to keep his kidney failure patients alive, some whether they wanted to or not. He is quoted as saying some of his patients begged him to let them die, but he felt it was his duty as a physician to keep them alive as long as possible. Transplants came much later.

citymouse · Mar 20, 2009

KF, you are correct. The first successful kidney transplant was in 1954.
I typed a bit more on this subject but I deleted my remarks because, unhappily, this is a topic that is close to me.
C

Kathie Freeman said:
Actually the dialysis machine was invented in 1944 by Dr. Willem Kolff as a way to keep his kidney failure patients alive, some whether they wanted to or not. He is quoted as saying some of his patients begged him to let them die, but he felt it was his duty as a physician to keep them alive as long as possible. Transplants came much later.

Info on outpatient Dialysis

Weebil

ColoradoGuy

I've seen worse.

citymouse

fantasy dweller

Weebil

DamaNegra

Mexican on the loose!

citymouse

fantasy dweller

Dale Emery

is way off topic

citymouse

fantasy dweller

Kathie Freeman

That Crazy Cat Lady

citymouse

fantasy dweller