Researchers confirm the advantages of renal transplantation on dialysis.

-70% Of transplants that occurred in Colombia in 2012 were kidney

-the overall number of transplants has increased in Colombia of 1,085 in 2011 to 1.107 in 2012, but promptly in renal transplant there was a decrease of 4%

– between three and five initial years the total cost of the transplant patient is less than the patient on dialysis

Bogotá, March of 2013- hope and quality of life of a patient with chronic renal failure are greater when the kidney is replaced that when dialysis is practiced.

An investigation carried out by the doctors Diego Rosselli and Juan David Rueda, of the Department of clinical epidemiology and biostatistics at the University Javeriana, concluded that, despite the improvement of techniques to filter blood (dialysis), transplantation the patient live, on average, 17 years after surgical intervention and without sacrificing their ability to substantially labor. In dialysis, on the other hand, the average survival of patients with similar characteristics reaches seven years and involves ten or more hours a week of treatment connected to a machine.

According to the research, which will be submitted for publication in a scientific journal, transplantation is also more beneficial than dialysis for the health system, both for the costs in the medium term as increases in quantity and quality of life. In the long run, the complications associated with dialysis, such as heart disease, significantly increase the costs of treatment.

Our research analyzes all elements related to each type of treatment – explains the doctor Juan David wheel –. When we delve into the medical costs and not medical, direct and indirect, observed a patient on dialysis not only has more disabilities that your condition also affects caregivers, who must also sacrifice their productivity ”.

Although transplantation represents one greater initial investment (about 35 million pesos) and some costs of medication which can also be high (about two million per month), medium-term can represent a saving. A month of dialysis costs about three million pesos, and is associated with a frequency of complications than transplantation. Dialysis, also has a few older out-of-pocket expenses ” (scroll to the site of dialysis, not covered by the system) and a social cost given by the decline in labour productivity.

In assessing this data, the researchers conclude that you between three and five initial years the total cost of the transplant patient is less than the patient on dialysis.

In the medical field there is no argument that transplant over dialysis – ensures Rosselli –. However, the advances in the techniques of dialysis and the reduction in the number of donors have led us to lower our guard against the transplant. Therefore it is necessary to properly inform people and reverse the trend ”.

When the kidneys do fail

Chronic kidney failure, also known as kidney failure occurs when the kidneys stop working, and therefore can not adequately filter toxins and other substances from waste from the blood. It is usually caused by hypertension, diabetes or specific diseases of kidney, acquired or hereditary.

People with kidney failure have three treatment options: peritoneal dialysis, hemodialysis and transplantation (see below treatments: its pros and its cons ”). The first two are considered temporary, and the final third.

According to the National Institute of health (INS), 1.107 transplants that occurred in Colombia last year, 767 (69%) were of kidney, 31 less than in 2011. In total, the country currently has more than 4,000 people with renal transplantation and 22,000 people on dialysis, of which 15,000 would be transplant candidates although, according to the INS, only 1,220 are in waiting list.

the shortage of donors is the primary cause and most widespread of the high volume of people waiting for a new organ. However, experts and rights defenders consider this is also related to the fact that patients receive little information, assume that dialysis is permanent, not claim their right to transplant, not admitted to waiting lists and, therefore, cease to exert pressure.

Is a vicious – says the sister María Inés Delgado, Director of the Colombian Association of sick liver and kidney (ACEHR) –: when there is no pressure, no donors; When there are no donors, patients lose hope; and when patients lose hope, do not exert pressure. so, they end up hooked to dialysis longer than necessary ”.

According to the religious, long waiting lists are a symptom of the shortage of donors, but also have a positive trait: a big waiting list helps to raise awareness about the importance of organ donation even among relatives of patients, and pressure for more aggressive campaigns are carried out. Why we must fight so that patients are on those lists. That is your right ”.

Treatments: its pros and its cons

Patients with chronic renal failure are entitled to three treatment options.

Transplantation

It is the replacement of a body which fails for one good, coming from a living or cadaveric donor.

Advantages: improves survival, increases the quality of life, increases the functionality of the person, decreases the time spent on the disease, lowers cardiovascular morbidity and does not commit so much productivity.

Disadvantages: it requires major surgery, their higher initial costs, increases the risk of certain infections by immunosuppression, drugs have side effects, the waiting lists are long and lack culture of transplantation.

Peritoneal dialysis

It is a technique whereby the patient is implanted it in the abdomen a catheter that attaches to the bag of dialysis solution. This technique can be manual (during the day, more or less every four hours) or by a machine during the night while the patient sleeps. This treatment is usually temporary.

Advantages: it can be in the House, the learning curve is short, it is possible the patient without the need to go to a hospital, it has fewer dietary restrictions that hemodialysis, is cheaper than hemodialysis, is associated with lower requirements of drugs for anemia and minor limitations to work.

Disadvantages: it takes a high degree of cleaning of the patient because it is associated with a greater number of severe infections, such as peritonitis; the House of the patient requires breaking and hernias may appear of the abdominal wall laxity.

Hemodialysis

It is a procedure that is carried out in a specialized center, where the patient is connected, for three or four hours to a dialyzer that extracts blood from the body to filter it. Also considered it a temporary treatment.

Advantages: it is the procedure most performed in the country and about which has more experience; There is support among groups of patients with the same disease; It does not require structural changes in the House.
Disadvantages: you must go to the hospital or dialysis Center to make them; in some centres there is no flexibility in opening hours; requires restrictions on diet, especially liquids; mood changes occur by high levels of uremia associated with the time between sessions and procedure generates a deterioration in the vascular access in the patienti.e., by weakening veins reduces the chance of the process is practiced.