Does Kidney Transplant or Chronic Dialysis Offer Longer Survival?

Last Editorial Review: 1/11/2018

Ask the experts

For people in endstage renal failure, which is better? Chronic dialysis? Or kidney transplantation? By "better" I mean which offers the longer survival?

Doctor's response

For saving lives, transplantation is superior to long-term dialysis. This is according to a report published in The New England Journal of Medicine late in 1999.

Kidney transplantation looks to be not only life-enhancing but also life-saving. Long-term survival is markedly improved among patients who receive a donor kidney compared with patients who remain on the waiting list for a kidney.

In the New England Journal study, the mortality rates were analyzed among over 200,000 patients who underwent dialysis for end-stage renal disease. Of these, some 23,000 actually received a kidney. The projected years of life remaining were 10 for patients who remained on the waiting list and 20 for those who received a transplant (N Engl J Med 1999;341:1725-1730).

In sum, kidney dialysis is an amazing procedure. But it is not yet as amazing as the kidney itself. For both the quality and length of life, a transplanted kidney is better than chronic dialysis. It's man over machine.


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