Does Kidney Transplant or Chronic Dialysis Offer Longer Survival?

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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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Reviewed on 1/11/2018