What Is Kidney Failure? And Kidney Transplants in Malaysia.
Kidneys are one of the most important organs in our body for blood cleansing. Don’t take it easy if there are any symptoms of kidney disease. Kidney failure also called end-stage renal disease (ESRD) is the last stage of chronic kidney disease where a dialysis or kidney transplant is needed in order to restore the normal process of our bloodstream. People may lose up to 90% of kidney functions before experiencing severe symptoms such as:
- Foamy urine is a sign of protein in the urine which is abnormal where kidney should be able to filter protein inside our body if functional.
- Frequent urination may be caused by kidney damage which can cause an increase in the urge to urinate especially at night.
- Unusual back pain caused by kidney failure that is deeper and higher up the back. Other causes of unusual back pain can be kidney infections, kidney stones and urinary tract infections.
- Swelling legs where decreasing kidney functions can lead to sodium retention causing body swelling (most commonly the lower part of our legs and feet), joint pain and joint stiffness.
Symptoms of Chronic Kidney Disease:
- Ammonia-smelling breath
- Loss of appetite
- Foamy urine
- Difficulty urinating or frequent urination
- Kidney pain/back pain
Five Stages of Chronic Kidney Disease:
- Stage 1 where 90% or more of normal kidney function are still available,
- Stage 2 where 60-89% of kidney function are still functional,
- Stage 3 where 30-59% of kidneys are still functional. There are no specific symptoms during these 3 stages but kidney function can slowly decline,
- Stage 4 where 15-29% of the kidney are only functional with very low capacity and treatment for kidney failure may be needed soon,
- Stage 5 the final stage of which only 15% of kidneys are functional and no longer keep up with removing waste products and extra water. Kidney failure is concluded at this stage and there is no cure, treatment options are available except kidney transplant.
Before Travelling From overseas to Malaysia:
- Patient has to conduct some study and research on their health condition and financial capacity before embarking their journey to Malaysia for the kidney transplant,
- Upon identified which medical centre or hospital for their choice of transplant, both the recipient and the donor have to travel to Malaysia and we can arrange and advise with the travel plan and ground transportation,
- First Consultation and Evaluation (3-5 Days) where clinical review and consultation with the Nephrologist will be conducted upon arrival of the patient. Lab tests, medical evaluations and donor-recipient compatibility are done. An application of Unrelated Transplant Approval Committee (UTAC) also required to be completed before proceeding to the next steps,
- Second Consultation and Evaluation (after 14 days of waiting for the 1st evaluation results) with the Nephrologist for the results which normally will take 2 days time,
- Approval Process (30 Days) which will normally take 3 days for the UTAC’s assessment and patient and donor will normally wait at their home country or they can choose to travel around Malaysia if they have the spare time,
- Admission (1-2 Days) where preparation is ready with consultation with Anaesthetist and Pre-surgery preparation. The surgery may take 3 hours and upon surgery patient will need to be hospitalized for 7 days where 1st day in ICU and 6 days in a normal ward for both recipient and donor.
- Outpatient (Estimated 14 Days) where the recipient needs to return to the hospital to remove the stent 14 days after the surgery where else donor can return home after the 10th day of the surgery,
- Home-bound where patient now needs to follow the medical dietary and lifestyle advice by the doctor and make the necessary adjustment back to a regular lifestyle. Patient will be follow-up by the home country’s doctor or return to Malaysia for follow-up if they feel the need to.
What Is Living Kidney Transplant?
A living kidney transplant is the transfer of a healthy kidney from one person into the body of a person who has little or no kidney function at all (only 10-15% kidney functionality). Typically kidney transplants can be done from a deceased donor or living donor. A living donor transplant is a procedure during which a kidney is removed from a healthy donor and surgically put into
An individual with kidney failure. The living donor can be an uncle, aunt, cousin, or even a spouse or friend. Living donors can also come from strangers, but it is subject to approval from the Unrelated Transplant Approval Committee (UTAC) of Malaysia.
Living donor transplant has many advantages over a deceased donor, the most important being that it has a significantly high success rate as it works immediately after the transplant. Lower risk of rejection especially when the donor is a close family member of the recipient.
However, a kidney transplant may not be suitable for everyone with the following conditions:
- Those who have active infections
- People who are severely overweight
- Donor/recipients who are advance in age
- Anyone with a severe heart disease
- Patient who have recently been treated for cancer
- People with poorly controlled mental illness
- People who have Dementia
- Alcohol or drug abuses
- Other possible factors that could affect their ability to safely undergo the procedure and take all medications needed to prevent organ rejection
Risks and Complications of Kidney Transplant:
- Blood clots
- Cancer that can be transmitted with the donated kidney
- Failure of the donated kidney
- Heart attack
- Infection or infection from the donor
- Leaking from or blockage of the tube (ureter) that links the kidney to the bladder
- Rejection of the donated kidney (although very rare)
- Urological complications
- Vascular complications (vein and artery clotting or narrowing)
As kidney transplant is major surgery, it may have the surgical risk of:
- Allergic reaction to general anesthesia
- Bleeding during operation
- Blockage of the ureter
- Blood clots
- Failure of the donated kidney
- Heart attack
- Leakage from the ureter
- Lymphoceles (a collection of lymphatic fluid within the body leading to potential renal failure)
- Rejection of the donated kidney
Anti-rejection Medication Side Effects:
- Bone thinning (osteoporosis)
- Bone damage (osteonecrosis)
- Excessive hair growth or loss
- High blood pressure
- High cholesterol level
- Higher infection risk
- Higher risk of developing certain skin cancer and non-Hodgkin’s lymphoma
- Puffiness (edema)
- Weight gain
Therefore a more comprehensive and careful analysis of your treatment plan is required where we can provide more information on how to assist your medical journey here in Malaysia a more reliable and pleasant one with all the supports and guidance provided.