This marks the end of National Diabetes Awareness Month. But it’s not something to be aware of for just a month. According to the Centers for Disease Control, some 29.1 million Americans suffer from diabetes, slightly more than 9 percent of the population. And many of those diabetics will ultimately develop kidney disease, and often End Stage Renal Failure, which means survival will depend on a transplant or dialysis. The link between diabetes and kidney disease is incontrovertible. According to the National Institutes of Health, diabetes is by far the largest cause of kidney disease, responsible for 44% of all cases. Second on the list is high blood pressure, responsible for 26%.
The human impact of kidney disease is immense. Each year, some 100,000 Americans are diagnosed with kidney failure. he only treatments are dialysis or kidney transplant. Either is costly. There are two kinds of dialysis. In hemodialysis, blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes that connect you to the machine. Hemodialysis is most often done in an institutional setting several times a week. It is debilitating, often leaving the patient exhausted. Realistically it will keep you alive, but will dramatically impact your quality of life. In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. It can be performed at home, but requires surgery to insert the plastic tube that introduces fluids to your belly. The surgical site can become infected. And while you can theoretically travel, in a limited fashion, while on peritoneal dialysis, it requires moving around a lot of chemicals and gear. Again, it’s going to have a major impact on your lifestyle.
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Transplantation is generally a much better option than dialysis. So why doesn’t everyone try to do it? For starters, there just aren’t enough kidneys to meet the demand. Here are the frightening numbers from the National Kidney Foundation:
- There are currently 100,791 awaiting kidney transplants in the United States (as of 1/11/16).
- The median wait time for an individual’s first kidney transplant is 3.6 years and can vary depending on health, compatibility, and availability of organs.
- In 2014, 17,107 kidney transplants took place in the US. Of these, 11,570 came from deceased donors and 5,537 came from living donors.
On average:
- Over 3,000 new patients are added to the kidney waiting list each month.
- 13 people die each day while waiting for a life-saving kidney transplant.
- Every 14 minutes someone is added to the kidney transplant list.
- In 2014, 4,761 patients died while waiting for a kidney transplant. Another, 3,668 people became too sick to receive a kidney transplant.
These numbers don’t reflect the thousands who want a transplant but don’t qualify for the Unified Organ Sharing List, or UNOS. Many are either too debilitated to survive a transplant, of because of other conditions the doctors who do the evaluations fear they are not good candidates for long term survival. nd there’s some politics here as well, since every transplantation center want to be able to report great outcomes, giving them an incentive to qualify only the healthiest of candidates.
Now, let’s look at some of the economic costs. In the hemodialysis population, total fee-for-service Medicare expenditures per person per year (PPPY) were $87,945 in 2011, the last year for which there are complete number. For peritoneal dialysis patients, the cost averaged $71,630. The cost of a kidney transplant is about $100,000, and the lifetime anti-rejection drug regimen that’s required comes to about $12,000 a year. Total costs for caring for End Stage Renal Failure in the United States in 2011 was more than $34 billion.
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Preventing Diabetes
Diabetes falls into two categories, Type I and Type II.
Type I diabetes is often called Juvenile Diabetes, even though almost as many adults are diagnosed with it. Type I results from failure of the immune system which destroys the ability of the pancreas to make insulin needed to process sugars. About 3 million Americans suffer from Type I diabetes. The causes of Type I diabetes are still not well understood. But Type II diabetes is far more of a problem, affecting some 26 million Americans. Overall costs of treating diabetes comes to about $243 billion dollars each year, a number that continues to grow. And most of that can be prevented by better lifestyle choices in terms of healthy eating and exercise. You’ll find a great list of tips from the National Institutes of Health here. If there’s been diabetes in your family, or if you are overweight, you are well advised to talk to your doctor about ways to reduce your risks.
An Update
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As for me, six weeks after my kidney transplant, I’m doing quite well, thank you. I’m restarting a full exercise regimen, though there are still many cautions I have to observe for another six weeks while my immune system is slowly rebuilding (it will always be compromised, but not as much as it is for the first three months). I’m feeling well, and generally able to work a full day. Thanks for all the good wishes.
The reality is that all of this could have been avoided had I had better information, better guidance, and made better choices going back some sixty years. So my best advice to our readers, do as I say, not as I did. The consequences otherwise are brutal.
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