Preemptive Renal Transplantation-The Best Treatment Option for Terminal Chronic Renal Failure.
Renal transplantation is the best therapeutic option for end-stage chronic renal disease. Assuming that it is more advisable if performed early, we aimed to show the clinical, social, and economic advantages in 70% of our patients who were dialyzed only for a short period. For this purpose, we retrospectively collected data over 28 years in 142 kidney transplants performed in patients with <6 weeks on dialysis. 66% of our patients were 30-60 years old; 98% of the patients had living donors. At transplantation, 64% of our patients had no public support; however, 64% of them returned to work and got health insurance 2 months later. Full rehabilitation was achieved in all cases, including integration to the family, return to full-time work, school and university, sports, and reproduction. Immunosuppression consisted of 3 drugs, including steroids, cyclosporine, and azathioprine or mycophenolate. The cost in the 1st year, including patient and donor evaluation, surgery, immunosuppression, and follow-up, was $13,300 USD versus $22,320 for hemodialysis. We conclude that preemptive renal transplantation with <6 weeks on dialysis is the best therapeutic option for end-stage renal failure, especially in developing countries such as Bolivia, where until last year, full public support for renal replacement therapy was unavailable.
Centro Médico Quirurgico Boliviano Belga, Cochabamba, Bolivia.
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Arze Aimaretti
Centro Médico Quirurgico Boliviano Belga, Cochabamba, Bolivia. Electronic address: rsarze@nefrodial.com.bo.
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D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000191:economics / Q000627:therapeutic use; D001838:Bolivia; D003365:Costs and Cost Analysis; D016572:Cyclosporine / Q000191:economics / Q000627:therapeutic use; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000191:economics / Q000706:statistics & numerical data; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000191:economics / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000191:economics / Q000627:therapeutic use; D006435:Renal Dialysis / Q000191:economics / Q000706:statistics & numerical data; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000191:economics / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D001379:Azathioprine