A Gift of Life for People with Chronic Kidney Disease

In 2024, more than 6,400 people gave someone else—frequently a person they loved—the gift of life by becoming living kidney donors. Living organ donation also produces a hugely positive ripple effect in that with one fewer person on a waiting list, others in need can move up and potentially find their own donors sooner. 

Some facts about chronic kidney disease

When a person has chronic kidney disease (CKD), their kidneys gradually lose the ability to filter out toxins and excess fluids from their body. Untreated CKD can result in the accumulation of waste, fluids, and electrolytes to life-threatening levels. Additionally, CKD impairs the kidneys’ capacity to make red blood cells, support bone health, and keep blood pressure in the healthy range.

Diabetes (both type 1 and type 2) and high blood pressure are the leading causes of CKD, with about 1 in 3 American adults with diabetes going on to develop CKD. The Centers for Disease Control and Prevention has found that more than 800,000 people in the United States are living with end-stage kidney disease. 

While treatment in the form of controlling the cause of CKD may help to slow its development, some patients go on to experience irreversible end-stage kidney failure, for which the only options are a lifetime of dialysis or a kidney transplant. 

The average wait time to be matched with a kidney donor through deceased donation is three to five years, longer in some regions and among people with certain blood types. For example, people with blood type O can linger on transplant wait lists for a decade.

Transplantation is usually better than dialysis

Yet studies show that for most people who are still healthy enough to undergo surgery, a kidney transplant is preferable to dialysis in terms of both a lower mortality rate and greater long-term quality of life.

On the other hand, the period between the process of identifying a living donor and successfully transplanting a kidney can be only a few months. The transplant can sometimes occur even before a patient needs to begin dialysis. 

The approximately 12 percent of Americans on transplant wait lists who receive a kidney from a living donor are also almost guaranteed a longer and healthier life than those who receive a kidney from a deceased donor.

A living-donor kidney is typically healthier than one from a deceased donor, and post-transplantation, a living-donor kidney functions well for about 20 to 25 years—versus about 10 to 15 years in the case of a deceased-donor kidney. For this reason, a recipient of a deceased-donor kidney may need a second, or even a third, transplant over the years.

What potential living donors need to know

A living donor will always have the satisfaction of knowing that they have quite literally saved the life of a person with advanced kidney failure. And, although this is a serious medical procedure, a living donor’s life expectancy isn’t usually affected by living with a single kidney. Physicians perform extensive medical tests on living donor candidates to ensure that they are in excellent health before a transplant can proceed. 

Transplant teams also work closely with living donors to be sure they explain the implications of the risks that do exist. Although these risks are very small, they can include developing slightly higher blood pressure—usually well-managed with medication—and developing diabetes. Less than 1 percent of donors go on to develop kidney disease themselves, a statistic that is far lower than the 14 percent of American adults who have chronic kidney disease.

Taking the risks inherent in any surgery into account, a living-donor transplant is very safe for the donor. The mortality rate for living kidney donation surgery is 1 in more than 11,000, far less statistically significant than the mortality rate for such common activities and occurrences as riding a bicycle (1 in about 3,100) or suffering a sunstroke (1 in about 4,400). 

Recovery time

Living donors do need to plan ahead for their own recovery time. Although that can vary, most people will be in the hospital for a few days and typically need to be away from work and decrease their physical activity significantly for four to six weeks. While it’s possible to do light office work sooner, lifting anything weighing more than a few pounds is not advisable for the first few weeks. Even driving a car is off-limits for the first couple of weeks, so donors will need their own post-surgery support system.

The two most common types of living donor kidney operations—laparoscopic and robotic—are non-invasive, allowing the surgeon to remove the kidney with minimal incisions. Post-recovery, most living donors can go back to their typical lifestyle and diet, including moderate alcohol consumption. 

Living donors should keep in mind, however, that heavy consumption of alcohol will put excess stress on their remaining kidney. For their own continued good health, they should also focus on staying hydrated, as people with one kidney face an increased risk of dehydration.

The body needs time to recalibrate its operations around functioning with a single kidney. That’s why pregnancy, for example, is best postponed for living donors until after six months to a year.

The best thing any living donor can do is to put a renewed focus on living the healthiest lifestyle possible to maintain their own good health.  

How to become a kidney donor

The organization Donate Life America provides extensive information about both living donation and deceased donation on its website at DonateLife.net. It also offers the ability to register online to become a donor.