Our moonshot: Eliminate the kidney transplant waitlist

 Kidney failure, also known as End Stage Renal Disease (ESRD), is a difficult road under the best of circumstances. For kidney failure patients living in Blaine, Birch Bay, Semiahmoo, Point Roberts and other north county areas, traveling to Bellingham three times a week for a four-hour dialysis treatment, is even more arduous. Though home dialysis modalities are ideal in these circumstances, many people, for various reasons, are not able to use them.

Access to dialysis is essential to high-quality treatment for people with ESRD, but the best treatment option for many patients is a kidney transplant from a living donor, ideally before they require dialysis. 

One in three American adults is at risk for chronic kidney disease (CKD) – it is a silent epidemic that affects over 37 million people in the U.S.; over 80 percent of people with the disease are undiagnosed and untreated. Early detection can slow the progression of the disease and, in some cases, prevent it. 

Knowing that you are at risk because of diabetes, hypertension or a family history hopefully leads to appropriately frequent testing of kidney function and urine testing for protein. 

Our Pacific Northwest region has a history of innovation in kidney research and dialysis with a legacy of mission-driven care to individuals with CKD. Outpatient dialysis, including home dialysis, was first performed in Seattle.

With over 550,000 people in the U.S. on dialysis, and about 170 in Whatcom County, we must strengthen our education and awareness programs about renal disease and its under-detected progression so that we can decrease the high burdens on patients, families, the healthcare system and society.

Successfully increasing the rate of living kidney donation will decrease reliance on dialysis, which is the most expensive and high-risk form of kidney replacement therapy. In the Pacific Northwest, the typical wait time for a kidney transplant is three to five years. 

People typically receive kidneys by being matched with a deceased donor from the transplant waiting list. The less common way to receive a kidney is through a living donor such as a family member, friend, or, increasingly from an altruistic stranger. 

Nationally, there are about 96,000 people on the kidney transplant waitlist, with 1,399 in Washington state. In Whatcom County, there are currently 20 people on the kidney transplant list. This includes those active on the list and those on medical hold, usually for updated testing, transient medical problems or dental clearance. There are an additional 12 people under evaluation and another dozen are interested or in the process of referral to a transplant center.

At three years after listing for a kidney, typically 18 percent received a living donor kidney, 26 percent a deceased donor organ and 20 percent either died or were too ill to remain listed. It is estimated that nationally 17 people die each day waiting for an organ.

A living donor is preferred because there is no waiting and you come off dialysis or are transplanted before dialysis is started. Patients live longer and have better quality lives with a kidney transplant than on dialysis. But living donors are hard to come by – we can change that. Let’s become the first county in the nation to eliminate the kidney transplant waiting list. 

We have two kidneys and only need one. 

Let’s shoot for the moon.

The Mount Baker Foundation is hosting a Living Kidney Donation forum from noon to 2 p.m. Sunday, September 10, including lunch, at the Squalicum Boathouse at Zuanich Point Park in Bellingham. Contact Maria Macpherson to reserve your spot for the event: maria@mtbakerfoundation.org.

Dr. Lombard is a retired nephrologist and past medical director of the Mt. Baker Kidney Center who volunteers at the Mount Baker Foundation.