What are the kidneys?
The kidneys are two bean-shaped, reddish-brown organs. Each are about the size of a fist. They are located on either side of the spine, under the lower ribcage.
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What do the kidneys do?
The kidneys' main job is to clean the blood. They also play an important role in:
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Regulating water
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Balancing chemicals in the body
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Regulating the building of bone
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Regulating blood pressure
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Controlling the production of red blood cells
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What happens if the kidneys don't work?
Kidney disease has two main causes: diabetes and high blood pressure. Kidney failure is when the kidneys can no longer filter the blood properly, so toxic waste products and fluid build up in the blood. If this happens, there are two treatment options:
Option 1: Transplantation
Although not a cure, a transplant offers the best possible improvement to health for people living with kidney failure. There are two different types of transplants:
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(1) Living kidney donor transplant
This is when a living person gives one of their kidneys to someone who needs it. The donor can be related or unrelated to the recipient. Living kidney donor transplants offer many advantages over deceased kidney donors. The waiting time is decreased, and the recipient may not need to go on dialysis. This option is also usually more successful, with transplants lasting longer (15-20 years) and rejection less likely.
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(2) Deceased kidney donor transplant
This is when a kidney becomes available for transplantation after someone has died. The kidney is removed with the consent of family or from previous donor consent. It is then stored on ice or connected to a machine that provides it with oxygen and nutrients until it is transplanted. Deceased kidney donor transplants last 10-15 years.
What happens if a living kidney donor is not a match?
An incompatible pair may occur when the donor and recipient are not a match. The Canadian Blood Services Kidney Paired Donation Program allows incompatible pairs to be matched with other incompatible pairs so that both recipients get a kidney. Here is an example of this:
Will wants to give a kidney to his sister Cecily,but they're not a good match. Zoya wants to give a kidney to her husband Nikolai, but they're also not a good match. However, Will is a match for Nikolai, and Zoya is a good match for Cecily. The two pairs swap kidneys so that everyone that needs a transplant gets one.
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The Ottawa Hospital participates in the Kidney Paired Donation Program managed by Canadian Blood Services. During the COVID-19 pandemic, Air Canada has been recruited to ship donated kidneys to patients in need across Canada. This way, a living donor in Toronto matched with a patient in Vancouver does need to travel to donate their kidney. The success of the program has motivated Canadian Blood Services to consider the possibility of kidney shipment as a standard post-COVID-19.
Option 2: Dialysis
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Dialysis is a method of artificially cleaning the blood. There are two types:
1. Hemodialysis: Blood is passed through a machine outside the body that cleans it.
2. Peritoneal dialysis: Blood is cleaned inside the body in the peritoneal cavity, an area that surrounds the abdominal organs.
Dialysis can be hard because it must be done regularly and requires dietary restrictions.