Leslie Spry: My name is Leslie Spry, and I am a kidney specialist in Lincoln, Nebraska. I am here on behalf of the National Kidney Foundation to talk to you today about understanding chronic kidney disease and this will introduce you to dialysis and transplantation. Unfortunately, as we've discussed, not all treatments can absolutely avoid the complication of chronic kidney disease. Chronic kidney disease still may progress overtime and there is a natural loss of kidney function that occurs just as a matter of aging such that beyond age 40, you can anticipate loosing approximately 1% of your kidney function per year.

Hence, we can never entirely stop chronic kidney disease. And ultimately, some patients may have to deal with the treatment of end-stage kidney disease. This generally occurs when the kidney function is in the range of around 10 of 15%, or an estimated GFR test between 10 and 15%.

Under those circumstances, one may have to consider treatment such as dialysis and transplantation. There are two forms of dialysis available. The most common form of dialysis is known as Hemodialysis and Hemodialysis is performed on a regular basis. Hemodialysis may be done in a center, where the patient travel and sits on a kidney machine for approximately four hours, three times per week.

Alternatively, we have newer forms of blood dialysis known as Hemodialysis that it can be done at home. Home dialysis using a blood dialysis machine is generally done five or six days per week, for about two or two-and-a-half hours, and seems to result in people feeling better and generally doing better because they are caring for themselves at home.

The other form of treatment for chronic kidney disease is Peritoneal dialysis. Peritoneal dialysis requires the insertion of a tube within your belly or abdomen. We instill fluids inside of the abdomen that is then drained out several times per day. This can either be done in the form of daytime dialysis, which we call Continuous Ambulatory Peritoneal Dialysis, or it is done at night time which is known as Nocturnal Peritoneal Dialysis where by a machine puts fluid into your abdomen through out the night time, exchanges that fluid repetitively, and then you are able to disconnect in the morning and go about your daily activities.

Blood dialysis requires the insertion of a fistula inside of your arm, this is a connection between an artery and vein that allows us to put needles into your arm and allows us access to your blood stream so that UV can cleanse the blood on a recurring basis. The best form of kidney treatment is actually transplantation for those that can undergo transplantation.

Transplantation can either be done with a living donor, this is known as living-related donor kidney transplantation and this is important. If you have chronic kidney disease and you have a donor available to you, this is the fastest and the most effective way to treat kidney diseases. In the case of Cadaver Kidney Transplantation, you must go on a waiting list and this means perhaps waiting form anywhere form three to five years for some one to die in such a manner that they can donate a kidney. Cadaver Kidney Transplantation is the most common form of transplantation today. Finally, we must always consider the fact that not every one is going to be a candidate for either dialysis or transplant. In certain circumstances, it's necessary to at least consider the possibility that dialysis or transplant is not appropriate for certain individuals. Patients who have advanced kidney disease as well as advanced heart disease, cancer, or other complex medical problems, may choose to forgo their option of dialysis or transplant. It is important that you discuss these issues with your family physician as well as your kidney specialist. The National Kidney Foundation remains committed to education and support of the kidney patients.