Patients & Caregivers

Transplant First Approach

Chronic Kidney Disease (CKD) often remains unnoticed until it reaches advanced stages, causing irreversible kidney damage. When CKD progresses to end-stage kidney disease, patients face a tough choice: kidney transplant or dialysis.

While dialysis may be a convenient treatment option, it negatively impacts quality of life, limits time with loved ones, and strains the healthcare system. Sadly, many patients are unaware of kidney transplantation as an alternative. Consequently, most start with dialysis when kidneys fail, making the path to transplantation difficult and emotionally taxing as health declines over time.

The Hopewell Health Difference

Learn More About Chronic Kidney Disease: Causes, Signs, Stages and Treatment Options

The kidneys are two bean-shaped organs located near the middle of your back, one on each side of your spine. Each kidney is connected to the bladder by a thin tube called a ureter.

The kidneys remove waste and extra fluid out of the blood to make urine.  Your kidneys filter waste and other toxins and excess salts from your blood.  This helps to keep a healthy balance of electrolytes and fluids in your body.


Fact:  Every day, your kidneys continuously filter your blood to remove extra water and waste products. The waste products in your blood come from the food you eat and the use of your muscles. 

This waste and extra water that your kidneys filter makes up your urine (pee). 

When your kidneys do not work, you are not able to make urine to get rid of fluid and waste. 

You need at least one kidney to live.

Other important things that your kidneys do:

  • Help control your blood pressure.
  • Help keep your bones healthy.
  • Help your body make red blood cells. 
  • Help with fluid balance in your body.

Kidney Transplant: A kidney transplant is a surgical procedure in which a healthy kidney from a living or deceased donor is transplanted into a patient with kidney failure. Transplantation is considered the best treatment option for many people with end-stage renal disease because it offers the potential for a better quality of life and fewer dietary restrictions compared to long-term dialysis. Not everyone is a candidate for a kidney transplant, and there may be a waitlist for available organs.  However, all types of kidney transplants can be lifesaving and life-improving procedures for individuals with end-stage kidney disease.


  1. Living Donor Kidney Transplant: In this type of transplant, the kidney is donated by a living person, typically a family member, friend, or altruistic donor. Living donor transplants are preferred whenever possible because they offer several advantages, including a higher chance of success and shorter waiting times. Living donors can either donate one of their two kidneys (living related donor) or, in some cases, choose to donate to a stranger (altruistic or non-directed living donor).
  2. Deceased Donor Kidney Transplant: Deceased donor transplants involve kidneys harvested from individuals who have recently died, usually due to brain death or circulatory death. These kidneys are recovered and transplanted into recipients who are on the transplant waiting list. Deceased donor transplants are further classified into two types:
  3. Paired Exchange Kidney Transplant: Also known as a kidney swap or paired kidney donation, this type of transplant involves two or more living donors and recipients who are incompatible due to blood type or other factors. The donors and recipients are matched with other pairs in a way that allows for compatible matches. For example, if a donor in one pair is compatible with the recipient in another pair (and vice versa), they may exchange kidneys. Paired exchange programs help increase the number of transplant opportunities for recipients with incompatible donors.


Dialysis: Dialysis is a medical procedure that helps filter waste, excess fluids, and electrolytes from the blood when the kidneys are no longer able to perform this function adequately. There are two primary types of dialysis:


  • Hemodialysis: In hemodialysis, blood is pumped out of the body to an external machine called a dialyzer, which acts as an artificial kidney. The dialyzer filters the blood and returns it to the body. Hemodialysis is typically done at a dialysis center and requires regular sessions, often several times a week.
  • Peritoneal Dialysis: Peritoneal dialysis uses the lining of the abdominal cavity (peritoneum) as a natural filter. A catheter is inserted into the abdominal cavity, and a special dialysis solution is introduced. The peritoneum absorbs waste and excess fluids from the blood, which are then drained out. Peritoneal dialysis can often be done at home and allows for more flexibility in treatment schedules.

When your kidneys do not work, waste and water is not filtered the way it should in your urine, and this flows back into your bloodstream. This causes waste and water to build up in your body.

Kidney damage also causes issues with the other important things that your kidneys do which makes it harder for the rest of your body to work the way it should. When this happens, you may experience some signs of kidney disease.
Kidney failure is when your kidneys stop working.

As kidney damage progresses over time, signs and symptoms of chronic kidney disease develop. Loss of kidney function can cause a buildup of fluid or body waste or electrolyte problems. 


Depending on how severe it is, loss of kidney function can cause:


  • Nausea and/or vomiting.
  • Decrease in appetite.
  • Tiredness and weakness.
  • Sleep problems.
  • As the kidney damage progresses, people will experience urinating more, especially at night.  
  • People may also see blood in their urine as the kidney filters become damaged and blood cells leak into urine.
  • Having trouble concentrating,
  • Muscle cramps,
  • Swelling of feet and ankles,
  • Puffiness around your eyes.
  • Dry and itchy skin.
  • High blood pressure (hypertension) that’s difficult to control.
  • Shortness of breath may happen if fluid builds up in the lungs.


Signs and symptoms of kidney disease can be nonspecific, which means they can also be caused by other illnesses.  Also, you might not develop signs and symptoms until irreversible damage has occurred.  


Should you be experiencing these symptoms it is very important to be seen by your healthcare provider for further evaluation.  Early detection might help prevent kidney disease from progressing further or from kidney failure.

There are diseases or conditions that impair kidney function, causing kidney damage to worsen over time (i.e., several months or years).  


These are:


  • Diabetes:  Type 1 or Type 2 
  • High blood pressure
  • An inflammation of the kidney’s filtering units called glomerulonephritis.
  • Interstitial nephritis, which is an inflammation of the kidney’s tubules and surrounding structures.
  • Polycystic kidney disease or other inherited kidney diseases,
  • Conditions such as enlarged prostate, kidney stones and some cancers may cause obstruction of the urinary tract and damage the kidneys.
  • Pyelonephritis, or a recurrent kidney infection.
  • A condition that causes urine to back up into your kidneys called vesicoureteral.


Other risk factors that put people at higher risk of chronic kidney disease and failure are:


  • Diabetes
  • High blood pressure (hypertension)
  • Heart (cardiovascular) disease
  • Smoking
  • Obesity
  • Being Black, Native American, or Asian American
  • Family history of kidney disease
  • Abnormal kidney structure
  • Older age
  • Frequent use of medications that can damage the kidneys.

Your healthcare provider may order blood, urine, and other tests to check on the health of your kidneys.  These tests might include:


  • Blood tests. Blood tests look for the level of waste products, such as creatinine and urea, in your blood.
  • Urine tests. Analyzing a sample of your urine can help identify the cause of chronic kidney disease.
  • Imaging tests like ultrasound may be used to check on your kidneys’ structure and size.
  • Removing a sample of kidney tissue for testing. Your doctor might recommend a kidney biopsy, which involves removing a sample of kidney tissue.

The Five Stages of Kidney Disease

Chronic kidney disease (CKD) is divided into five stages. The stages are based on a blood test, called the eGFR, and the test result shows how well your kidneys work to filter waste and extra fluid out of your blood. As the CKD stages go up, it means that your kidney disease is getting worse, and your kidneys work less well. At each stage, it is important to take steps to slow down the damage to your kidneys.  It is important to note that kidney disease stage cannot be reversed, but it can be slowed down to prevent further damage to your kidneys.  With treatment and healthy life changes, many people can slow or stop the progression of kidney disease.

Stage 1

Stage 2

Stage 3a

Stage 3b

Stage 4

Stage 5

1 in 7

Adults in the USA are
estimated to have CKD

About 35.5 million people, or 14% of the population

9 out of 10

Adults with CKD do not know they have it

On Average

1 in 3

Adults with severe CKD do not know they have CKD

On Average

Removing every barrier to kidney transplantation so that more late-stage CKD patients rediscover hope and freedom.