Georgia’s dialysis crisis: Living, and dying, on a mechanical kidney

[Clark]

http://america.aljazeera.com/articles/2015/2/27/georgias-dialysis-crisis-living-and-dying-on-a-mechanical-kidney.html

Georgia’s dialysis crisis: Living, and dying, on a mechanical kidney
In the state with the lowest transplant rate in the US, clinics fail to refer patients to organ donation list
by Joaquin Palomino

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Whether or when Sanders will receive a transplant, though, is particularly uncertain because she lives in Georgia, which has the lowest transplant rate in the nation. In 2013, less than three percent of Georgians with end-stage renal disease received a new kidney, according to data from the United Network for Organ Sharing. And Emory University researchers found that between 2005 and 2011, people living in some northeastern states were four times more likely to get a transplant than Georgians. As a result, many patients in the southern state spend a disproportionate amount of time on dialysis; they live and die hooked up to the machine.

The problem will most likely become more pronounced in the future, and not just in Georgia. Kidney disease is approaching a state of crisis in the United States. From 1980 to 2009, the rate of people living with end-stage renal disease increased nearly 500 percent nationwide, from 290 to 1,738 cases per million U.S. residents. The number of patients is still climbing, albeit at a slower pace. Meanwhile, after a sharp uptick in the 1990s, the national organ-donor pool is relatively stable and will most likely continue to remain steady, experts say.

As a result, the wait list for a new kidney is growing, and transplants will likely become scarcer in the future. “There’s going to keep being a huge gap [between supply and demand], and people will keep dying waiting for a kidney,” says Stephen Pastan, medical director of Emory University’s kidney and pancreas transplant programs.

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But some experts think that in order to solve Georgia’s transplant problem, the state first has to fix its obesity, diabetes and hypertension problems — all root causes of kidney failure. That’s a tough task, considering the state is one of the poorest in the nation. “When you go into a grocery store, fruits and vegetables are expensive; fats, sugars and high-fat meats are cheap,” says Titte Srinivas, a nephrologist at the Medical University of South Carolina, adding that poor diet is one of the leading causes of kidney failure. “You can’t help but wonder, where do you even start solving this problem?”

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