A kidney transplant may be considered when kidney function has declined significantly or a person has reached kidney failure requiring dialysis. Some patients may undergo a preemptive transplant before dialysis begins if they are suitable candidates and a compatible donor kidney is available. Transplant evaluation may begin before kidney failure becomes severe, allowing time to assess eligibility and identify potential living donors. The decision depends on kidney function, overall health, other medical conditions and whether transplantation is expected to be safe and beneficial.

Kidney function is primarily assessed through blood and urine tests. Blood tests measure waste products such as creatinine, which helps doctors estimate the glomerular filtration rate, or eGFR. Urine tests can identify protein, blood and other signs of kidney damage. Depending on the condition, doctors may also use ultrasound, CT or MRI to examine the kidneys, while a kidney biopsy may be recommended when the cause of kidney disease is unclear. These findings help determine the severity and guide treatment.

Treatment depends on the stage and cause of kidney disease. It may include medicines, dietary and lifestyle changes, and treatment of conditions such as diabetes or high blood pressure that can worsen kidney damage. As kidney function becomes severely reduced, options may include dialysis, kidney transplantation or supportive care. A transplant may be considered for suitable patients with advanced kidney disease or kidney failure. The treatment plan is based on kidney function, underlying disease, overall health and individual circumstances.

A living kidney donor may be a relative, friend or, in some cases, an unrelated person. Potential donors must undergo a detailed medical evaluation to determine whether donating a kidney is safe for them and whether their kidney is suitable for the recipient. Blood type, tissue compatibility and other factors are assessed. Donors must be healthy enough to undergo surgery and continue living safely with one kidney. The transplant centre determines eligibility after completing the required medical and psychological assessments.

Before transplantation, the recipient undergoes a comprehensive evaluation to determine whether surgery and lifelong anti-rejection medicines are likely to be safe. This may include a physical examination, blood tests, imaging, cancer screening and psychological assessment. Doctors also evaluate the heart, blood vessels, infections and other conditions that could affect transplant outcomes. Compatibility testing includes blood typing, tissue typing and a crossmatch between donor and recipient. The transplant team reviews these findings before deciding whether transplantation is appropriate.

Protecting kidney health involves managing conditions that can damage the kidneys, particularly diabetes and high blood pressure. Regular medical check-ups can help monitor kidney function and identify changes early. Following prescribed medicines, maintaining a healthy lifestyle and discussing all medicines and supplements with your healthcare professional are also important. People with kidney disease may need specific dietary or fluid recommendations based on their condition. Regular blood and urine testing can help monitor kidney function and guide changes in treatment when needed.