Kidney Transplant

[sue7211]

At my son's last nephrology dr. appt. they mentioned that when he is in his 40s, based on his last kidney biopsy, he will definitely need a kidney transplant. He is 17 now, was diagnosed at 15. I'm just curious if anyone else has been told something similar. We were so stunned at the time that we didn't think to ask questions but we will next visit or by email sooner if we want to.

Thanks,

Sue

[drz]

Some of these predictions are more like wild guesses even if they are their best opinion at the time. Like Yogi Berra said, "it is difficult to predict things, especially the future."

Who know how your son will respond? The doctors thought I was heading toward dialysis too a couple years ago, now they say it may never happen, but of course it could as another Wegs attack on the kidneys could wipe them out. Kidneys can sometimes recover a great deal with proper treatment and in ten or twenty years who knows how treatment might improve for your son. Just see the best nephrologists you can find and follow their advice and try not to worry about things that may never happen in distant future. Best wishes for good health.

[elephant]

What is his creatinine level?

[Al]

Sue, this is silly. They seem to be projecting present knowledge into the far future. In fact, no one can say what will happen to the state of the art, nd the state of knowledge. It is true that kidneys, while sometimes recover in remarkable ways, are more resistant than most organs to regeneration: What is now damaged tends to stay damaged. But, as I say, that truth is a projection of present knowledge. However, it is also true that the very definition of "transplant" is in a state of flux, and may be totally re-written within a few years. Great progress has already been made in using pluripotent cells ("stem cells") in building new kidneys from scratch. Since these would use the subjects' own cells, there would be no rejection to attend to with immunosuppressive drugs. Yes, all implementations of this are still in the future, but that is true with everything in the future. In all cases, your son has a lot of living to do between then and now, so...go ahead and live it.

Al

[sue7211]

Thanks so much for your responses and reassurances! I, too, think that in 20-30 years kidney transplants may be very different than now and so might my son's health. one of you asked about his creatinine level: 1.29-1.6 usually. I still can't quite figure out why this came out of this doctor's mouth. He's been so great about teaching, encouraging and having my son plan great things for the future. Yet, he is only 3 years into being a nephrologist so perhaps his fascination with medicine got in the way. I will talk to him about the effect it had on my son and me.

[pberggren1]

I find some docs just plainly too blunt. My doc tells it like it is but is also very encouraging. He always tries to see the bright side of things.

[Al]

Thanks so much for your responses and reassurances! I, too, think that in 20-30 years kidney transplants may be very different than now and so might my son's health. one of you asked about his creatinine level: 1.29-1.6 usually. I still can't quite figure out why this came out of this doctor's mouth. He's been so great about teaching, encouraging and having my son plan great things for the future. Yet, he is only 3 years into being a nephrologist so perhaps his fascination with medicine got in the way. I will talk to him about the effect it had on my son and me.To look at matters charitably, Sue, he could have been thinking: "don't worry--no need to fret about a transplant for a long time." Still, I think you are right: He is too fascinated with medicine to worry about the perspective of actual patients. You can do him a great service by telling him your reaction. ("I'm gonna help your with your education, Doc. That'll be $200.")

Just to reiterate: The future is full of possibilities. Most are unforeseen and unforeseeable. When I was an undergraduate in the late 1960s, psychology was held in the thrall of behaviorism.. A few years later, when I was still in graduate school, behaviorism took a humiliating, thudding dive into the dustbin of history. (In my own area, I had a terrific fight with my adviser over what constituted a proper thesis topic. I didn't know, then, that my own choice was a direct challenge to his own ultimately disastrous rear-guard fight against a new paradigm. As it happened, I would have chosen well, a few years later....) In the 60s, it was preached that it was impossible for adult primates to generate new brain cells. Now, adult neurogenesis in at least two areas of the brain is fully accepted. [Note to Jim: I assume you've read that London taxi drivers have larger hippocampi than most people....] Indeed, new paradigms of how brains work have lead to amazing new therapies for stroke victims, sufferers of autism, addictions, and even dyslexia. To be sure, there are fewer researchers working on kidney regeneration (or on the re-training of the immune system), but my point remains: The future is always unknown until it happens.

Al

[Sangye]

Sue, what an idiotic and completely unnecessary thing for your son's doctor to say! If it were me, I'd point that out to him. :mad1: