I recently read that Selena Gomez needed a kidney transplant due to her SLE. What is SLE and why did she need a kidney transplant?

SLE stands for Systemic Lupus Erythematosus. It is more commonly known simply as “lupus”, which means wolf in Latin.

About 1.5 million Americans suffer from it, and a lot of Malaysians are also afflicted by it.

It is a chronic and disabling autoimmune disease. This means that the symptoms and complications are caused by the body’s own immune system destroying its tissues and organs.

No two cases of lupus are alike. For some, it is mild and only certain organs are affected. For others, it is severe, with the development of kidney disease and heart disease.

No one knows what causes lupus or how to cure it. Right now, we can only manage its symptoms, try to slow the disease down and treat the complications as they come.

If your kidney is badly affected by lupus – enough to cause kidney failure – then one of the ways to treat this is by a kidney transplant.

In what sort of cases do you need a kidney transplant? It’s not just lupus, right?

Definitely not. A kidney transplant is a type of procedure to manage end stage renal disease.

First, let’s talk about the kidneys. They are two bean-shaped organs located in your loins, more to the back of your body than your front.

The kidney’s function is to filter out wastes, minerals and fluids from the body to keep it in balance and functioning well. The two kidneys do this by producing urine.

It is extremely important that you urinate, because this eliminates toxic substances and waste products from the body, and is also the main route in which you lose excess water.

If the kidney is affected by disease or is impacted in any way, such as by a blunt force in an accident, they may diminish or lose this filtering ability. Harmful substances and water then accumulates in the blood and body, raising blood pressure and resulting in all sorts of symptoms.

It is true that you need only one kidney to survive.

End stage renal disease is what happens when both kidneys have lost 90% of their function. You don’t usually progress to end stage renal disease overnight. Kidney functions can be impaired in gradations.

Other than SLE, common causes of end stage renal failure include:

  • Diabetes
  • Chronic and uncontrolled high blood pressure
  • Chronic glomerulonephritis (inflammation that leads to scarring of kidney tissue)
  • Polycystic kidney disease

I thought dialysis was the method of treatment for kidney failure?

Dialysis, kidney failure, kidney transplant, Star2.com

Dialysis, as seen in this filepic, is time-consuming and expensive, and you have to do it for life.

Dialysis is one of the treatments, yes.

But don’t forget that dialysis can be time-consuming and expensive.

You have to do it for life, and be hooked up to the dialysis machine for three times per week if you are on haemodialysis.

For peritoneal dialysis, you have to keep changing your dialysate bags and wear them around your body – something some patients find difficult.

So a kidney transplant is a way out. Compared to dialysis, it gives you a better quality of life.

If a kidney transplant is the method of choice for end stage renal failure, then why aren’t more people opting for it?

There are certain criteria you have to fulfill in order to be able to qualify for a kidney transplant.

But there are also a lot of criteria that excludes you from having a kidney transplant. These include:

  • If you are very old. It would not be fair to give a brand ‘new’ kidney to you then because you won’t be using it for as long as a younger person will.
  • Severe heart disease – you might not be able to take the surgery or the drugs that you have to take for life after the surgery.
  • Active or recently treated cancer – if you are not cured or in remission, then your body might be affected by the cancer, and whatever new kidney you receive might not be that useful in the long-term.
  • Poorly controlled mental illness and dementia.
  • Alcoholism or drug abuse – obviously, you don’t deserve a new kidney yet if you allow it to be destroyed by continuous substance abuse.
  • Any other factor that can affect your ability to safely undergo surgery and take the medications needed to prevent organ rejection.

Bear in mind that someone needs to donate that kidney to you, and there are far less donors than people waiting for a kidney transplant in the world.

Healthy kidneys meant for transplant are difficult to come by, and so you really have to be screened for it.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.