The Field

Time Is not on Duane Oates' side. His body is slowly poisoned.

Three years ago, he found Out That His kidneys close had begun to. Now, most of the days of the 56-year-old spends hours connected to a dialysis machine, which removes excess fluid and waste building up in him.

Though the doctors referring to dialysis as a "kidney replacement therapy", it is a stopgap at best. The Machine has only 15% of The Job of a normal kidney. "What's the matter with The Other 85% [] I'm always?" Oates asks, sitting in a medical recliner in a clinic in the vicinity of Washington DC. "Every Day I'm on dialysis, my body is becoming less and less healthy. "

What is he a new kidney, the Filter is needs to be blood around The Clock . As His physician, Ashté Collins puts it: "The optimal renal replacement therapy is Transplantation. "

The problem is That we, like almost every country, a permanent shortage of donors runs. Oates is healthy enough for a kidney transplant, but only 22,000 are performed in the U.S. each year. There are 100,000 people in the queue.

The lack of the Problem is especially acute in large cities, where The Wait can be as long as 10 years. Meanwhile, as the poisons continue to gather in the body of the patient, they are facing increasing risks of heart disease and stroke.

"Most of the people who have a kidney transplant, unfortunately, never received it, because they die while on the waiting list," says Dr. Keith Melancon, who heads the kidney transplant unit at the George Washington University Hospital .

the extent of The Crisis in the USA, more for kidney Care , and performs more transplants than any other Nation - is frightening. Kidney disease affects One in seven adults.

37mhave chronic kidney disease, but 90% don't know

726,000 suffer from end-stage renal disease

Nearly 90,000 people on dialysis each year

Due to a genetic mutation, Afro-die-Americans are Three Times more likely than whites to develop full-blown failure. Oates is a case in point - His kidney function as a result of "focal segmental glomerulosclerosis", a condition That affects disproportionately on black people stopped.

Also for those who are still relatively healthy, such as Oates, dialysis, carries a heavy load. He worked as a project manager in the construction industry. Although he tries to stay active, with your blood four mornings filtered in the week makes it impossible to keep, job.

"When you first meet him, you are in a dark place. But you have to fight and not allow it to take over. "

This is a battle That many lose the patients. "Boredom is The Kiss of death," says Towanda Maker, the hospital is a terrible Director. "It leads to depression, which is The Number -One mental illness in dialysis patients. "

dialysis does not have to be done in a clinic. Many patients are given the machines enable you to make dialysis more efficient from the comfort of their homes. But in spite of Ms Maker is not friendly to carp, Oates feels quite ready for self-Care , which requires, stick thick needles into His veins.

dialysis, in any form, can only do so much. Instead of languishing for years on the transplant list, Oates has decided to act.

He has a program, sponsored by The National Kidney Foundation, the "Big issues, Big Give" which will give you tips on How To ask people to save if they have a kidney - because we all have two but only need One .

Some of the Ms Maker ' s patients have their own strategies. A put on a successful call, on Facebook. Some of them had "I need a kidney" T-shirts with your contact details on the back. "People have gotten very creative," she says.

a Further innovative way of increasing your chances of a donor where the Mutual Benefit is through the kidney exchanges.

Such initiatives may help individuals, but it is not. the underlying problem: fix not enough kidneys for Transplantation

in Many countries, particularly in continental Europe, have tried to promote the supply of dead donors by a "presumed consent" approach. Such a System , also known as "opt-Out ", automatically places the people on a national registry for donors, unless they choose not to be.

All US States have an "opt-in" laws. Would make the change to the "opt-Out " - a Big Difference ? International studies That suggest,. Spain, which has presumed consent, only slightly ahead of the United States, The Number of transplants in relation to its population, France and Belgium, with similar legislation, less transplants.

Wales is currently the only part of Britain with an opt-Out System - England is due to follow later this year. But the Welsh have not an increase in The Organ to see donations, it changed its law in 2015.

A similar System in the US can help, just a little bit, Dr. Melancon, George Washington University Hospital , says. "We would still fall short, if we had presumed consent," he says.

According to Joseph Vassalotti, The National Kidney Foundation's chief medical officer, a way to make The Most of dead donors is throws by the improvement of the "return". About a fifth of the kidneys, which you offer, are considered as unhealthy and discarded.

If the US followed the French policy accepted and kidneys of older patients and diabetics, for example, could it be 17,000 extra for a transplant, says Dr. Vassalotti.

There is a wide consensus That the surest way to significantly alleviate the shortage of the kidneys by an increase in living donors. But there is fierce disagreement on How To achieve this.

A prominent contribution to The Debate Sally Satel is. A Scholar at The American Enterprise Institute (AEI), a Washington-based Think Tank , has an intense personal interest in the topic. In 2004, her kidneys began to fail. She was desperate to avoid dialysis, but as an Only Child with no Immediate Family nearby, she was not sure How To find a donor. Your search was mainly the mention of their condition to those around you.

"I've never asked anyone remembers outright," Satel, sitting in the hushed foyer of the AEI. "I brought it. I don't know what I thought. I just kind of assumed That it would happen. "

Several friends have pulled their kidney but Out - on two occasions, according to your spouse's divorce threatened That if the donations continue. In 2006, Satel, the health has been deteriorating rapidly. She was weeks away from dialysis, if the hoped-for miracle happened.

Virginia result of some bad practice, a political writer, is One of the Satel the predicament in the Small Talk at a party. Result of some bad practice went home and did some Research on the donation of kidneys and by E-Mail, Satel said, you would have a your.

The Message with The title "a serious offer", was immediately followed by a second, single-line E-Mail, which was: "I'm not going to again. "Fourteen years After America's most famous kidney donor, result of some bad practice demurs at any suggestion That their decision was admirable.

"I call it The World 's easiest good deed," she says. "You show up, you get anesthesia, you Wake up. There is very little to do. People do more extraordinary things Every Day , in relation to the Care of parents in old age. "

The intensity in her voice suggests it is not false modesty. "The traditional journalistic narrative of" Oh, The Hero blah blah blah' - I think it makes it less likely That people will donate. It needs to be normalized. "

result of some bad practice kidney lasted Satel 10 years. By the time your immune System rejected it, at the age of 60 years, they found another donor. Satel is now kidney on your third right, and feel good.

she had the good fortune not once, but Twice . But as a policy expert, The Experience , the Links Satel profoundly dissatisfied with a System That is based on luck and the kindness of strangers. The reason for this is That so couple of kidneys for transplant available, she claims, is That under The National Organ Transplant Act, 1984), where for the organs is illegal.

The United States is not exceptional, Iran is the only country That allows transactions, and it has no kidney deficiency. Satel is not parts for an Iranian-style market for the body. But she believes a well-designed financial incentives can expand the pool of donors, while questions about payment for organs.

Source of news: bbc.com