Kidney failure & transplant assessment
When kidney function falls far enough to need dialysis or a transplant, the decision is about timing as much as technique.
What it is
Chronic kidney disease is usually silent until it is advanced. Most people are picked up on a blood test rather than through symptoms, which is why a falling eGFR deserves a conversation long before dialysis becomes urgent.
A transplant is not a last resort. Where it is possible, transplantation offers better long-term survival and quality of life than staying on dialysis, and the results are best when it happens before dialysis has been running for years.
Symptoms you may notice
- Tiredness that does not improve with rest
- Swelling of the ankles, hands or face
- Passing less urine, or getting up repeatedly at night
- Nausea, poor appetite and a metallic taste
- Itching, cramps and restless legs
- Breathlessness on mild exertion
- High blood pressure that is hard to control
Get seen promptly if
- A creatinine that is rising month on month
- eGFR below 20 without a transplant plan in place
- Fluid overload with breathlessness lying flat
How it is assessed
- Blood tests — creatinine, eGFR, electrolytes, haemoglobin
- Urine protein quantification
- Ultrasound of the kidneys and bladder
- Immunological workup: blood group, tissue typing, cross-match
- Cardiac and infection screening for transplant fitness
- Donor evaluation, where a living donor is available
What the options actually involve
Other conditions
Kidney & ureteric stones
From a single calculus to complex staghorn and multi-tract stone burdens, cleared by the least invasive route that will actually work.
Symptoms and treatmentProstate cancer
Diagnosis, staging and robot-assisted radical prostatectomy, with treatment planned through a multidisciplinary tumour board.
Symptoms and treatmentKidney cancer
Partial and radical nephrectomy, with nephron-sparing surgery wherever the tumour allows it.
Symptoms and treatmentHave a scan or report about this already?
Send it before your appointment. The consultation then starts from your findings rather than from scratch.