Kidney disease, transplants and dialysis

Chronic kidney disease and chronic renal failure 

Chronic kidney disease relates to a serious decrease in renal function as kidneys are no longer able to properly filter blood from the body.

Common causes are genetic predisposition, other health conditions (such as diabetes, cardiovascular disease and high blood pressure, rheumatoid arthritis, lupus) but also obesity, a sodium-rich diet, poisoning, severe allergic reactions, etc.

It is sometimes possible to slow, stop or even reverse its progression.

Advanced chronic renal failure refers to a total or near-total loss of kidney function. End-stage kidney failure is a life-threatening condition and is often irreversible.

The two possible courses of treatment are renal replacement therapy (also known as dialysis) or a kidney transplant.

Kidney transplants are subject to organ availability, and locating viable donors with a viable kidney can be a lengthy and complex process. A typical course of treatment for people with end-stage kidney failure therefore usually begins with dialysis. This is a process to filter the blood and maintain balanced blood chemistry.

There are several types, but in France, most people undergoing this treatment are using ‘hemodialysis’.

Patients with end-stage renal disease must undergo dialysis several times a week, as prescribed by a kidney specialist (nephrologist), usually in a hospital or a dedicated facility.

However, it is also possible for patients to do dialysis treatments at home, using special medical equipment.

A nurse drop-by service exists to assist people with using the equipment at home.

People with chronic kidney disease or end-stage kidney failure register as patients with an affection longue durée (ALD).

All medical costs, including some related non-medical costs, are covered by Assurance Maladie at 100%.

Transplants: waiting times vary from 13 to 66 months depending on area 

Kidney transplant from a living or deceased donor makes it possible to restore kidney function in a person with end-stage kidney failure.

A transplant requires the donation of one kidney, as it is possible for both the living organ donor and the recipient to live a normal life with only one kidney without adverse impact on life expectancy or general health.

Waiting times for kidney transplants in France vary from 13 and 66 months depending on area.

People receiving a kidney transplant must be monitored by a nephrologist at regular intervals and are required to take immunosuppressive treatment for life to avoid rejection of the kidney transplant. Transplant patients can otherwise resume a normal lifestyle.

French law allows kidney donation from living donors, typically if the donor and the recipient are related. This is widely considered to give the best results.

Hospitals manage efforts to locate a viable kidney for people who are unable to find a viable donor among their relatives.

In France, people with end-stage kidney failure are systematically assessed for transplant to determine compatibility and possible contraindications and are put on a national waiting list.

Several thousand kidney transplants are carried out per year in France (about 15% involve living donors).

For more official information on organ donation, see: dondorganes.fr

Dialysis treatment can be reimbursed when travelling

If you are a dialysis patient and are planning to travel, Assurance Maladie may cover the costs of your treatment abroad. Your Ceam or Ehic European health insurance card can cover you in the EU and UK.

Elsewhere, dialysis costs are not reimbursed unless there is a bilateral agreement between France and that country. In the latter case, you should contact your Cpam before travelling for a form you can present in the country.

It may exceptionally be possible to obtain permission from Cpam to visit other countries and have dialysis refunded on your return, in which case it will be reimbursed at a maximum rate of €86.95 per dialysis session.