Can people with Alport’s syndrome have dialysis or a kidney transplant?

Dialysis can be performed in someone with Alport’s syndrome, just as in other people with kidney failure. For information on the two main types of dialysis, click here for haemodialysis and peritoneal dialysis

Kidney transplantation can usually be performed in someone with Alport’s syndrome, just as in other people with kidney disease. Indeed, because kidney failure develops slowly, it may be possible to get a transplant from a relative just before complete kidney failure, so that the person affected does not need dialysis. A history of cancer or heart trouble could make transplantation unsafe. Click here for more information on kidney transplantation and living donor transplants.

Living donor transplantation can be performed from a healthy family member. One question that sometimes arises is whether a mother who has Alport’s syndrome, but with normal kidney function, could donate a kidney to her son, who has kidney failure from Alport’s syndrome. There are only one or two reports of this ever happening, because doctors have been worried that either the mother will develop kidney failure with only one kidney, or the slightly abnormal kidney transplanted to the son will be more likely to fail. Such transplants must be considered experimental, but may be performed in individual cases after much consideration.

Rarely, kidney transplantation in someone with Alport’s syndrome can be virtually impossible. Alport’s syndrome makes collagen in the kidney an unusual shape, which the body recognises as if it were an invader or a germ, and produces an antibody to fight it off. The antibody is called ‘anti-glomerular basement membrane antibody’, or anti-GBM. These antibodies can attack a kidney transplant and cause it to fail. Someone with Alport’s syndrome should have tests for these antibodies if transplantation is considered. A single blood test is all that is necessary. If anti-GBM antibodies are present, their significance should be discussed with the kidney specialist to see if there is any chance of removing them prior to a transplant.

Anti-GBM antibodies can develop after a kidney transplant, even if they were not present before. This may occur in about 1 in 20 transplants. This can be treated, although the success rate is not 100%.

NKF Controlled Document No. 51, Can people with Alport’s syndrome have dialysis or a kidney transplant?, written 2 September 2002. Last reviewed 29 November 2010.

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.