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CARRIE SCHINSTOCK: Whenever you're preparing your patient for dialysis or thinking about dialysis, you should also be thinking about whether your patient may be a candidate for a kidney transplant. A transplant before dialysis is called a preemptive kidney transplant. And these preemptive kidney transplants are associated with better outcomes. Patients who get preemptive transplants live longer and also their kidney transplant lasts longer.

We can start working a patient up for a kidney transplant when their glomerular filtration rate is less than 25. And patients can begin to accrue waning time on the waning list when their GFR reaches less than 20. Example of a second opinion we often get is for someone who has a recurrent disease. They have had a kidney transplant. They lost it because their original kidney disease came back. We have research protocols to help many of those patients.

Additionally, I think one of the issues that many patients are now experiencing is obesity. Some patients may have not been transplant candidates in the past because of obesity. Their weight is above what is considered the traditional cutoff for a kidney transplant. But now, here at Mayo, we have novel protocols to help people lose weight and do well after a kidney transplant.

We have access to a lot of different research protocols. We are involved in kidney-paired donation and have access to large national programs. And one thing that really sets us apart is we not only are important for kidney transplant in Rochester, in Phoenix, or in Jacksonville, but we actually work together. We work together to integrate our protocols so that we have best practice. And if there's something that we can't do in Rochester, for example, I can talk to my colleagues in Arizona or Jacksonville.

One of the main reasons I think people should choose Mayo Clinic is our dedication for that kidney transplant to last a long time and take care of patients whether they're having side effects from medications, developing infections, malignancies, or other complications from their transplant. What sets us apart is we're dedicated to that patient long-term.