I am Dr. Nadiesda Costa.
I am a physician.
I specialize in kidney transplantation at
MedStar Georgetown Transplant Institute.
I see patients with
End Stage kidney disease
looking for treatment options.
The typical treatment options are dialysis or transplantation.
Kidney transplantation has been
the best choice for patients
with end stage kidney disease.
I also see patients
that are of Spanish descent that speak Spanish.
For my patients, I treat them as a whole.
I treat them like they are my family.
In part, my work feels like an extension of my family.
I have a bigger family here and I want to treat the whole person.
A long time ago, when I was in medical school, I did work
with a nephrologist that inspired me in kidney transplantation.
For a long time, I
put that aside and went through my standard training.
But in the end, I really wanted to help people
with kidney disease.
There are so
many people with kidney disease
in the world and in the place that I am from,
a kidney transplant was a dream when I was training.
It was
nothing that you could see in reality.
So, getting to that point,
when I was seeing patients with end stage kidney disease
struggling with dialysis, I wanted to do more.
I wanted to give the patients a close to a normal life as possible.
And transplantation does offer that.
My job is exciting,
I think, every day. Every day is a challenge.
We see a lot of diversity
in people,
in culture, and disease presentations.
My colleagues also are wonderful, the environment is very nice.
I do love coming to work
and seeing what's
ahead of my day, but also just having my partners, my
colleagues and all the
staff just making it better.
That's one of the most important parts.
So, in the last five
years, in transplantation, there's been a lot of excitement and
looking at the future, as far as making the kidneys
last longer, we have a shortage of kidneys.
We have a lot of
patients that need kidney transplants.
And so diagnostic testing,
non-invasive diagnostic
testing has advanced recently. That's one of
the things I'm very interested in and to make sure
that we can get ahead, we can predict early,
what's next with the transplant?
What do we have to face? What are our challenges?
So, that's been the most
exciting part and the most innovative in the last five years.
Patients should come to MedStar Georgetown University Hospital.
Because we have a great team. We look at
the whole person. For kidney transplantation, particularly,
we offer a lot of services
from before the transplant in the early
days, in the pre-transplant stage,
helping them obtain a living donor, offering them
services such as how to build a website.
There's also donor benefits that we have
and we have access to state of the art
testing to a high level of expertise
across all the fields of medicine.
I chose MedStar as my future in my career
because I do believe in all of those things.
I believe in
treating the whole person.
I believe in having collaborative team
to make it better for the patient.
The most common cause of
kidney disease in the United States
is diabetes, followed
by high blood pressure.
Diabetes and high blood pressure are chronic conditions that are progressive.
And, in time,
especially if
they're not recognized or particularly well cared for, they can affect
the kidneys.
It is not clear exactly
how diabetes and high
blood pressure cause kidney disease,
but it is thought that over time, just
the constant
process of the high blood sugar
and high blood pressure affects the kidney tissues.
The treatments for end stage
kidney disease
are dialysis
and kidney transplantation.
Kidney transplantation, by far, is the best treatment.
It improves the life of
the patient,
and allows you to live longer and better.
There are two main different types of kidney transplants.
One from a living donor and one from a cadaveric donor.
A living donor transplant,
it's better.
it lasts longer,
the patients do better,
the patients live longer.
So, we recommend living donor transplantation as
the best treatment choice.
We have special programs
that can help
patients obtain a living donor.
They do not have to
be the same blood type.
If you have a potential donor that is not the same
blood type, we can enter an exchange program.
We can enter a registry where
your donor can give on behalf of you to another
recipient, and that recipient's donor can give a kidney to you,
and thus solving the problem with the blood type.
So, that is an unique program
that we participate in.
We probably have one of the largest
participations in the country.
A patient receiving a kidney transplant allows
them to be close to a normal person.
They will live longer and better.
They will have a close to a
routine that a normal person would have
that has any medical condition.
It is, compared to dialysis, less time consuming.
Dialysis can be hard on the body
and it takes a long time.
With transplantation, patients to need to take medications.
They need to see
doctors, once they are stable,
about 3 to 4 times a year.
That allows them to do more things with their life, allows them to travel,
to stay healthier, to be more
present for their families.
Unfortunately, the wait for a kidney transplant
for a donor from the list, a cadaveric donor can be a long time.
There are many factors that go into it.
The primary driving force is blood type.
But if you have a living donor, there is no
wait time.
And this is why it's important to really
enforce that, to really
think about that.
We don't think about
living donation from kidney
as part of our daily thing like we think about
other things like blood donation.
So, we're trying to get the message out.
People need to
talk about this and tell their stories.
And it is true,
people do not realize that there are
kidney donors needed.
If you go to
wait on the list, the wait time could be
seven years or more
for certain blood types
that usually wait the longest.
To get a
living kidney donor,
we need to tell our story.
We need to say,
we have kidney disease.
We need to get
the message out there that kidneys are not readily available.
That we need
our friends or family to help.
To get a living kidney donor,
we have resources
at MedStar Georgetown Transplant Institute
that can help donors get the message out.
Such as the ability to create
a microsite where you can share with your friends on your social media
Tell your story of why you
have kidney disease.
That your doctor has said that that is the best treatment option.
I think that is what gets you the furthest.
And in my experience,
we've seen a lot of people being successful that way
So, when a patient gets a kidney transplant,
they're going to look towards the future
for a long life as compared to dialysis.
Dialysis, it's hard on the body
and it causes a lot of problems.
And patients
start having complications
very early on. With a kidney transplant,
at five years,
over 95% of people are alive.
Especially if you get a living donor.
Living donor recipients live longer.
So, it is a very fruitful life
where you are close to what the general
population is
that does not have kidney disease
or have a transplant.
Patients that receive kidney
transplants can have the transplant for a long time.
All you have to do
is take your medications every day, listen
to your doctors,
listen to the advice of your team, come to your appointment.
It really is
something you can do.
And when compared to
being on dialysis or treating other
diseases
such as diabetes
or high blood pressure, it's
very similar to just going to your doctor for your regular checkups,
usually, after the first year, every 3 to 4 months.
So, the medications are essential, but it is doable
and they become simpler over time.
I think in the beginning it may seem like patients
have to take a lot of medication for a kidney transplant.
But over time, the medications
become a lot simpler.
Most of the
patients usually
don't take a lot of medications
compared to the medications that they were taking before.
A lot of the conditions tend to improve.
And there may be less medications
for high blood pressure and less medications
overall. I think it is a very it's
a very good tradeoff considering the amount of time
and medications that are necessary
when you are on dialysis.
I offer services to Spanish speaking patients.
There is a large population
of Spanish speaking patients that
come to MedStar Georgetown Transplant Institute.
We have, now, a team
that includes myself and other level of staff
to make their care more personal, to make them more comfortable.
It is important
to see a familiar face
when you come to your medical care.
End stage kidney
disease and kidney transplantations
are stressful conditions.
It is hard to go through the process of evaluation and
continue to care for a kidney transplant.
So, when you have a familiar team that shares
some of the background and culture and
speaks the same language, it is better.
And that's one of the reasons that I joined
MedStar Georgetown Transplant Institute,
to provide that service to those patients
that really need it.
Nosotros ofrecemos una clínica en español.
Yo soy una doctora que viene
de un país latino y me
gusta darle a los pacientes
la opción de ver alguien más familiar,
alguien que pueda ser más personal, que pueda hablar el mismo idioma.
Este servicio particularmente ofrecido por
mi y tenemos también
otros asistentes que hablan español.