The ideal time to receive a transplant is when a person’s kidney function is poor but not so bad that they are very ill or requiring dialysis. The estimated glomerular filtration rate (eGFR) level, which is checked regularly in people with kidney disease, can be considered as an approximate percentage of kidney function – someone in their mid-20s with two good kidneys is considered to have 100% of function. Most people will feel pretty poorly and need a transplant or dialysis by the time that their function is at 10%, and the ideal window for transplantation is between 10% and 15%. For some people, whose kidney function declines very slowly, this window may be as long as 2 or 3 years, however for others with a rapid decline in function it is a few months only.
Unfortunately there are still more people needing a transplant than available organ donors, and it is unusual for someone to be offered a kidney from a deceased donor (someone who has died) before dialysis is required. However, if there is a family member or friend who is willing and suitable to give a kidney (a living donor) then it is certainly possible to avoid dialysis entirely.