Chronic kidney disease (CKD) affects over 35 million adults in the U.S., yet most remain unaware due to its asymptomatic nature until advanced stages. For those diagnosed later in the disease’s progression, the path forward usually involves dialysis and/or a kidney transplant are the only options for survival. Here, kidney transplant Nancy Marlin shares her deeply personal journey through CKD and offers a powerful argument for legislative action that could save thousands of lives.*

The Urgent Need for Living Kidney Donors

Marlin’s story reflects the grim reality for many: after being diagnosed with a genetic kidney condition, they were told a deceased-donor kidney would take 7 to 10 years to receive — a dire timeframe when over 91,000 people are already on the national transplant waitlist. 

Dialysis can extend life for people with kidney failure, but does not offer the same quality of life or long-term outcomes as transplantation. More than 8,500 people are removed from the kidney transplant wait list each year because they grow too frail for the surgery to be approved even if an organ should become available. Marlin’s own mother died while on dialysis, illustrating the system’s failure to meet urgent needs.

Marlin herself was fortunate enough to receive a transplant from a friend who acted as her living donor. This experience has galvanized her advocacy for expanding living donation, which remains the most effective but underutilized solution to the transplant shortage. For organ recipients, living donation:

• Decreases transplant wait times, 
• Reduces the risk of organ rejection, and
• Improves long-term outcomes and quality of life for the recipient.

Despite increased promotion efforts, living donor rates have stagnated, and systemic obstacles persist. Lost wages, travel costs, recovery times, and rigid work environments all act as barriers to living donor participation.

The “End Kidney Deaths Act”

In response, the author champions H.R. 2687 – the End Kidney Deaths Act—a bipartisan bill proposing a $10,000 refundable tax credit for five years to incentivize living kidney donations. This policy would ease financial burdens associated with donation, such as lost wages and travel expenses, while saving federal dollars, as transplants cost far less than ongoing dialysis.

Though some raise concerns about the exploitation of vulnerable populations, the rigorous donor evaluation process and delayed, staggered credit structure serve as safeguards. The proposed bill would also:

• Help address existing disparities, 
• Counteract illicit organ markets, and 
• Promote equity in a system where recipients are disproportionately affluent and White.

Ultimately, the author urges lawmakers and citizens alike to take action and support H.R. 2687 to offer a meaningful, measurable response to a growing public health crisis.

*Marlin, N. (2025, June 3). Opinion: Here’s a smart way to help many suffering from kidney disease. The San Diego Union-Tribune. https://www.sandiegouniontribune.com/2025/06/03/opinion-heres-a-smart-way-to-help-many-suffering-from-kidney-disease/