I have been unable to find a kidney donor. My nephrologist wants me to start dialysis, but I don’t want to. Why can’t I just put my name on the list and wait for a transplant to become available?

Unfortunately, the waiting time for a deceased donor kidney transplant can be years. Also, you do not receive waiting time unless you are on dialysis. You may be listed for a kidney transplant when your GFR is less than 20 mL/min but you will not receive any waiting time (so you will not advance up the waiting list). However, if a 6 antigen matched (“perfect”) kidney became available, you would receive that kidney before everyone above you on the list. This is a rare occurrence, so you probably need to start dialysis while waiting for a kidney to become available.