KIDNEY REPLACEMENT THERAPY

WHAT YOU NEED TO KNOW

RENAL DISEASE is a spectrum of abnormal function of the kidneys. It ranges from mild, with minimal and possibly reversible abnormalities, to chronic and permanent dysfunction.

Data from the United States (US) in 2014 indicated that over half a million persons had been diagnosed with the chronic and permanent form of renal disease known as End Stage Renal Disease (ESRD). ESRD costs the medical services in the US over US$2 million a year to treat at a cost of over US$50,000 per patient.

When the kidneys fail completely, replacement therapies are needed to accomplish the natural functions of the kidneys and preserve the patient’s life. These methods include:

Dialysis

Haemodialysis

Peritoneal dialysis

Transplant

Dialysis is the process by which external devices clear the body of the waste products, which would normally be cleared by the kidneys.

In haemodialysis, the patient’s blood is passed through a machine which clears the waste products and returns the blood to the patient’s body.

In peritoneal dialysis, the internal lining of the abdomen is used as a filter with specialised fluid to accomplish the clearance of the waste products.

Haemodialysis is by far the most frequently used treatment therapy (64 per cent).

In order to be able to access the patient’s bloodstream, several methods have been devised. They include:

Catheters

Arteriovenous (artery to vein) connections

Arteriovenous grafts

Arteriovenous fistulas (AV fistualas/AVF)

The creation of an access into the patient’s bloodstream is the most critical part of this process, and each type has advantages and disadvantages.