Description
Renal Replacement therapy is used to replace the lost functions of the kidneys, such as filtering the blood, regulating electrolyte balance, and producing hormones. There are two main types of RRT: hemodialysis (HD) and peritoneal dialysis (PD). Hemodialysis is a process that involves removing blood from the body, filtering it through a machine, and then returning it to the body. PD involves using the lining of the abdomen as a filter for waste and excess fluid removal. RRT can help patients maintain their quality of life by improving their symptoms, reducing complications, and extending their lifespan. Choice of RRT modality is based on various factors such as age, health status, lifestyle, and preferences of the patient.
Résumé
- Renal Replacement Therapy (RRT) addresses kidney dysfunction by supplementing or replacing kidney function with external devices or transplantation. While kidney transplantation involves adding an organ, RRT, including dialysis, focuses on substituting lost kidney function in patients with varying degrees of kidney failure. The increasing prevalence of secondary kidney diseases like those linked to diabetes and hypertension, is predicted to dramatically increase the need for RRT by 2030.
- Emergency indications for RRT include hyperkalemia, metabolic acidosis, and fluid overload, often addressed via hemodialysis. Chronic symptoms like anorexia, nausea, and malnutrition also warrant RRT consideration, especially when diet and medication fail to manage the patient's condition. Treatment options encompass hemodialysis, peritoneal dialysis, and kidney transplantation, each with its own set of indications, contraindications, and suitability for individual patients.
- Hemodialysis involves filtering blood externally using a dialyzer with a countercurrent mechanism to maximize toxin extraction. A surgically created arteriovenous fistula facilitates access for blood removal and return. However, fistulas present risks of infection and thrombosis. Peritoneal dialysis utilizes the peritoneal membrane as a natural filter, with dialysate fluid infused into the abdominal cavity.
- Peritoneal dialysis is good for some time period, and then HD provides better benefits to those, if not transplantation is always beneficial in compare to HD and PD, vaccination against hepatitis B, pneumonia, and influenza are crucial for patients undergoing dialysis due to their increased susceptibility to infection in dialysis centers. Preserving residual renal function is also important for survival and better patient outcomes.
- Kidney transplantation is offered to patients with good overall fitness, willing donors, and adequate financial support. While transplant kidneys are placed in the iliac fossa, the original kidneys are usually left intact. When RRT isn't feasible or desired, palliative care prioritizes comfort and symptom management. Emerging technologies like regenerative medicine and wearable artificial kidneys hold promise for future kidney care.
Exemple de certificat
À propos des intervenants
Dr Govardhan Gupta
MBBS, DNB (General Medicine), DNB (Nephrology), MNAMS (New Delhi)
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