Acute kidney failure is recoverable, whereas chronic one is irreversible and generally progressive, although progression varies depending on the cause of chronic kidney failure. Dr Tarun Kumar Saha, Sr. Consultant Nephrologist & Transplant Physician, Yashoda Hospitals, Hyderabad, shares that kidney failure can occur when the body's toxic levels of waste and fluid build-up due to the kidneys lose their ability to filter. The condition is called end-stage renal disease.
All kidney failure patients don't require Kidney replacement treatment. Instead, kidney failure patients are staged per kidney function, which is described as GFR(Glomerular filtration rate). GFR can be calculated by e-GFR APP, which can be downloaded on mobile or computer.
Patients in CKD stages 1 to 4 are managed without renal replacement treatment. Proper management of CKD at these(stages 1 to 4) stages can retard kidney disease progression and prevent the need for kidney replacement treatment for years or even decades.
Kidney replacement treatment can be in the form of either lifelong Dialysis or kidney transplantation. There are two types of Dialysis- Hemodialysis(HD) and Continuous Ambulatory Peritoneal Dialysis(CAPD). For long-term Haemodialysis, one needs to have a functioning Arterio- Venous Fistula (AV Fistula).
Continuous Ambulatory Peritoneal Dialysis
The CAPD body's Peritoneum, a membrane inside our abdomen, is used for dialysis. Although regular HD and CAPD can substitute the kidney's filtration function, non-filtration functions like maintaining the body's blood haemoglobin level, activation of vitamin D and many other kidney functions cannot be done by dialysis. At the same time, successful Kidney transplantation restores all parts of the kidney. One has to undergo HD at least two or three times a week. It's primarily done in a hospital setup. CAPD needs to be done at least three times daily at home. For any dialysis, one has to spend lots of time which affects one job and lifestyle.
Except for people with very short life expectancy due to other diseases like incurable cancers, chronic irreversible other organ failures, and advanced dementia, all others can be considered for kidney transplantation.
In kidney transplantation, a healthy kidney from a donor is removed and attached to the lower part of the abdomen of the recipient suffering from End-stage Kidney Disease. Immediate family and close friends may qualify for Kidney donation after the due legal process.
In both types of kidney Transplantation, both donor and recipient are screened for immune-related matching, infections and may parameters to prevent complications.
Although dialysis treatment is readily available and feasible for almost all patients, Kidney transplantation, either from a live donor or a deceased donor, is the best option for stage 5 Chronic Kidney failure patients.
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