Kidney transplantation and renal replacement techniques

The kidneys are those organs of the body with the highest throughput of blood. They fulfil very important functions: They eliminate harmful or useless metabolic end products as well as foreign ("non-self") substances (such as medicines) from the body, they regulate the body's fluid balance and excrete various hormones which are involved in blood formation (haematosis), blood pressure regulation and bone metabolism. Kidney disorders can be caused by diabetes, long-term intake of large doses of certain drugs and by genetic diseases such as cystic kidney condition and renal shrinkage. In addition, secondary damage can be caused to the kidneys, for instance when chronic hypertension is not treated adequately. Kidney insufficiency or pyelonephritis are further severe pathological renal conditions. Failure of both kidneys is fatal unless treated. 

One way of treating insufficient kidney function is with the aid of so-called dialysis techniques. Two different dialysis techniques are used: haemodialysis and peritoneal dialysis. In the first case a dialysis device is used as an external, artificial kidney which filters the blood. The dialysis takes four to five hours and is carried out three times a week. The patient must follow a strict and permanent diet so that certain toxic substances which the device cannot eliminate from the blood do not accumulate in the body. Also, patients must not drink too much, because the malfunctioning kidneys are not able to sufficiently remove fluids from the body. Peritoneal dialysis, which is only very rarely practised in Germany, does not involve a device. In this technique the peritoneum is used as a natural filter organ. As kidneys usually come in pairs, the risks involved in living donation are smaller than for instance in the case of donating a part of ones liver. The single kidney remaining to a living donor still reaches up to 80% of the filtration capacity of two kidneys.

Verband Deutsche Nierenzentren (DN) e.V. – German professional association of medical specialists for hypertension and renal diseases Online Version (German)

Kuratorium für Dialyse und Nierentransplantation e.V. (KfH) Online Version (German)

Further information on the website of the DSO: Online Version

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