Haemodialysis is the most commonly used modality of renal replacement therapy for end stage renal disease and some cases of acute kidney injury. A vascular access required for it could be a Arterio- venous fistula, Arterio venous graft or a dialysis catheter (tunneled or non-tunneled). Option (Intermittent haemodialysis, SLED or CRRT) might vary depending upon the underlying cause of renal failure, associated comorbidities and haemodynamic stability of the patient.
Kidney disease can be reversible if diagnosed and evaluated appropriately in early stages. It requires intervention in form of kidney biopsy, which is usually done under USG guidance. Glomerular disease requires appropriate use of immunosuppressive medications and other treatment modalities.
Relationship between hypertension and kidney disease is like between Hen and Egg; It’s difficult to decipher which came first. Adequate management of hypertension prevents the occurrence of kidney disease and cardiac diseases in future. The choice of antihypertensive depends upon the underlying comorbidities, age and race of the patients.
Peritoneal dialysis is a kind of renal replacement therapy, although a bit under rated. It requires an insertion of a catheter in abdomen through which regular dialysis can be performed at home or office. It provides a good quality of life and dialysis, without coming to hospital or dialysis center. CAPD or CCPD are usually preferred in patients with underlying cardiac disease and patients coming from remote areas where a good dialysis center is not available in vicinity.
Renal transplant is the best option for treatment for End stage renal disease patients. It provides the best results in terms of years and quality of life of a person as compared to any other modality of renal replacement therapy (Haemodiaysis and Peritoneal dialysis). Armamentarium of renal transplant is not just limited to live related blood group compatible transplant but it includes ABO incompatible transplant, swap renal transplant and deceased donor transplantation.
