How do the kidneys fail?
What does it mean when the kidneys fail?
So-called blood washing, hemodialysis, has been carried out since 1960. In Germany there are currently more than 60,000 patients requiring dialysis. In order to be able to clean enough blood in the hemodialysis machine, a connection between an artery and a vein on the forearm is necessary. This should be surgically applied under local anesthesia a few weeks before the planned start of dialysis, the so-called "shunt". The dialysis treatment itself is time consuming. The patient is treated on the artificial kidney three days a week, four to five hours each. Strict regulations regarding diet and, above all, the amount of water you drink (approx. ½ liter per day) determine his daily life.
Another method is the so-called "peritoneum dialysis" (peritoneal dialysis, or CAPD), which is carried out at home without any mechanical equipment, i.e. by the patient independently. A sterile rinsing solution is allowed to run into the abdomen via a surgically inserted tube (catheter) (2 liters), drain out again after approx. 4 hours and refilled with fresh solution. This change is repeated four times a day. The peritoneum acts as a membrane and the toxins get into the fluid from the blood.
Which method is suitable for the individual patient depends on various requirements and is discussed in detail with the patient. During the years that a patient is on dialysis, hope of a successful kidney transplant remains. It represents the best type of kidney replacement therapy. In the meantime, kidney transplantation has become a standard procedure (approx. 2250 per year in Germany alone) with excellent 5-year function rates of over 75%.
We are pleased that we can look after some of our long-term dialysis patients who have had kidney and, in some cases, simultaneous pancreatic transplantation at our nephrological center with the freedom we have gained for them. You are welcome to discuss these brief explanations with doctors and nurses in nephrology and dialysis in greater depth.
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