Medical problems in dialysis patients awaiting renal transplantation

Abstract

While awaiting renal transplantation, patients with end-stage renal failure frequently have to spend a period of time on dialysis. Although dialysis controls uraemia, the patient undergoing dialysis still faces problems related to the continuing uraemic state such as anaemia, renal bone disease, malnutrition and cardiovascular complications. Apart from the problems related to uraemia, patients on dialysis are also exposed to problems that are peculiar to the mode of dialysis. In haemodialysis, patients face complications related to the use of heparin and dialyser related problems such as air embolism and haemolysis. Patients on continuous ambulatory peritoneal dialysis (CAPD) are exposed to complications such as infection, hernias and hypertriglyceridaemia. The introduction of hormone therapy with erythropoietin and vitamin D and recent advances in dialysate solutions and biocompatibility of membranes in haemodialysis and in control of infection and a better understanding of peritoneal kinetics in CAPD have helped to overcome some of the problems in dialysis patients.