Renal Failure and Kidney Transplantation
Renal failure occurs when the kidneys become unable to perform the excretory functions needed to maintain homeostasis. When kidney filtration slows for any reason, urine production declines. As the decline continues, signs and symptoms of renal failure appear because water, ions, and metabolic wastes are retained. Virtually all systems in the body are affected. Fluid balance, pH, muscular contraction, metabolism, and digestive function are disturbed. The individual generally becomes hypertensive; anemia develops due to a decline in erythropoietin production; and CNS problems can lead to sleeplessness, seizures, delirium, and even coma.
Acute renal failure occurs when renal ischemia, urinary obstruction, trauma, or exposure to nephrotoxic drugs causes filtration to slow suddenly or stop. The reduction in kidney function occurs over a few days and may persist for weeks. Sensitized individuals can also develop acute renal failure after an allergic response to antibiotics or anesthetics. Most deaths associated with acute renal failure are caused by the underlying non-renal disease. With supportive treatment, the kidneys may then regain partial or complete function. (With supportive treatment, the mortality rate is approximately 50 percent.) In chronic renal failure, kidney function deteriorates gradually, and the associated problems accumulate over years. This condition generally cannot be reversed; its progression can only be slowed, and symptoms of end-stage renal failure eventually develop. The symptoms of end-stage and acute renal failure can be relieved by kidney dialysis, but this treatment is not a cure.
Probably the most satisfactory solution to the problem of end-stage renal failure, in terms of overall quality of life, is kidney transplantation. This procedure involves the implantation of a new kidney obtained from a living donor or a cadaver. Of the 17,090 kidneys transplanted in 2006, 6434 came from living...