Question

Discuss in brief about non-transplant modalities for renal replacement therapy.

Hint:

Choosing the appropriate non-transplant modality for renal replacement therapy depends on the patient's clinical condition, availability of resources, and the patient's preference.

Answer 1

Renal replacement therapy (RRT) is used for patients with end-stage renal disease (ESRD) to replace the function of the kidneys. Non-transplant modalities for renal replacement therapy include:
Step 1: Hemodialysis (HD):
Hemodialysis is the most common form of non-transplant renal replacement therapy. Blood is removed from the body, filtered through a dialysis machine, and then returned to the body. This helps remove waste, excess fluids, and electrolytes from the blood. Hemodialysis is typically performed three times a week in a dialysis unit or at home, depending on the patient's needs.
Step 2: Peritoneal Dialysis (PD):
In peritoneal dialysis, a catheter is placed into the abdominal cavity, and a special dialysis fluid is introduced. Waste and excess fluids are removed by diffusion across the peritoneal membrane, which acts as a natural filter. PD can be performed at home and provides greater flexibility for patients.
Step 3: Continuous Renal Replacement Therapy (CRRT):
CRRT is a dialysis modality used in critically ill patients with acute kidney injury (AKI) who are unstable for intermittent hemodialysis. It is a slower, continuous process that can be performed 24 hours a day in an intensive care setting.
Step 4: Plasmapheresis:
Plasmapheresis involves the removal of plasma from the blood to remove harmful substances such as antibodies, toxins, or inflammatory mediators. It is used in certain conditions like autoimmune diseases, nephrotic syndrome, or in the management of nephritis.