Renal Replacement Therapy

What is kidney transplantation?

When a new kidney is surgically placed in a patient whose native kidneys are not functioning, it is called kidney transplantation.

Which are the patients who need transplantation?

End stage kidney disease or CKD stage 5

Common causes of ESRD

1. Diabetes
2. Uncontrolled high blood pressure
3. Chronic Glomerulo nephtitis
4. Polycystiiz kidney disease

Renal transplantation is a form of renal replacement therapy which is a definitive treatment for pts with CKD stage 5.

Only one donated kidney is needed to replace 2 failed kidneys the donor kidney is usually placed in the lower abdomen and the connections are made between new kidney and patients arteries, veins and ureters is connected to bladder.

More about KT

There are two types of Kidney Transplantation

1. Live;- From first degree relative
2. Cadaver- brain dead donor
3. Living – donor kidney Transplant
4. Deceased –donor kidney transplant (cadaver)
5. Pre-emptive kidney transplant

Donation from unrelated or commercial donation is not acceptable and is illegal one can not buy or sell kidney the relationship is proven by tissue matching and other means

Compared to dialysis, Kidney Transplant is associated with

1. Better quality of life
2. Lower risk of death
3. Fewer dietary restrictions

Pre-emptive Kidney Transplant

Some patients may also benefit from receiving a kidney transplant before needing to go on dialysis, it is called as pre-emptive Kidney transplant.

Contraindications to Kidney transplant

1. Advanced age
2. Severe heart disease
3. Active or recently treated cancer
4. Poorly controlled mental illness
5. Dementia
6. Alcohol or drug abuse


When the loss of kidney function is severe and GFR drops < 15ml/min the kidneys cannot excrete the waste material from the body this leads to accumulation of toxins, extra water and electrolyte disturbance.