| Kidney (Renal) Involvement (Main Menu) |
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| Kidney (Renal) Dialysis and Transplant |
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| Renal Dialysis and Transplant Overview |
| There are two primary treatment options for end stage renal disease, dialysis and transplant. Dialysis is an artificial system for cleansing the blood. Kidney transplantation is a surgical procedure that places a healthy, donated kidney into the patient with kidney failure. |
| The question of the best method of treatment is a difficult one to answer. There are several issues that need to be addressed. The advantages and disadvantages of each kind of treatment affect each person differently. Renal patients should learn all they can about each method of treatment. Treatment should be tailored to meet the individual’s need so that she/he can remain as self-sufficient as possible and continue to be a productive member of society. Emory Transplant Center |
| Renal Dialysis |
| When the kidneys fail, dialysis of some form must be instituted to take over the work of the failed kidneys. There are two types of kidney dialysis: hemodialysis and peritoneal. |
| FAQ about Dialysis Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs. You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function. NKFI. |
| Renal manifestations of systemic autoimmune disease: diagnosis and therapy. Renal involvement is relatively common in certain systemic autoimmune diseases, but can be clinically silent. Scleroderma renal crises are managed by blood pressure control using angiotensin-converting enzyme inhibitors and other agents as required. Dialysis and transplantation can be successful in these conditions. PubMed. Best Pract Res Clin Rheumatol. 2004 Jun;18(3):411-27. (Also see: Renal Involvement) |
| Hemodialysis |
| Home Hemodialysis. In 1960, Dr. Belding Scribner and his colleagues in Seattle demonstrated for the first time that patients with chronic kidney failure could be kept alive for long periods with the use of an artificial kidney. Within a few years, the idea was developed to treat patients with the artificial kidney in their homes. Home hemodialysis is now accepted as an excellent method of caring for patients with kidney failure. NKFI. |
| Improving Quality Of Life For Dialysis Patients. The mission of the Cincinnati Dialysis Access Research Program (CAP) is to improve the quality of life for dialysis patients by reducing the problems associated with dialysis vascular access. Medical News Today. 09/15/07. |
| Association between calciphylaxis and inflammation in two patients on chronic dialysis. The interactions between inflammation-mediated changes in the levels of endogenous inhibitors of calcification and abnormalities in calcium-phosphorus metabolism merit intensive study in the future as potential mechanisms of calciphylaxis. PubMed. Adv Perit Dial. 2006;22:171-4. (Also see:Calcinosis ) |
| Peritoneal Dialysis |
 Peritoneal Dialysis. With peritoneal dialysis (PD), you have some choices in treating advanced and permanent kidney failure. Since you don't have to schedule dialysis sessions at a center, PD gives you more control. You can give yourself treatments at home, at work, or on trips. NIH Publication No. 06–4688 May 2006. |
 Treatment Methods for Kidney Failure: Peritoneal Dialysis The most common form of PD, continuous ambulatory peritoneal dialysis (CAPD), does not require a machine. As the word ambulatory suggests, you can walk around with the dialysis solution in your abdomen. Other forms of PD require a machine called a cycler to fill and drain your abdomen, usually while you sleep. The different types of cycler-assisted PD are sometimes called automated peritoneal dialysis, or APD. NIDDK. The cycler — which automatically fills and drains your abdomen, usually at night while you sleep — can be programmed to deliver specified volumes of dialysis solution on a specified schedule. NIDDK. |
| Kidney Options. See: Continuous Cycling Peritoneal Dialysis. Kidney Options. |
| Anemia and Erythropoietin |
| Anemia in Kidney Disease and Dialysis Anemia is common in people with kidney disease. Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs. Diseased kidneys, however, often do not make enough EPO. As a result, the bone marrow makes fewer red blood cells. If no other cause for EPO deficiency is found, it can be treated with a genetically engineered form of the hormone, which is usually injected under the skin two or three times a week. NIDDK. (Also see: Anemia) |
| Erythropoiesis-Stimulating Agents (ESAs): FDA Public Health Advisory. ESAs have shown a higher chance of serious and life-threatening side effects and greater number of deaths in patients treated with these agents. FDA Advisory, 03-09-07. |
| Diet and Dialysis |
| Well Nourished Patient Once a patient begins dialysis treatments, there are four main restrictions to their "renal diet": Fluids, Sodium (Na), Potassium (K), and Phosphorus (P). RenalWEB. |
| Kidney Transplant |
| Belatacept: New drug that selectively blocks immune responses protects kidneys after transplant. Patients who took the experimental drug, a co-stimulatory blocker called belatacept (LEA29Y), also had better kidney function and experienced less of the toxic side effects associated with standard anti-rejection drugs. News-Medical.Net 08/24/05. |
| Are autoimmune diseases or glomerulonephritis affecting the development of panel-reactive antibodies in candidates for renal transplantation? There is an association between high PRA level and autoimmune diseases causing renal failure regardless of the previous KTx status. Besides the risk of recurrence, autoimmune disease seems to affect the risk of graft loss due to rejection. PubMed. Transplant Proc. 2005 Mar;37(2):645-7. |
| Late Recurrence of Scleroderma Renal Crisis in a Renal Transplant Recipient Despite Angiotensin II Blockade. Late recurrences of scleroderma renal crisis are possible in renal transplant recipients and angiotensin-converting enzyme inhibitors, rather than angiotensin II receptor blockers, may be the superior drugs for such patients. PubMed. Am J Kidney Dis. 2005 May;45(5):930-4. |
| Detecting the Genes That Contribute to Transplant Rejection. The Scripps Research Institute has been awarded a new federal research grant of more than $12 million over five years to apply cutting-edge genomic technologies to advance our understanding of kidney transplantation. AScribe. 11/19/04. |
| Kidney Transplantation for Systemic Sclerosis Improves Survival and may Modulate Disease Activity. Kidney transplantation confers a survival benefit in ESRD (end stage renal disease) due to SS. Transplantation may be associated with an improvement in systemic manifestations of disease. Despite suboptimal graft survival, kidney transplant should be considered the treatment of choice in ESRD due to SS. PubMed. Am J Transplant. 2004 Dec;4(12):2027-31. |
| Research Articles |
| Far-infrared (FIR) therapy: a novel treatment to improve access blood flow and unassisted patency of arteriovenous fistula in hemodialysis (HD) patients. FIR therapy, a noninvasive and convenient therapeutic modality, can improve access flow (Qa) and survival of the arteriovenous fistula (AVF) in HD patients through both its thermal and its nonthermal effects. J Am Soc Nephrol. 2007 Mar;18(3):985-92. |
| Dialysis-associated systemic fibrosis (nephrogenic fibrosing dermopathy): Study of inflammatory cells and transforming growth factor beta1 expression in affected skin. Our findings indicate that the fibrotic process of NFD affects not only the dermis, but also the subcutaneous tissues, fascia, and other organs, including striated muscles, heart, and lungs. We therefore believe this is a systemic fibrosing process, and we suggest that dialysis-associated systemic fibrosis would be a better term for the condition. PubMed. Arthritis Rheum. 2004 Aug;50(8):2660-6. (Also see: Diseases Similar to Scleroderma: Nephrogenic Fibrosing Dermopathy) |
| Increased risk of anemia in dialysis patients with comorbid diseases. Recent analyses conducted by the United States Renal Data System indicate that dialysis patients with concomitant comorbidities such as systemic lupus erythematosus, multiple myeloma, acquired immunodeficiency syndrome, or other secondary glomerulonephritis/vasculitis are at greater risk for anemia. PubMed. Nephrol Nurs J. 2004 Mar-Apr;31(2):211-4. |
| Historical and Clinical Overview of Recombinant Human Erythropoietin. In addition to renal disease, recombinant human erythropoietin (RHuEPO) is used to treat anaemia associated with other conditions requiring blood product support, including premature birth, malignancy, bone marrow/stem cell transplantation, surgery, HIV, rheumatological disorders, haemolysis, and anaemia in the critically ill. Doctor's Guide. 08/19/2003. Postgrad Med J 2003 Jul;79:933:367-376. (Also see: Renal Involvement) |
| Scleromyxoedema-like changes in four renal dialysis patients We describe four renal dialysis patients from our hospital who, over a 6-month period, developed erythematous, thickened, indurated dermal plaques. The plaques were limited to the limbs and in three patients there were associated flexion contractures. The clinical features most resembled scleromyxoedema. We believe this to be a new and distinct phenomenon. PubMed. Br J Dermatol 2003 Mar;148(3):563-8 (Also see: Diseases Similar to Scleroderma: Scleromyxedema) |
| Nephrogenic fibrosing dermopathy: an unusual skin condition associated with kidney disease We report the case of a patient who, while on long-term hemodialysis (HD), developed nephrogenic fibrosing dermopathy, a newly described sclerosing skin disorder. This disorder is characterized by thickened, hardened skin with brawny hyperpigmentation and raised plaques. In contrast to scleroderma, inflammatory cells are generally absent. PubMed. Semin Dial 2003 May-Jun;16(3):276-80 (Also see: Diseases Similar to Scleroderma) |
| Long-Term Outcomes of Scleroderma Renal CrisisRenal crisis can be effectively managed when hypertension is aggressively controlled with ACE inhibitors. Patients should continue taking ACE inhibitors even after beginning dialysis in hopes of discontinuing dialysis. 17 October 2000 Volume 133 Number 8 Annals of Internal Medicine. |
| Patient Support |
| National Kidney Foundation Inc. The National Kidney Foundation, Inc., a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability of all organs for transplantation. NKFI. |
| Patient & Caregiver Stories |
| Archie Bailey: Scleroderma: Sue's Story Time has passed since Sue's death. Only those who have experienced the grieving process can understand... |
| Corey C: Surviving Daughter of Scleroderma Patient It was a very long process and scary because she really did not know what to expect next... |
| Judy Dee: Diffuse Scleroderma My skin began to harden and turn a shade of brown... |
| Robin H: End-Stage Renal Disease (ESRD)/Transplant Recipient It has been almost two years now since my kidney transplant. I am doing better than ever... |
| (Turkish) Ruko: Sistemik Skleroz Mart itibari ile sistemik skeleroz tanisi ile Cerrahpasa Tip Fakultesi Romotoloji servisinden taburcu oldum... |
| Sandy: Diffuse Scleroderma After years of complaining about various symptoms to doctors, I was diagnosed with Diffuse Scleroderma in 1993... |
| Sherrill: Diffuse Systemic Scleroderma (New Zealand) I could no longer walk, due to knee contractures. My hands resembled claws. I had elbow contractures and neck contractures, and could not straighten my arms... |
| Sherrill: My Experience with Anemia Since I became ill with diffuse scleroderma just over eight years ago, I have found that anemia is a quite complex subject... |
| Susan H: Eosinophilic Fasciitis While I was in the hospital and starting dialysis, my right arm became hard as a rock and swollen... |
| Related Pages |
| Scleroderma Kidney Involvement ISN. |
| What is Scleroderma? ISN. |
