PROSPECTS FOR RETRANSPLANTATION KIDNEY. CLINICAL CASE

Abstract

According to a number of large epidemiological studies, about 10% of the world's population suffer from chronic kidney disease (CKD), the most severe stage of which is end-stage chronic renal failure (ESRD). Chronic renal failure is a symptom complex that develops in chronic bilateral kidney diseases due to the gradual irreversible death of nephrons and is characterized by a violation of the homeostatic function of the kidneys. The disease is diagnosed in 10-13% of the adult population, and 20% of them are people over 60 years of age. In Russia, according to international studies, up to 27 million people suffer from chronic kidney disease. The task of conservative therapy is to slow down the progression of chronic renal failure, to eliminate factors that aggravate its course, as well as to correct hormonal and metabolic disorders inherent in uremia - anemia, hyperphosphatemia, hyperlipidemia. The fifth stage of chronic kidney disease, also called the stage of end-stage renal disease, means a decrease in kidney function by more than 80%, which leads to life-threatening disorders of homeostasis and metabolism. The only way to continue life at this stage is lifelong use of renal replacement therapy, which includes three varieties: hemodialysis, peritoneal dialysis and kidney transplantation. The aim of each type of this therapy is to replenish, as far as possible, the lost functions of the patient's kidneys. Recently, the quality and reliability of dialysis machines, water purification systems, vascular access has improved significantly. However, there are complications associated with the procedure. This is also facilitated by an increase in the number of patients with diabetes mellitus, cardiovascular pathology, who are most susceptible to interaction with a dialysis machine. If there is no possibility of a transplant, a long waiting list, or there are contraindications to surgery, dialysis therapy is the treatment of choice. It must be remembered that dialysis is also supportive therapy for transplant rejection.