Present and future dialysis challenges

Abstract

A brief historical review of the successful development of dialysis as treatment for replacing lost renal function is given here. A discussion on the short-comings of different dialysis treatments is followed by references to the merits and limitations of kidney transplantation, xeno-transplantation, of newer biological systems and of novel ideas and devices. A discussion on current unmet dialysis challenges includes the design of services suitable for an aging and frail population, quality of life and acceptability of treatments taking into account cultural social and individual diversity. A general review of current dialysis Best Practice includes references to national and international guidelines with the need for technical improvements in different modalities and variations of different therapies aimed at solving individual patient problems. The need for more attention and for better solutions to the problem of chronic fluid overload is presented with the place for new dialysis technology in addressing it. © 2013 Springer-Verlag Berlin Heidelberg.