Renal failure and renal transplantation

Abstract

Acute renal failure, nowadays called acute kidney injury (AKI), is a sudden-onset disease with the inability of the kidneys to maintain body homeostasis and to excrete creatinine and urea adequately. AKI may be completely reversible but can be the first step to a chronic disease with a diminished number of nephrons, named chronic renal failure (CRF). In addition, AKI may be superimposed on CRF worsening the prognosis significantly. Neonatal AKI (nAKI) has to be seen in the context of switching from fetal situation to postpartal renal function and is discussed separately. Children suffering from congenital, hereditary, or severe acquired renal disease, basically or caused by injury, have a substantially diminished number of nephrons. Loss of nephrons cannot be replaced by new units, and recovery is impossible. Consequently, according to the patient’s age, different diseases enter a common pathway of progressive renal dysfunction, CRF. End-stage renal disease (ESRD) is reached when survival is only possible with renal replacement therapy. Aside from all medical and psychosocial care during CRF and ESRD, renal transplantation (RTx) is the ultimate goal to optimize rehabilitation and lifestyle.