Optimal Treatment Strategies for End Stage Renal Failure

Optimal Treatment Strategies for End Stage Renal Failure
Claude Jacobs
During the past 40 years there have been major conceptual and technical advances in the domain of dialysis methods and renal/organ transplantation for long-term treatment of patients with End-Stage Renal Failure (ESRF). This now enables better defined, more selective strategies of treatment
to be undertaken, according to patient-specific criteria such as age or underlying renal disease also taking into account the lifetime duration of these treatments. For many patients this implies necessary successive changes of mode of therapy depending on their availability, occurrence of
medical/technical complications or failure and social environment and economic factors. This rationale has inspired the structure of this volume which is divided into four sections: 1/A descriptive overview of the various modes of renal replacement therapy (RRT): Extracorporeal
dialysis/filtration, peritoneal dialysis, kidney and multi-organ transplantation. 2/Most appropriate indications and use of these methods, respective advantages, drawbacks and outcome in children, pregnant women and elderly patients. 3/ In diabetic patients and in patients with heredity/congenital
diseases.4/ The ethical issues generated by this new domain in Medicine by limitations in treatment facilities or medical dilemas for acceptance, best technical choices, withdrawal or termination of RRT in individual patients. Finally, contributors from Eastern European Coutnries, Africa and Far
Eastern Countries analyse the current status of RRT in their respective geographical area and the ways and means required for a wider implementation of RRT in thus far lesser economically developed countries where the great majority of the populations still have no access to these life-saving
therapeutic procedures.