Iran (IMNA) - Kidney failure represents the final stage of kidney diseases, disrupting essential functions such as blood filtration, blood pressure regulation, and electrolyte balance. This impairment not only threatens physical health but also diminishes quality of life, daily functioning, and mental well-being. Treatment decisions depend on multiple factors including patient age, underlying conditions, and lifestyle.
Dialysis plays a vital role in sustaining life for those with kidney failure, but it is not a definitive cure. It serves as a substitute kidney function, yet long-term dialysis imposes limitations that can reduce patient independence and necessitate regular visits to healthcare facilities or reliance on home equipment. Hemodialysis and peritoneal dialysis are the two primary modalities, each operating through different mechanisms: hemodialysis requires advanced machinery and clinical visits, while peritoneal dialysis is home-based, granting patients greater freedom but requiring careful training and hygiene adherence.
Kidney transplantation, unlike dialysis, is a long-term and effective treatment that restores natural kidney function and enables patients to resume an active, independent lifestyle. However, transplantation demands comprehensive preparation—physically and mentally—and hinges on donor availability and compatibility. Successful outcomes rely on matching tissue types, meticulous post-surgical care, and consistent immunosuppressive therapy to prevent organ rejection.
Dialysis and Transplantation: Treatment Pathways for Kidney Failure Patients
Majid Shirani, a urology specialist and the faculty member of the Urology Department at Isfahan University of Medical Sciences, explained in an interview with IMNA that when kidney failure reaches end-stage—causing fluid and electrolyte imbalance—patients must pursue replacement therapies, namely dialysis or transplantation. He emphasized that although transplantation is preferred, dialysis remains essential both pre-transplant and for patients ineligible for transplant.
Shirani detailed that hemodialysis removes toxins and waste through blood filtration, while peritoneal dialysis uses the abdominal cavity to cleanse the body. Both prolong life but interfere with social and normal living. Hemodialysis requires multiple weekly sessions lasting several hours, whereas peritoneal dialysis demands multiple daily treatments by the patient. Despite its burdens, transplantation allows many patients to escape the constraints of dialysis and regain normal life.
The decision to proceed with transplantation involves evaluating the patient’s overall condition and readiness, as transplantation is a significant procedure requiring suitable donor identification. Shirani stressed that patients with kidney failure are best served by transplantation to restore normalcy, but some may not qualify, leading physicians to recommend ongoing dialysis instead.
Beyond physical health, kidney failure patients face psychological challenges including dependency feelings, fear of the future, social limitations, and financial strain—all threatening mental health. Psychological support, counseling, and robust support networks are critical in improving patients’ quality of life.
Families and society play pivotal roles in supporting kidney patients by participating in treatment decisions, providing daily care, and creating a stable, comforting environment. Public awareness about organ donation and reducing stigma related to chronic illness can facilitate smoother treatment journeys for patients.
Medical research holds promise for more sustainable, less costly, and effective treatments to complement or replace dialysis and transplantation. Advances such as bioengineered organs and regenerative technologies may soon transform care for millions of kidney failure patients worldwide, bringing renewed hope for longer, healthier lives.
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