Kidney Dialysis and Kidney Transplantation - Essay Example

"A Comparison of Kidney Dialysis and Kidney Transplantation" INTRODUCTION Kidney failure is one of the most common and most lethal type of organ failure. The kidneys, a pair of bean-shaped organs acts as filters for blood and other body fluids. Without the kidneys, the body will succumb to the toxins it encounters everyday. Toxins filtered by the kidneys are excreted out of the body through the urinary system mixed with urine. Toxins and other harmful substances, come from various sources such as the environment (in the air, water and other environmental factors), from our food especially those laced with high amounts of preservatives and artificial flavours, from the liquids that we drink such as alcoholic drinks and liquid medicinal preparations, and from imbibed poisons taken in accidentally or intentionally. Many die from kidney failure each day and in the U.K. alone, about 5,000 people develop renal failure annually (RDS Online, 2000). Kidney failure can be averted by performing either a kidney transplant or by hooking up the patient in a dialysis machine. Using a dialysis machine involves connecting the patient's circulatory system to a huge dialysis machine or artificial kidney which takes the role of a pair of kidneys. About 19,000 of people suffering from kidney failure are connected to dialysis machines (BBC, 2004). A kidney transplant on the other hand, involves surgically removing a patient's failed kidneys and replacing them with a healthy pair from a kidney donor. Such operations are rare and risky, and sometimes a kidney patient must wait for a year or more to receive a healthy kidney. More often than not, a patient dies before he or she receives the kidney. Both methods however are seen as the only viable solutions in the treatment of kidney failure available today. A comparison of both methods of kidney failure treatment and their procedures and the effectivity of each is discussed herein. Kidney dialysis machine A kidney dialysis machine replaces the kidney in patients with kidney failure. It works by connecting the patient in the machine through a series of tubes connected to his/her circulatory system. The blood flowing out of the patient's body will then go through a series of a series of special membranes that filter off the toxins from the blood. The procedure was first performed by John Abdell in 1914. He first hooked up small mammals into his dialysis machine which had treated parchment for filter membranes. Blood clotting was a problem, and Abdell solved this by treating the blood with hirudin, an anti-coagulant from leeches. After 2 to 3 hours the experimental animals recovered and lived on normally. This first set-up was effective for animals but was deemed unsuitable for humans because it was still crude and allergic reactions from hirudin was exhibited in some patients (RDS Online, 2000). Dialysis machines made their big leap in 1959 when the improved version of Abdell's machine, the Artificial Kidney Unit (AKU) was used to dialysed patients in Ward 21 of the Royal Infirmary of Edinburgh (Royal Infirmary of Edinburgh, 2001). Recently, there has been a report that a new type of dialysis machine that perfectly mimics the kidneys actions is under development and promises a lot for kidney patients who are undergoing dialysis (BBC, 2004). There is nothing like having a natural pair of kidneys, as these organs are very efficient in filtering the body's wastes and toxins. The kidneys' microstructure shows that it is made up of millions of nephrons that filter blood in a process called ultrafiltration. The clean water and blood is the reabsorbed and returned to the circulatory system. The kidneys are also capable of osmoregulation, a fluid regulatory mechanism that proceeds through osmosis. Although dialysis machines are effective in filtering blood, they are not as efficient as two kidneys. Dialysis machines are often considered as a transition treatment prior to a full kidney transplant, it helps the patient cope up with kidney failure until a suitable kidney is found. A disadvantage of being in a dialysis machine is that the patient has to be dialysed 2 to 3 times a week for several weeks. There are also cases where the patient is hooked unto the machine for life. Kidney Transplants Kidney transplants can be undergone by nearly all renal failure patients, but is needed most especially by patients with acute failure. It involves a major surgical operation and is not recommended for the aged and patients with heart disease. First, a suitable organ match must be found in order to minimize rejection of the new kidney by the patient's body. Kidneys come from donors who died from an accident or from a relative who has the same blood type and the right type of kidney cell marker (Watson, 2005). Kidneys from relative are more preferable since rejection is seen as minimal. A patient also undergoes a thorough dialysis and drug treatment before undergoing the transplant. Immunosuppresive drugs are taken to minimize rejection. First is Cyclosporin which minimizes the rejection although it has ceratin side effects such as increased blood pressure and increased hair growth in the face. Next is Azathioprine another immunosuppressant which also reduces blood cell production by bone marrow. The third immunosuppressant is a steroid called Prednisolone which increases a patient's appetite among its side effects (Watson, 2005). X-ray examinations are also done before surgery. This treatment is minimised as it can damage the lymph glands and bone marrow. After these preparations, what follows is the actual surgery which requires a very sterile environment as with any major organ transplant. The patient is anesthetized and both the 'kidney graft' (the kidney to be transplanted) and the patient is worked on by two surgical teams working simultaneously. Although out the operation, the urine, blood and other body fluids are kept in check. The operation takes about 2 hours or more depending on surgery conditions. A series of examinations and treatments will be undergone by the patient until he or she fully recovers. The recovery time is usually 10 days or more (NHS Direct Online Health Encyclopaedia, 2006). Recently, several new discoveries have been made in the field of renal failure treatment. Aside from the treament reported by BBC as mentioned earlier, Veryan Medical Limited has developed the Swirlgraft machien which also mimics how actual kidneys function inside the body. The new technology in Swirlgraft was created by Professor Colin Caro at Imperial College, baked by almost 40 years worth of research in blood flow dynamics. CONCLUSION Both kidney dialysis and kidney transplants are seen as very effective means of treating renal failure although nothing can replace what real kidneys can do. A dialysis machine offers about the same efficiency and effeticvity of actual kidneys but is cumbersome and inconvenient as it requires the patient to be hooked to the machine frequently. It is also quite expensive and seen as a transitory treatment before a kidney transplant. A kidney transplant on the other hand is the best solution for renal failure as it replaces a patient's failed kidneys with healthy ones. Though it is the best and only way to acquire new kidneys, it is very time-consuming, expensive and requires a lot of preparation. And since it is a major operation,it is risky and difficult to perform just like any othe major organ transplant. Also, most of the waiting time for a donated kidney is long, it sometimes takes years or months to receive a healthy, fully functional kidney. REFERENCES BBC News Network Sunday 15 August, 2004, http://news.bbc.co.uk/1/hi/health/3562980.stm Ideas21 2002-06, "Breakthrough in treatment for kidney dialysis patients" http://www.ideas21.co.uk/404 NHS Direct Online Health Encyclopaedia 2006, http://www.nhsdirect.nhs.uk/en.aspxarticleID=223 NHS Direct Online Health Encyclopaedia 2006, http://www.nhsdirect.nhs.uk/en.aspxarticleId=223§ionId=11114 RDS Online 2000, http://www.rds-online.org.uk/pages/page.aspi_ToolbarID=3&i_PageID=128 Royal Infirmary of Edinburgh Renal Unit October 2001, http://renux.dmed.ed.ac.uk/EdREN/Unitbits/historyweb/PremisesMachs.html Watson, Chris 2005, "FAQ's on Kidney Transplants" http://www.cambridge-transplant.org.uk/program/renal/assessment.htm#drugs Read More