© Borgis - Postępy Nauk Medycznych 10/2015, s. 750
Regular renal replacement therapy (RRT) is the success of nephrology and the defeat of medicine – many people can enjoy a reasonably good and long life after the health system has failed in saving their kidneys. This holds true for nearly 20,000 adults on regular haemodialysis in Poland – mostly as a consequence of diabetes, hypertension, atherosclerosis, glomerulonephritis, and polycystic kidney disease. It is already well documented that the adequate treatment of each of the first three aforementioned entities results in slower progression to haemodialysis. In line with our principle to prevent kidney loss first, this “Progress in Medicine” issue presents two papers showing the new trends in treating the other two of them – the IgA nephropathy, which is the most frequent primary glomerulonephritis (Florczak et al.), and the polycystic kidney disease (Grenda). In the elderly the haemodialysis treatment introduction is frequently hastened by episodes of acute kidney injury (AKI) resulting mostly from dehydration. This is why the paper summarising the signs and symptoms of dehydration in the aged accompanies the aforementioned overview of new therapeutic options (Gellert). Once a patient has lost native kidneys, the best for him/her would be to receive a kidney transplant. Unfortunately, the medical staff attitudes towards transplantation are not universally positive, which could negatively affect the transplantation numbers (Kobus et al.).
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