The Kidney Navi of the German Society of Nephrology (DGfN)

Kidney failure is when the kidneys are no longer able to perform their functions and remove toxins and excess fluid from the body. It is a life-threatening condition. The causes of kidney failure are varied and range from diabetes to high blood pressure. Symptoms such as fatigue, nausea and dizziness are possible signs of progressive kidney failure. Early diagnosis is crucial to maximize treatment options and avoid complications. Effective treatment can be either dialysis or transplantation, depending on the severity of the disease and the patient's individual circumstances.

If the kidneys are no longer functioning properly, dialysis may be required. Dialysis involves passing the patient's blood through a machine that removes waste products and excess water from the blood. There are two types of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, the blood is passed through a machine outside the body, while in peritoneal dialysis, the peritoneum is used as a filter. The choice of dialysis method depends on various factors, such as the patient's state of health and personal preference. However, dialysis is not a long-term solution for kidney failure and should only be considered as a temporary solution until a transplant is possible or other treatment options have been found.

In a kidney transplant, a healthy kidney from a donor is transferred into the recipient's body. Before the operation, both the donor and the recipient are thoroughly examined to ensure that the transplant is successful. During the procedure, the recipient's diseased kidney is removed and replaced with the donor's healthy kidney. The new kidney is then connected to the recipient's blood vessels and ureters. After the operation, the recipient must take regular medication to prevent their body from rejecting the transplanted organ. A successful kidney transplant can offer the patient an improved quality of life and a higher survival rate compared to dialysis treatment.

There are various alternatives to dialysis and transplantation that can be considered for kidney failure. One option is peritoneal dialysis, which uses the peritoneum as a filter to remove excess fluid and waste products from the body. Another alternative is hemodiafiltration, which is a combination of hemodialysis and filtration of fluid through a membrane. Renal replacement therapy using hemoperfusion or plasmapheresis can also be used in certain cases. There are also approaches such as regenerative medicine, which attempts to regenerate or replace damaged kidney tissue. It is advisable to discuss all options at a kidney center and select the best treatment method.

When it comes to deciding which treatment option to choose for kidney failure, as many factors as possible need to be considered. These include not only medical aspects such as the severity of the kidney failure and possible complications, but also personal factors such as lifestyle, age and preferences. The availability of donor organs or the possibility of dialysis also plays an important role. Take your time to weigh up all the options thoroughly. Ultimately, the decision should be based on individual needs and wishes and made in collaboration with the medical team.

The German Society of Nephrology has developed a Kidney Navigator to make the decision-making process easier for you and to answer any questions you may have. You can find the DGfN kidney navigator: here