Chronic renal replacement therapy (CRRT) is needed once kidney functions are less than 10% in non diabetics and less than 15 % in diabetic patients. Such patients are labeled as End Stage Renal Disease Patients (ESRD).
There are several forms of kidney replacement therapies.
Chronic peritoneal dialysis
The selection of the therapy depends upon the suitability of the patient for that specific type of therapy and upon the patient’s choice. Renal replacement therapies do not improve the functions of the native kidneys rather replace the functions to a certain extent.
Hemodialysis and peritoneal dialysis removes waste products like urea and creatinine along with salt and water from the body but these processes do not overcome the problem of anemia due to the deficiency of a hormone known as Erythropoietin which occurs in kidney failure.
To overcome this deficiency, synthetic erythropoietin is given in the form of injections along with dialysis. Similarly there are many other functions which are not replaced neither by hemodialysis nor by peritoneal dialysis.
As a result patients need additional medicines such as calcium and Vitamin D supplements to prevent weakness of the bones seen commonly in renal patients