Optimal Treatment Strategies in End-stage Renal Failure

During the past 4O years there have been major conceptual and technical advances in the domain of dialysis methods and renal/organ transplantation for long-term treatment of patients with End-Stage Renal Failure (ESRF). This now enables better defined, more selective strategies of treatment to be undertaken, according to patient-specific criteria such as age or underlying renal disease also taking into account the lifetime duration of these treatments. For many patients this impliesnecessary successive changes of mode of therapy depending on their availability, occurrence of medical/technical complications or failure and social-environmental and economic factors. This rationale has inspired the structure of this volume which is divided into four sections:: 1/ A descriptive overview of the various modes of renal replacement therapy (RRT):: Extracorporeal dialysis/filtration, peritoneal dialysis, kidney and multi-organ transplantation.2/ Most appropriate indications and use of these methods, respective advantages, drawbacks and outcome in children, pregnant women and elderly patients 3/ In diabetic patients and in patients with hereditary/congenital diseases. 4/ The ethical issues generated by this new domain in Medicine by limitations in treatmentfacilities or medical dilemmas for acceptance, best technical choices, withdrawal or termination of RRT in individual patients. Finally, contributors form Eastern European Countries, Africa and Far Eastern Countries analyse the current status of RRT in their respective geographical area and the ways and means required for a wider implementation of RRT in thus far lesser economically developed countries where the great majority of the populations still have no access to these life-saving therapeutic procedures.