Replacement therapy

Replacement therapy is necessary when more than 90% of the nephrons have been destroyed.
People suffering from chronic renal failure must be able to choose freely between the various forms of treatment appropriate to their state of health, thanks to clear and comprehensive information provided by the nephrologist and his team. They may be assisted by a support person of their choice.
Substitution treatments are used to replace the functioning of the kidneys.

There are two types of replacement: dialysis and kidney transplant:

Dialysis: haemodialysis or peritoneal dialysis*.

(*peritoneal dialysis is not carried out at HPAM)

You will find the following information on our website:

- Dialysis methods
- Haemodialysis
- Dialysis techniques

Transplantation: kidney transplantation

This is a surgical procedure to replace a kidney that has permanently ceased to function with a "healthy" kidney from a donor. Some people are transplanted directly without dialysis, while others are transplanted after several years of dialysis or after an initial graft rejection. Transplantation may be envisaged for all patients suffering from chronic renal failure or about to do so, if they express a request and have no contraindications. Patients must undergo a pre-transplant assessment before they can be placed on a waiting list. This registration is validated by the Etablissement Français des Greffes.

The advantages of a transplant are numerous:

• Improved recovery of renal function
• Increased life expectancy and quality of life

However, waiting a long time for a compatible organ can be difficult in everyday life, and rejection of the organ can sometimes occur.

Transplantation requires regular medical monitoring and the daily use of anti-rejection drugs, which can sometimes have side effects.

Thanks to these treatments, kidney failure is no longer a fatal disease.

Associated treatments

Diet and hygiene

Your nephrologist will give you details of the hygiene and dietary requirements appropriate to your new treatment.
Compliance with a certain number of hygiene and dietary rules will improve the quality of your treatment and limit the risk of complications.

Blood transfusions

There is a definite probability that you will receive a blood transfusion at some point during your dialysis treatment.
You will be given specific information about transfusion, the risk of transfusion and transfusion monitoring.
You will be asked for your consent.

What about vaccinations?

Your vaccinations will be monitored on arrival and throughout your care.
You will systematically be offered vaccination against hepatitis B and regular serological tests will be carried out.
Hepatitis C cannot be prevented by vaccination. It is screened for by regular serological tests.

Biological tests?

As far as possible, these should be carried out during dialysis sessions, to avoid unnecessary punctures outside dialysis.

It is important to inform the medical team of your treatment and of any changes prescribed outside dialysis, in order to avoid any contraindications.