[Mechanical therapy of terminal renal failure--outdated, proven and new procedures]

The arsenal of mechanical techniques, which is presently a part of the nephrological daily routine, has become so extensive, that it seems essential to differentiate between those methods which are out-dated, proven, or new. This differentiation can be summarized as follows: The subcutaneous Cimino fistula is preferred in 95% of dialysis patients. The Scribner shunt remains applicable for exceptional situations. In peritoneal dialysis the flexible Teckhoff catheter has replaced the "repeated puncture technique" which used rigid teflon catheters. Hemodialysis, especially in its cost efficient application as limited care or home dialysis, has proven itself reliable and now accounts for the majority of treatments. Hemofiltration and hemodiafiltration offer significant advantages, however, their application is growing slowly, apparently due to the higher costs involved. CAPD represents an alternative treatment which is applicable to 10% of end-stage renal failure patients.