[Renal replacement therapy in Germany: An overview with a clinical focus]

Area of Science:

• Nephrology
• Internal Medicine
• Public Health

Background:

• Approximately 80,000 individuals in Germany require permanent renal replacement therapy (RRT).
• The prevalence of kidney failure is increasing due to demographic shifts and improved life expectancy.
• Emerging pharmacological agents like SGLT2 inhibitors and GLP1 agonists show potential in slowing disease progression.

Purpose of the Study:

• To provide an overview of current renal replacement therapy (RRT) methods.
• To compare the efficacy and outcomes of different RRT modalities.
• To highlight the significance of kidney transplantation and hemodiafiltration (HDF).

Main Methods:

• Review of existing literature on RRT modalities.
• Analysis of mortality and life expectancy data for different RRT methods.
• Consideration of recent clinical trial findings, such as the CONVINCE trial.

Main Results:

• Kidney transplantation (KTX) significantly improves life expectancy by approximately 55% compared to dialysis.
• Peritoneal dialysis (PD) and hemodialysis (HD) demonstrate equivalent mortality rates.
• Hemodiafiltration (HDF) is gaining prominence following evidence of its superiority over conventional HD.

Conclusions:

• Kidney transplantation is the most effective RRT for enhancing patient survival.
• Hemodiafiltration (HDF) presents a superior alternative to conventional hemodialysis (HD).
• Dialysis patients face a substantially reduced life expectancy (around 67%) due to complications.