UROLOGY · CONDITIONS
Renal Failure
Loss of kidney function from urological obstruction, disease, or end-stage renal failure , requiring urgent decompression, dialysis access, or renal transplantation.
ABOUT THIS CONDITION
What is Renal Failure?
Renal failure from a urological perspective encompasses obstructive (post-renal) uropathy , the most reversible cause , as well as end-stage renal disease requiring dialysis access creation or renal transplantation. Obstructive renal failure requires urgent drainage to prevent irreversible kidney damage. ESRD is definitively treated with renal transplantation. Dr. Vipin addresses the urological component of renal failure , from emergency decompression of obstructed kidneys to AV fistula creation for dialysis access, Tenckhoff catheter insertion for peritoneal dialysis, and nephrectomy prior to transplantation , working in coordination with the nephrology and transplant teams.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Bilateral ureteral obstruction from stones or tumour
- Massive BPH causing bilateral hydronephrosis
- Retroperitoneal fibrosis encasing both ureters
- Diabetic nephropathy , most common cause of ESRD
- Hypertensive nephrosclerosis
- Polycystic kidney disease reaching end stage
CLINICAL DETAILS
KeyFacts
Bilateral obstruction is reversible , urgent JJ stenting or PCN restores renal function.
AV fistula created at the wrist , maturation takes 6–8 weeks before haemodialysis begins.
Tenckhoff catheter allows at-home peritoneal dialysis , independence from dialysis centres.
Renal transplantation is the gold standard for ESRD , superior survival to dialysis.
Native nephrectomy for polycystic kidneys or infection creating space for the transplant kidney.
Post-renal AKI: full recovery if decompressed promptly. ESRD: transplant restores normal function.
HOW WE TREAT IT
Treatment Approach
Renal Transplantation
A donor kidney is placed in the iliac fossa and anastomosed to the iliac vessels and bladder , the definitive treatment for end-stage renal disease, providing superior survival and quality of life over dialysis.
- 1
Emergency Decompression
Bilateral JJ stenting or PCN placed urgently for obstructive renal failure , creatinine typically recovers substantially within 48–72 hours.
- 2
Dialysis Access
AV fistula created for haemodialysis access. Tenckhoff catheter inserted for peritoneal dialysis , chosen based on patient lifestyle and preference.
- 3
Transplant Workup
Renal transplant assessment includes crossmatch, tissue typing, imaging, cardiac evaluation, and native kidney assessment.
- 4
Transplantation
Living or cadaveric donor kidney transplanted into the iliac fossa , immediate function in most living donor transplants.
AVAILABLE TREATMENTS
Treatment Options
AV Fistula (AVF) Creation
Surgical arteriovenous anastomosis (Brescia-Cimino at the wrist) creating permanent haemodialysis vascular access.
Renal Transplantation
Living or cadaveric kidney transplantation into the iliac fossa , definitive treatment for ESRD, restoring normal renal function.
PD Catheter Insertion (Tenckhoff)
Silicone Tenckhoff catheter placed into the peritoneal cavity for at-home peritoneal dialysis.
Nephrectomy (pre-transplant)
Removal of massively enlarged polycystic, chronically infected, or hypertensive native kidneys to create space for the transplant.
COMMON QUESTIONS
Frequently Asked
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