Q.John has two options as treatment for his renal problem: Dialysis or kidney transplants. Which option should he choose? Why?

The chapter's own framing is useful here: dialysis is described as a 'holding measure' until a renal transplant can be performed, or as the only supportive measure for patients for whom a transplant would be inappropriate. This implies that a transplant is generally the more complete, long-term solution — a transplanted kidney can carry out every kidney function, including secreting erythropoietin (needed for red blood cell production), renin (blood pressure regulation) and calcitriol (active vitamin D, needed for calcium absorption), none of which a dialysis machine can replicate. Dialysis (haemodialysis or peritoneal dialysis), by contrast, filters the blood or peritoneal fluid mechanically but does not restore any of the kidney's hormonal roles, and haemodialysis in particular needs to be repeated regularly for life. …

Weigh the transplant option against dialysis using the chapter's own framing of dialysis as a 'holding measure' and the kidney's non- …

• Declaring one option universally 'better' without acknowledging that the real-world choice depends on donor availability and John's fitness for surgery. …