Q.(a) A person is suffering from chronic renal failure. What are the treatment measures you will suggest? Explain. OR

Chronic renal failure is treated with a combination of dietary/medical management and, as kidney function worsens, dialysis (hemodialysis or peritoneal dialysis) or ultimately kidney transplantation to take over the failing kidneys' filtering role.

Chronic renal failure (CRF) is the progressive, usually irreversible, loss of kidney function over time, leading to a build-up of nitrogenous wastes and fluid/electrolyte imbalances in the body. Treatment measures include:

1. Hemodialysis: the patient's blood is withdrawn and passed through an external machine (the 'artificial kidney' or dialyzer) containing a semipermeable membrane; nitrogenous wastes, excess fluid, and excess electrolytes diffuse out of the blood into a dialyzing fluid across this membrane, and the cleaned blood is returned to the body. This is typically done periodically, e.g., 2-3 sessions per week, at a dialysis centre or hospital.

2. Peritoneal dialysis: a dialyzing fluid is introduced into the patient's own peritoneal cavity via a surgically placed catheter; the peritoneum (the natural membrane lining the abdominal cavity) acts as the filtering membrane, allowing wastes to diffuse from the blood vessels in the peritoneal lining into the dialysis fluid, which is then drained out after a set time. This can often be done at home.

3. Kidney transplantation: the most complete, permanent solution — a surgical procedure to replace the patient's failed kidney with a healthy, compatible donor kidney, restoring normal kidney function without the ongoing need for dialysis (though it requires lifelong immunosuppressive medication to prevent organ rejection).

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