Treatment with the artificial kidney (dialysis).

For patients with chronic renal disease, haemodialysis can provide reasonable rehabilitation and, in most cases, a life expectancy in excess of 10 years. However, dialysis is unable to provide for any loss of the kidneys' endocrine or metabolic activities and the kidneys' excretory capacity is only replaced suboptimally. Recent well controlled studies on the frequency, time and techniques of dialysis, instigated mostly as a consequence of recent hypotheses, such as the "middle molecule" theory and consideration of the potential importance of residual renal function, have resulted in a complete reassessment of the nature of adequate dialysis. Developments such as sorbent-based dialysis are leading to a wearable dialyser. Theoretical and hardware developments are providing not only more adequate treatment, but improved rehabilitation for those patients on chronic dialysis therapy.