• The principal etiology of end-stage renal failure in the adult population includes diabetes mellitus, hypertension, and chronic glomerulonephritis.
• In children, congenital abnormalities of the urinary tract or renal dysplasia constitute the greater majority of patients with renal failure that receive kidney transplantation

Renal transplantation is the treatment of choice for patients with end-stage renal failure.
Irreversible (or approaching) end-stage renal failure who require dialysis are candidates for renal transplantation

Contraindications to renal transplantation

• Presence of active infection
• Substance abuse
• Recent history of malignancy
• Although advanced coronary artery occlusive disease constitutes a relative contraindication, a careful cardiac evaluation and a definitive treatment minimizes the risk for the potential candidates of renal transplantation

References

Hariharan S, Johnson CP, Bresnahan BA, Taranto BA, McIntosh MJ, Stablein D: Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med, 342:605-612, 2000.

Makowicz SB, Perloff LJ: Urologic considerations in renal transplantation. Surg Gynecol Obstet 160:579-587, 1985.

Terasaki PI, ed: Clinical Transplants 1998. Los Angeles, UCLA Tissue Typing Laboratory, 1998.

Wolfe RA, Ashby MA, Milford EL, et al: Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 341:1725-1730, 1999.

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