Bonomini V, Scolari M P, Stefoni S, Vangelista A
Ann Ital Med Int. 1993 Apr-Jun;8(2):73-9.
The history of renal replacement therapy is traced from the early days of dialysis and kidney transplantation through the era of miraculous technology and the alleged certainties of anti-rejection therapy. Attention is focused on the newly found or anomalous biotypes that are common to both dialysis and transplantation. In dialysis not only the patient but also uremia is maintained and either hyper- or hyporeactivity in different biological systems may occur with or without clinical symptoms. In transplantation, while the balance between immunomodulation and immunotolerance is far from ideal, extrarenal complications may occur with an atypical mode of presentation, serious immunological renal lesions may develop asymptomatically and clinical signs of rejection may appear without noticeable laboratory alterations.
肾脏替代疗法的历史可追溯到透析和肾脏移植的早期，历经了神奇技术时代以及抗排斥疗法所谓的确定性阶段。重点关注透析和移植中常见的新发现或异常生物类型。在透析中，不仅患者得以维持，尿毒症也持续存在，不同生物系统可能出现高反应性或低反应性，且可能伴有或不伴有临床症状。在移植中，尽管免疫调节与免疫耐受之间的平衡远非理想，肾外并发症可能以非典型的表现形式出现，严重的免疫性肾脏病变可能无症状地发展，而排斥反应的临床体征可能在实验室检查无明显改变的情况下出现。
