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Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

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Dr. Wang was getting ready to leave work when the phone rang in the emergency room. "Come on! One of the uremia patients is in critical condition!" The anxious voice of the nurse came. Dr. Wang hurried to the emergency room and saw a middle-aged man with a sallow face and shortness of breath lying on a hospital bed.

"Doctor, is my dad going to die?" The young woman on the side grabbed Dr. Wang's arm, her eyes full of fear, "I heard that nine out of ten die, does my father really need dialysis?"

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

Dr. Wang reassured, "Don't worry, let's check the specific situation first." He took a careful medical history and quickly scheduled a series of tests. After the test results came back, Dr. Wang breathed a sigh of relief: "Fortunately, your father's kidney function has not deteriorated to the point where he needs dialysis. We can try conservative treatment first. "

The young woman breathed a sigh of relief, but there was still doubt in her eyes: "But it is said on the Internet that uremia must be dialyzed?" Nine out of ten die, is it true?"

Dr. Wang smiled and shook his head: "This statement is a bit exaggerated. Let's start at the beginning and talk about the truth about uremia and dialysis. "

Uremia, also known as the end-stage of chronic renal failure, is the end-stage manifestation of various chronic kidney diseases that progress to an advanced stage. When the kidney function is severely impaired and the metabolic waste products in the body cannot be removed in time, a series of clinical symptoms will appear, such as fatigue, decreased appetite, nausea and vomiting, itchy skin, etc.

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

"There are three main treatments for uremia: haemodicalysis, peritoneal dialysis and kidney transplantation. Dialysis is a treatment that replaces kidney function and removes excess water and metabolic waste from the body and corrects electrolyte imbalances. However, not all people with uremia need immediate dialysis. "

He pointed out that according to the Chinese Guidelines for Dialysis Initiation of Chronic Kidney Disease developed by the Chinese Society of Nephrology, only patients who meet one of the following conditions need to be considered for dialysis treatment:

1. Glomerular filtration rate (GFR) less than 15ml/min/1.73m², and uremia symptoms or complications appear.

2. If the GFR is less than 6ml/min/1.73m², dialysis should be started even if there are no symptoms.

3. Water, electrolyte, and acid-base balance disorders that are difficult to correct.

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

4. Difficult-to-control hypertension.

5. Progressive malnutrition.

"Your father's GFR is 18ml/min/1.73m², and although he has entered stage 5 chronic kidney disease, he has not yet reached the point where dialysis is necessary. We can start with medication and strict dietary control to improve the symptoms. Dr. Wang said.

Hearing this, the young woman was a little relieved, but still had questions: "How did the saying 'nine out of ten die' come about?"

Dr. Wang explains, "There is a certain misunderstanding in this statement. Dialysis itself does not lead to death, but can significantly prolong the life of uremia patients. However, mortality is relatively high because patients are often already in the advanced stage of the disease at the time of initiation of dialysis and may have multiple complications. "

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

He cites data from a study: "According to the 2018 National Hemodialysis Case Information Registration Report released by the China Center for Quality Control and Improvement of Hemodialysis, the annual mortality rate of hemodialysis patients in mainland China is 7.72%. Although this number does not seem low, it is important to know that uremia patients without dialysis usually only survive for a few months. "

"So, is dialysis really that scary?" The young woman asked.

Dr. Wang shook his head: "Dialysis is not scary, the key is to do it in a timely and standardized manner. Many patients delay dialysis due to fear or financial reasons, and instead miss out on the best time for treatment. "

He further explains, "Dialysis does cause some discomfort to patients, such as blood pressure fluctuations, muscle cramps, anemia, etc. But these side effects are usually manageable. What's more, dialysis can significantly improve patients' quality of life, allowing them to return to work and enjoy life. "

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

To illustrate this, Dr. Wang recounted a real-life case:

Mr. Lee, aged 52, is a secondary school teacher. Five years ago, he was diagnosed with uremia and started hemodialysis. At first, he was also afraid of dialysis and even gave up on treatment for a while. But with the encouragement of his family, he insisted on regular dialysis and strictly controlled his diet and medication. Now, Mr. Li has not only returned to the podium, but also regularly participates in outdoor activities, and his quality of life has greatly improved.

"So, dialysis is not the end of life, but the beginning of a new life." Dr. Wong concluded.

The young woman thought, "So how can we prevent uremia?"

Dr. Wang smiled, "That's a good question. Prevention is always better than cure. The key to the prevention of uremia lies in the early detection and control of various primary kidney diseases, such as chronic glomerulonephritis, diabetic nephropathy, hypertensive kidney damage, etc. "

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

He suggested the following:

1. Have regular physical examinations and pay attention to kidney function indicators.

2. Control chronic diseases such as hypertension and diabetes.

3. Eat a reasonable diet and limit the intake of high-protein, high-salt, and high-fat foods.

4. Quit smoking and limit alcohol to maintain good habits.

5. Avoid drug abuse, especially nephrotoxic drugs.

"In addition to this, it is also important to pay attention to the timely treatment of various infections, such as upper respiratory tract infections, urinary tract infections, etc., because repeated infections may aggravate kidney damage." Dr Wong added.

Nine of ten die? The doctor bluntly said: uremia has not reached this level, no need for dialysis

After listening to Dr. Wang's explanation, the young woman smiled with relief: "Thank you, doctor. I now understand that dialysis is not scary, the key is to be scientific. We will cooperate with the treatment. "

Dr. Wang nodded: "Yes, it is also important to maintain an optimistic and positive attitude. I believe that with our joint efforts, your father's condition will be well controlled. "

Seeing off the father and daughter, Dr. Wang breathed a sigh of relief. He knows that there is still a long way to go to dispel misconceptions about dialysis. But he believes that as long as both doctors and patients work together, they will definitely bring hope to more uremia patients.

As night falls, the hospital is still brightly lit. Here, countless medical jobs like Dr. Wang's

They are continuing their efforts to dispel the pain and fear with professionalism and care, and to write a new chapter in their lives.

(Disclaimer) The process and pictures described in the article are from the Internet, and this article aims to advocate positive social energy and no vulgar and other bad guidance. If it involves copyright or character infringement issues, please contact us in time, and we will delete the content as soon as possible! If there is any doubt about the incident, it will be deleted or changed immediately after contact.

Bibliography:

1. Chinese Society of Nephrology. Dialysis start-up guidelines for chronic kidney disease in China. Chinese Journal of Nephrology,2010,26(2):61-64.

2. Chinese Center for Quality Control and Improvement of Hemodialysis.2018 National Hemodialysis Case Information Registration Report.Chinese Journal of Nephrology,2019,35(9):641-644.

3. Liu Zhihong, Wang Haiyan. Influencing factors and intervention strategies of quality of life of hemodialysis patients. Chinese Journal of Nursing,2018,53(3):357-360.