How to Break Away from Dialysis for Patients with ESRF

　　End-Stage Renal Failure(ESRF) was like malignant tumor, short of effective treatment method. Once patients with kidney disease progressed to end-stage renal failure, there was no way to maintain their life. Now, with the development of modern medical technology, dialysis, kidney transplantation, stem cell treatment and integration of Western Medicine treatment and Traditional Chinese Medicine treatment bright light to them. Even, some patients with end-stage renal failure can break away from dialysis after some time treatment. How can them break away from dialysis?


　　1. Early detection, early intervention
　　End-stage renal failure is the final result of kidney disease. Early detection and timely treatment are always the most effective prevention method of end-stage renal failure and also the first choice to break away from dialysis. In China, the occurrence rate of chronic kidney disease is 10.1%-13%, but the awareness rate is only7.9%-8.2%. Most people are due to unaware of their kidney disease to lose the best time for early treatment. Even, once detecting, they have been relying on dialysis or kidney transplantation. In fact, chronic kidney disease can be required early diagnosis and effective treatment. But the key is to know, understand and give sufficient attention to kidney disease. Breaking the start link of kidney disease progressing to end-stage renal failure, patients will be far away from dialysis treatment.


　　2. Clearly knowing the cause and judging ‘Acute’or ‘Chronic’
　　Once detecting kidney disease or abnormal kidney function，when they go to hospital to see doctor, they may be required to do dialysis. At that time, the point is changing to looking for the root cause and judge the abnormal kidney function “acute” or “chronic”. Different diseases leading to kidney diseases has different prognosis, which is the key point that whether patients can break away from dialysis. According to the statistics from some research, more than 80% patients with acute kidney injury can break away from supportive dialysis treatment. And 10%-15% may progress to chronic kidney disease, and the rest are getting back to the normal.

　　3. Coordinating with treatment to improve prognosis
　　Whether patients with chronic kidney disease occur to kidney function abnormality, they should go to kidney specialty hospital to see doctor and begin to treat primary disease, at the same time, they should been given integration treatment method, including adjusting lifestyle, diet, lowering proteinuria, control blood pressure, regulating blood lipid, controlling blood sugar, rectifying acid-base balance and calcium-phosphorus metabolism disorder. All these treatment method effective practice needs patients’ positive cooperation. In clinical work, we often see the condition of creatinine stabilizing in 200-300 umol/L for several years to tens years, and also another condition that patients with creatinine 140 umol/L progress to end-stage renal failure with 1-2 years and have to receive dialysis. For that, in addition to disease intrinsic factors, whether patients cooperating with treatment and paying sufficient attention to controlling kidney disease progression are also very important factors.



　　Even though patients have to receive dialysis, each patient should choose the suitable dialysis according to personal condition and medical staff’s introduction. Seen from research at home and abroad, when patients have to require long-term dialysis, they should begin with peritoneal dialysis, and then according to patients’ condition and effect, if peritoneal dialysis cannot meet the need, patients can use hemodialysis or kidney transplantation. This way can make patients have a longer life. Patients with refractory high blood pressure, heart failure, severe Nephrotic Syndrome, rapid progressive renal failure, analgesic nephropathy or non-steroid anti-inflammatory drugs kidney disease, chronic urinary obstruction or waiting for kidney transplantation should firstly take consider peritoneal dialysis. If patients have abdominal operations history and peritoneal failure, they should firstly take consider hemodialysis. Peritoneal dialysis has advantage for protecting remaining kidney function and improving patients’ life quality. What’s more, peritoneal dialysis has different types, such as automated peritoneal dialysis at night and hemodialysis, which will maximize reduce dialysis influence for patients’ normal work and life to realize ‘break away from’ dialysis. (End)