Do all ESRD patients need dialysis? If it was before the 1950s, the answer was no, because there was no dialysis technology at that time. For more than half a century, dialysis has been the mainstay of life for ESRD patients.

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Do All ESRD Patients Need Dialysis

2019-04-17 16:17

Do All ESRD Patients Need DialysisDo all ESRD patients need dialysis? If it was before the 1950s, the answer was no, because there was no dialysis technology at that time. For more than half a century, dialysis has been the mainstay of life for ESRD patients. Uremia is almost equal to life-long dialysis.

However, with the progress of medical technology and the improvement of patients' economic and health literacy, the control of complications in patients with renal failure is getting better and better. In recent years, we have found that when the glomerular filtration rate drops to 15 ml/min, that is to say, when entering the ESRD stage or uremic stage, many patients can be maintained by medication (conservative treatment), avoiding obvious complications, thus maintaining a normal life without dialysis for a long time.

Which ESRD patients can take conservative treatment rather than dialysis?

1. Stable condition or slow progress

2. Complications are not obvious.

3. Occasionally need help

For ESRD patients who meet the above three conditions, especially the young patients with better physique, it usually takes several years for their glomerular filtration rate (GFR) to decrease from 15 ml/min to 10 ml/min with only conservative treatment rather than dialysis. During this period of time, we will communicate with them, pay attention to whether the patients have family support, whether they can maintain good mood and reasonable diet structure. And if the patients want conservative treatment, we will help them set up a medical care plan in advance.

However, patients with rapid progression, bed rest for most of the time and more complications are usually not recommended for conservative treatment, but for dialysis as soon as possible. This part of uremia patients often have poor primary diseases, such as lupus, anka-related nephropathy, membranous proliferative nephropathy, crescent nephritis, etc.

Key points of conservative treatment for ESRD patients

1. To control blood pressure. Because many antihypertensive drugs can lead to glomerular filtration rate decline, breathing difficulty, and systemic peripheral edema, It is unnecessary for blood pressure to fall to normal, and it can be relaxed to 160/90 mmHg.

2. To limit salt and sodium in diet to avoid capacity overload.

3. To correct anemia. Erythropoietic stimulants and iron can be used to improve symptoms of fatigue and breathing difficulty. Blood should be examined once every 3 months for anemia.

4. To improve acidosis. It can alleviate fatigue, bone loss, muscle atrophy and malnutrition. It is suggested to take sodium bicarbonate orally and check the carbon dioxide binding force once every 3 months to judge the acidosis condition.

5. To regulate the balance of calcium and phosphorus. Abnormal metabolism of calcium and phosphorus can lead to myalgia, joint pain, pseudogout and restless leg syndrome. It is necessary to limit the intake of phosphorus, and use phosphorus binder to reduce phosphorus. And check the level of calcium and phosphorus every three months.

6. To supplement low-dose active vitamin D. It can improve the symptoms of fatigue, weakness and muscle loss.

7. To maintain normal blood potassium. There is a need to limit the diet high in potassium and use potassium-bound resins. If life-threatening hyperkalemia occurs, sodium polystyrene sulfonate can be used. Blood potassium should be tested once a month.

8. To try Toxin-Removing Treatment. It can help cleanse the blood and make internal environment good for kidney self-healing and other medication application.

Do all ESRD patients need dialysis? Of course not. For more information on alternatives to dialysis, please leave a message below or contact online doctor.

As for you own illness conditions, you can get some guidance related to diet, exercise, medicines or some natural remedies. The online consultation service is free. Please remember to leave your email address, or phone number so that we can contact you and help you!
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Our Treatment Effect

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You can take a look at this patient's report. His creatinine was 1028 and urea level was 39.7 on 2018-12-11; creatinine level was reduced to 331 and urea was 16.1 on 2019-1-5. After about 25 days' treatment in our hospital, his creatinine level was reduced by 697, and urea was reduced by 23.6. Hope his condition gets better and better.

Our Treatment effect

Proteinuria is a common symptom of kidney disease

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It can make your urine foamy. Although it does not make you feel uncomfortable, it can impair your renal function and make your kidney disease worse. Conventional treatment such as steroids and immunosuppressants can hardly make it negative. In our hospital, systemic Chinese medicine treatment can help you turn it negative. Look at this picture, bubbles in urine become less and less with our treatment going on.