Uremia is the end-stage of chronic renal failure. What treatments are available for a patient who has progressed to the uremic stage? And what are the advantages and disadvantages of each?
Kidney transplantation, hemodialysis and peritoneal dialysis are the three treatments that have been commonly carried out in clinical practice.
1. Kidney transplantation: A healthy kidney donated by another person is “planted” in the patient’s body, so that this kidney can work in the patient’s body to replace the kidney that is no longer working properly. Without a doubt, this is the most effective and preferred treatment for UTI.
Advantage: It is a near “once and for all” treatment, after the operation, the patient can work and live like a normal person when the transplanted kidney is working normally.
Disadvantages
(1) Anesthesia and surgery-related risks associated with kidney transplantation itself.
(2) The need for long-term immunosuppressive drugs after surgery, resulting in a higher incidence of various diseases such as infections, tumors, diabetes, and cardiovascular diseases than normal people.
(3) There is a risk of rejection of the transplanted kidney and gradual decrease in the function of the transplanted kidney.
2.Hemodialysis: The patient’s blood is introduced into the dialysis machine through the vascular pathway, and the “toxins” in the blood are cleared in the dialyzer, and then the purified blood is returned to the patient’s body. Some patients can survive for more than 10 to 20 years if they are on dialysis for a long time.
Advantages: No major surgical procedures are required, and the toxins and metabolites can be removed from the body on a regular basis to maintain survival.
Disadvantages.
(1) Requires the use of a hemodialysis machine and requires regular hospital visits several times a week.
(1) Intermittent immersion of body organs and tissues in “toxin” containing blood, which increases the incidence of cardiovascular disease.
(3) The risk of contracting infectious diseases such as hepatitis B and C during the hemodialysis process is greatly increased.
(4) The need for strict control of diet and water intake, and the need for other medications to assist in treatment.
(3) Peritoneal dialysis: a special liquid called “peritoneal dialysis fluid” is instilled into the abdominal cavity through a “peritoneal dialysis tube”, and the toxins in the body enter the peritoneal dialysis fluid, and after a few hours, the “toxin” containing peritoneal dialysis fluid is removed from the abdominal cavity. After a few hours, the liquid containing the “toxin” is released from the abdominal cavity, and a new liquid is filled in, and so on and so forth.
Advantages.
(1) Reduces dialysis complications due to an unstable body environment.
(2) Less dietary restrictions, better nutritional status of patients, and less impact on the growth and development of children.
(3) Less chance of infectious diseases such as hepatitis B and C.
(4) Dialysis can be performed at home in the evening and on weekends, without going to the hospital.
Disadvantages.
(1) The need to place a peritoneal dialysis tube in the abdominal cavity and the need to change the peritoneal dialysis fluid frequently, which can easily become infected and lead to peritonitis, making it impossible to continue peritoneal dialysis.
(2) The requirements for the patients themselves are relatively high, and most patients in China have poorer dialysis results than hemodialysis.