1. How many times a week is appropriate for dialysis? Why? In order to avoid dialysis imbalance syndrome during the induction period, it is recommended to increase the frequency of dialysis per week. Depending on the patient’s residual kidney function before dialysis, dialysis can be started 3 to 5 times in the first week, and then gradually transitioned to 2 to 3 times per week depending on the treatment response, residual kidney function and volume status of the body. 2. What is the appropriate duration of each dialysis session? Why? For 3 times a week, 4~4.5 hours/time, the total treatment time is not less than 10-12 hours per week. The best dialysis regimen is 4 hours three times a week. Of course, programs such as short daily dialysis can better approximate the human physiological state, reduce long-term complications and improve the quality of life. 3. Why should we check liver function, kidney function, electrolytes, blood routine, lipid analysis, blood iron test, blood β2 microglobulin, parathyroid hormone, hepatitis B, hepatitis C, HIV, ultrasound, heart ultrasound, etc. regularly? (1) Blood routine and kidney function are recommended to be checked once a month, and iron index is recommended to be checked once every 3 months. In order to keep abreast of anemia and dialysis, once abnormalities are found, dialysis prescription and medication should be adjusted in time. (2) Liver function, blood glucose, lipids and other metabolic and nutritional indicators are recommended to be checked once every 1 to 3 months if available, so as to understand the nutritional status of the body and adjust the treatment in time, because malnutrition is a risk factor for the long-term prognosis of dialysis patients. (3) Hepatitis B, C and HIV indicators: Patients who have been on dialysis for less than 6 months should be tested every 1 to 3 months; patients on maintenance dialysis for more than 6 months should be tested every 6 months. This allows for partitioning and splitting of hemodialysis patients to avoid cross-infection and increase the safety of dialysis. (4) It is recommended that blood electrolytes should be tested once a month and blood iPTH should be checked every 3 months to allow timely adjustment of medications and dialysis regimen, maintain calcium, phosphorus and bone metabolism in the normal range and reduce long-term complications. (5) Regular testing of blood β2 microglobulin can reduce the occurrence of dialysis-related amyloidosis by timely adjustment of dialysis prescription in case of abnormalities. (6) Measurement of cardiovascular structure and function includes electrocardiogram, cardiac ultrasound, and color ultrasound of peripheral blood vessels, which is recommended every 6-12 months. It is recommended to check the plasma cavity effusion and cardiovascular complications in time to make adjustment of treatment. 4. What is the appropriate weight for each dialysis interval? Why? The weight gain between dialysis should not exceed 3% to 5% of the dry weight, or not more than 1 kg per day. Too much weight gain between dialysis will cause excessive blood volume load before the next dialysis, and even require emergency dialysis due to acute pulmonary edema; it will cause high blood pressure, which will increase the probability of cardiovascular and cerebrovascular accidents and reduce the survival rate of the patient; it will also increase the amount of water that needs to be eliminated during dialysis, which will cause hypofiltration during dialysis. Ultrafiltration, resulting in hypotension and painful muscle spasms during dialysis. 5.What is the appropriate blood pressure control range? Why? The blood pressure control target for hemodialysis patients is <140/90mmhg before dialysis, <160/90mmhg in elderly people, and <130/80mmhg after dialysis, but the systolic blood pressure should not be lower than 110mmhg, because too high blood pressure can cause cardiovascular complications, and too low blood pressure can cause hypotensive reactions during dialysis and internal fistula occlusion. 6.Why do we need HDF (double pump machine)? Ordinary hemodialysis can only remove small molecule toxins, while HDF can remove small molecule toxins and medium and large molecule toxins (such as parathyroid hormone, β2 microglobulin, etc.) by both diffusion and convection. Therefore, it is recommended that hemodialysis patients should have HDF once every 1-4 weeks. 7. What is the importance of correcting anemia and what is the harm of anemia? How to treat anemia is reasonable? Patients with chronic renal failure are prone to anemia due to erythropoietin deficiency, malnutrition, iron deficiency, etc. Anemia can lead to weakness, dizziness, palpitations and insomnia, and even syncope and hypotensive shock. To correct anemia, erythropoietin should be used to understand the presence of iron deficiency. If ferritin <200ng/ml and transferrin saturation <20% in hemodialysis patients, iron supplementation is required. Intravenous is better than oral iron supplementation. 8.Why levocarnitine? Levocarnitine is a natural substance required in mammalian energy metabolism and its main function is to promote lipid metabolism. Levocarnitine is indicated for a series of complications arising from secondary carnitine deficiency in chronic renal failure long-term hemodialysis patients, with clinical manifestations such as cardiomyopathy, skeletal myopathy, arrhythmia, hyperlipidemia, as well as hypotension and myospasm in dialysis.