When is dialysis a good idea? is a topic of much debate. As patients and their families, they often think that dialysis is very troublesome, so they should not do it as much as possible, and it is not too late to make a decision when their lives are in danger; some doctors think that neither dialysis nor transplantation is a foolproof solution, and there are complications and death, so why not use non-dialysis treatment in the early stage of renal failure when they still feel well, and try to extend the non-dialysis treatment period as long as possible, and then do dialysis for maintenance when they cannot survive anymore. If hemodialysis or peritoneal dialysis cannot be maintained, the patient should switch to dialysis first, and then take turns to support his life until he finally receives a kidney transplant. These are a painful philosophy of living, because the focus is on keeping the patient alive and living as long as possible, but not caring whether they live comfortably and happily, in medical terms, what is the quality of life? Let’s look at the situation of early dialysis and late dialysis patients to get an insight. (1) Hospitalization time: Early dialysis patients have an average hospitalization time of 5.8 days, while late dialysis patients have 34.5 days; (2) Treatment costs are significantly reduced because of the improved physical condition, good quality of life and reduced comorbidities after dialysis; (3) Survival rate is significantly higher; some people have been investigated and observed for 4 years, 85% of early dialysis patients survived, while late dialysis patients survived only 50%. (4) Early dialysis helps to reduce excessive water retention in the body, which is beneficial to control hypertension, thus reducing the use of antihypertensive drugs and eliminating the gastrointestinal discomfort and various symptoms brought about by taking too many drugs; (5) Early dialysis can improve malnutrition; (6) Early dialysis patients have better nutritional, mental and physical status than those on dialysis. (6) Early dialysis patients have better nutritional status, mental and physical strength than late dialysis patients, and their return to work and contribution to society are better than late dialysis patients. In the mid-1960s, the conventional indications for dialysis were established, including absolute and relative indications. In recent years, it has been proposed that malnutrition is an early and objective indicator for choosing the timing of dialysis for people with chronic renal failure. Indications for starting dialysis: Absolute indications: Chronic renal failure presents with progressive, pathogenic conditions such as pericarditis, hemorrhagic failure, pulmonary edema, hemorrhage, or irreversible lesions. However, the emergence of fatal conditions is unpredictable, and waiting for such conditions to emerge before dialysis can lead to the risk of death of the patient, which is very passive. Relative indications: loss of appetite, weight loss, significant weakness, nausea and vomiting, etc. However, these manifestations are often overshadowed by other manifestations and ignored, or the patient will automatically adjust his work and change his feeling of health; they will also be disturbed by other factors and appear as uremic-like symptoms, so they lack objectivity. In recent times, it is believed that dialysis or kidney transplantation is not only to prolong life, but to live better and get the best recovery, which can only be done in early dialysis. In modern times, when this treatment is announced at the beginning of dialysis, patients and their families will be panicked and have difficulty in deciding, therefore, the publicity and education of dialysis should also be ahead of time to prepare for the rainy days. If you have chronic kidney disease with renal insufficiency, it is important to measure the kidney function regularly. When the creatinine clearance of the kidney drops to about 20 ml/l, education on the treatment plan should be strengthened and preparations should be made to choose the dialysis method.