Let’s continue to follow the previous section to explain which kidney diseases are prone to progress to uremia? Which kidney diseases are prone to progress to uremic syndrome? According to the kidney function, chronic kidney disease can be divided into five stages, glomerular filtration rate of 90 ml/min/1.73m2 (i.e. ≥ 90 units) or more, called chronic kidney disease stage I; stage II is glomerular filtration rate of 89-60 units; stage III glomerular filtration rate is 59-30 units; stage IV glomerular filtration rate is 29-15 units; glomerular filtration below 15 units is chronic kidney disease stage V, which is often referred to as uremia. The main treatment for patients in this stage is peritoneal dialysis or hemodialysis and other renal replacement therapies. What factors will lead to the progression of kidney disease to uremia? The first one is the presence of proteinuria, 24h urine protein more than 1 gram. The second is hypertension, and these patients are prone to deterioration of kidney function. The third is patients with poor kidney function at the onset, and elevated blood creatinine, which also predicts the deterioration of kidney disease. Among the various kidney diseases, diabetic nephropathy, polycystic kidney, acute nephritis, amyloid nephropathy, and membranoproliferative glomerulonephritis, all of them have a poor prognosis and are prone to deterioration of kidney function. The most serious kidney disease is focal segmental glomerulosclerosis, which has the fastest rate of kidney function damage if it is manifested by nephrotic syndrome (large proteinuria, hypoproteinemia, high edema, hyperlipidemia, etc.). If left untreated, the disease will develop into uremia in six or seven years. Another condition that deteriorates faster is membranoproliferative glomerulonephritis, for which there is no effective treatment, and it will develop into uremic syndrome in about ten years. The next is IGA nephropathy. 30% of IGA nephropathies develop into uremic syndrome, which takes about 20 years. Another more slowly developing disease is membranous nephropathy, with 30% of patients presenting with nephrotic syndrome developing uremic syndrome after more than 20 years. Diabetic nephropathy develops in 20-40% of diabetic patients, usually after 20 years of disease, with significant proteinuria. Once proteinuria appears, it means that the kidney function is damaged faster, and uremia will develop after about five years. For polycystic kidney, the disease develops more slowly, usually more than ten years after the onset of the disease, the kidney function only begins to appear slow damage. When the blood creatinine rises, it means the condition will deteriorate sharply, and the average glomerular filtration rate will decrease by 3~4ml per year, which will lead to uremia in about ten years. Chronic kidney disease treatment principles of kidney disease emphasizes the comprehensive treatment of many aspects, mainly divided into five areas: First, patients diagnosed with chronic kidney disease do not be too pessimistic, do not have too much pressure, maintain an optimistic attitude; also do not be too tired, because tiredness will aggravate the progress of kidney disease. Second, to eat less salt, salt eating more easily induced hypertension, aggravating proteinuria. Patients with chronic kidney disease should not exceed 6 grams of salt intake per day, such as stir-fry with half of the salt, do not put MSG, and put salt when the dish is almost cooked; usually do not eat salted vegetables and so on. At the same time, also appropriate to limit the intake of protein, eat too much protein will increase the burden on the kidneys, do not overeat; if the creatinine clearance rate is less than 50 ml / min, kidney function is not good, more strict restrictions on protein intake, not more than 0.6 grams per kilogram of body weight per day. Thirdly, lowering blood pressure, actively controlling blood pressure is a very important way to protect the kidneys. Choose suitable antihypertensive drugs, especially non-blood pressure-dependent drugs with kidney-protective effects, such as ACEI drugs, Benazepril, ARB drugs, Valsartan, Coxsartan potassium, etc. Chinese medicine also has some auxiliary therapeutic effect. Some refractory kidney diseases can be treated with Chinese medicine when western medicine is not good. When the resistance is poor, or when multi-organ damage can choose to find Chinese medicine to help regulate. Fourth, immunosuppressive therapy, such as the use of hormones, cyclophosphamide, mycophenolate and other immunosuppressive drugs, must be used under the guidance of a doctor. Fifth, the development of chronic kidney disease to the end stage, that is, chronic kidney disease stage V, the emergence of uremia, this moment need to do renal replacement therapy, including hemodialysis, peritoneal dialysis, there are donors and conditions can also do kidney transplantation.