According to the authoritative results of scientific research in recent years, the latest international guidelines on the treatment of chronic kidney disease currently recommend that when chronic kidney disease is in CKD stage 5 and the estimated glomerular filtration rate, i.e., eGFR, is less than 15 ml/min/1.73m2, the nephrologist should decide when and what method to use to start renal replacement therapy based on the patient’s specific situation, weighing various factors. However, when to start dialysis treatment involves many aspects, including the patient’s own condition (such as primary disease, complications, age, nutritional status, cardiac function, severity of uremic symptoms, etc.), the patient’s family situation (including the availability of manpower to care for the patient, economic status, etc.), medical institutions (medical technology and resources), society (medical security system), etc. Therefore, it is difficult to clearly propose an absolute standard value for starting dialysis treatment. Therefore, it is difficult to specify an absolute standard value of eGFR for starting dialysis treatment. It is important to emphasize that it is not scientific to determine the time to start dialysis treatment based solely on blood creatinine values. Because there are many factors affecting the blood creatinine value, especially age, weight and gender, and it is not sensitive to use blood creatinine to reflect kidney function. If certain complications are serious, such as intractable volume overload, hyperkalemia, metabolic acidosis, hyperphosphatemia, hypercalcemia or hypocalcemia, anemia, peripheral or central neuropathy, pleurisy or pericarditis, hypertension, malnutrition, abnormal gastrointestinal function, and other unexplained functional abnormalities, even if eGFR is greater than 15 ml/min/1.73m2, it is appropriate to Early initiation of renal replacement therapy, and even emergency dialysis is required in severe cases to save lives.