1.Is chronic renal failure uremia a terminal disease? A: Nowadays, dialysis, kidney transplantation and other renal replacement therapies have been widely used in patients with uremia, so that the lives of many patients can be extended and the quality of life is getting better. Most dialysis patients can take care of themselves and even return to work after regular dialysis, adhering to reasonable diet and life arrangements, and applying erythropoietin and other drugs. Zhang Yu, Department of Nephrology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine Currently, there are three types of renal replacement therapy: hemodialysis, peritoneal dialysis and kidney transplantation. Kidney transplantation is the most ideal and effective means of treating uremia, but due to the shortage of kidney sources, the majority of patients need to choose dialysis treatment. Hemodialysis is to help uremic patients remove metabolic wastes, toxins and excess water from their bodies and correct acidosis and electrolyte disorders through the application of artificial dialyzers and dialysis machines. It has to be done in a hospital, and hemodialysis is usually performed 3 times a week for 4 to 5 hours each time, operated by a nurse, and the doctor will monitor the patient’s condition throughout. Peritoneal dialysis uses the body’s own peritoneum as the dialysis membrane. By injecting dialysis fluid into the abdominal cavity, metabolic wastes, toxins and excess water removed by the peritoneum are discharged into the dialysis fluid, while replenishing the body with essential substances, and blood purification can be achieved by constantly replacing fresh dialysis fluid. Before starting abdominal dialysis, a soft and flexible silicone tube needs to be surgically inserted into the lowest part of the abdominal cavity to ensure that the fluid can enter and exit the abdominal cavity. 2.How do I choose the right dialysis method for me? A: Hemodialysis and peritoneal dialysis are similar in efficacy, but each has its own strengths and weaknesses, and they complement each other in application. The choice of dialysis modality should be based on the patient’s own situation and the characteristics of the two dialysis modalities. The vast majority of patients are suitable for both abdominal and hemodialysis. A small number of patients have contraindications to either hemodialysis or peritoneal dialysis and can only choose one or the other. Peritoneal dialysis is particularly suitable for the elderly, patients with cardiovascular disease, diabetics, pediatric patients, etc. It is important to note that the two dialysis modalities can be interchanged if there are not absolute contraindications, i.e., patients on hemodialysis can be switched to peritoneal dialysis if they have severe arrhythmias, heart attacks, active bleeding, etc., while patients on peritoneal dialysis can be switched to hemodialysis to continue treatment if they have recurrent or refractory peritonitis. A dialysis patient once said that she was doing abdominal dialysis now and would try to do it for 10 years. When you can’t do abdominal dialysis anymore, you can switch to hemodialysis for another 10 years, and then you can do a kidney transplant, adding up to at least 30 years of life. 3. Is it better to start dialysis as late as possible? A: Many people are afraid to talk about dialysis and feel that dialysis is a desperate situation, so they instinctively refuse and reject it, thinking that the later they start dialysis, the better it is, and only when there are serious or even life-threatening complications do they come to the hospital for emergency dialysis treatment. In fact, the time to start dialysis treatment must not be too late, otherwise it may be life-threatening. Even emergency dialysis carries a high level of risk. In the preparation stage of emergency dialysis, patients may have various accidents; and the risk of patients having accidents during emergency dialysis is also high. 4. Can dialysis be done at home by myself? Recently, it has been reported that patients with uremia are forced to do dialysis at home because they cannot afford the high cost of dialysis and cannot afford to go to the hospital. At first glance, it really makes people sigh and sigh. But what many people don’t realize is that dialysis can be done at home. Peritoneal dialysis is a form of dialysis that can be done at home. Patients or their families can change the dialysis fluid at home after a short training period. Fluid changes are often scheduled before and after three meals and at night before going to bed, which does not affect daily life much. Alternatively, a peritoneal dialysis machine can be used for automated dialysis treatment, where the machine is connected every night before going to bed and disconnected in the morning for fluid changes, for children and adults who need to go to school or work during the day. Patients only need to visit the hospital once a month for follow-up, and the doctors and nurses will evaluate the efficacy and adjust the prescription accordingly. Except for the fluid change time, peritoneal dialysis patients can continue their daily life and work. The cost of peritoneal dialysis is also lower than hemodialysis, making it more suitable for some patients who are financially strapped.