What kind of UTI is irreversible?

  In the clinic, we often encounter some patients who have kidney dysfunction ask the doctor, can I cure this disease? So how to answer this question, if you say it can not be cured, then let people lose hope in life; if you say all can be cured, then it is a little bragging. So what reversible uremia is there?  Generally speaking, for uremic patients we should observe the following indicators: blood routine, urine routine, 24-hour urine protein quantification, kidney function, endogenous creatinine clearance, blood sedimentation, immune index, kidney ultrasound, etc. It is generally believed that the presence of anemia, creatinine greater than 500, and kidney atrophy is irreversible. Is there reversibility even after reaching this state?  My personal experience is that a significant proportion is still reversible. From the diagnostic indexes, fast sedimentation and abnormal immune indexes such as low complement suggest reversibility. From the treatment response, those who respond to hormone therapy and can show diuretic response as soon as possible are reversible. Those who can actively cooperate with doctors, do not slacken, do not falter, do not fold, adhere to long-term, systematic treatment, adhere to the combination of Chinese and Western medicine treatment, can achieve better results.  The recovery of chronic renal failure is similar to the recovery of acute renal failure, that is, there will also be a polyuric phase, the earlier and faster this polyuric phase comes, the better the recovery. We once met a patient who was transferred from a foreign hospital to hemodialysis. At that time, he had anemia, creatinine 1000, and kidney ultrasound volume shrinkage, but the hematocrit was fast.  There is more than one case like this. I know that, after appropriate treatment, a significant proportion of patients with stage IV and V uremia can obtain a fairly good treatment effect. The most important prerequisite is to have a high urine output, including urine induced by drugs, and if it can reach more than 5,000 ml, 80% of them are effective. Every patient with uremia should not miss this critical time, because if the urine volume can only reach about 2000 ml, then the only way to go is dialysis or transplantation. As a nephrologist, we should take the responsibility to stop the patient from entering dialysis, to cure a patient is to save a family, and also to reduce a heavy burden for the society.