The survival of patients with creatinine 500 μmol/L without dialysis is related to the primary disease and cannot be generalized. Creatinine is a small molecule toxin produced by the body’s metabolism, and the excretion pathway is through the kidneys. If the body produces more creatinine or the kidneys are dysfunctional in excretion, it will lead to accumulation of creatinine in the body. If creatinine rises to 500 μmol/L due to diseases such as acute renal failure, hyperkalemia, and severe gastrointestinal reactions, treatment of the primary disease will allow the patient to live as long as a normal person without the need for dialysis. In the case of chronic renal failure, such as glomerulonephritis and diabetic nephropathy, which cause creatinine to rise to 500 μmol/L, and when the primary disease cannot be controlled, not performing dialysis will cause creatinine to gradually increase, endangering the patient’s life, which usually leads to death within 2-3 years. In addition, whether creatinine 500μmol/L needs dialysis should follow the guidance of nephrologists and should not be decided without authorization. Chronic renal failure non-dialysis conservative treatment, it is recommended to take Chinese medicine etc. on the basis of good dialysis preparation.