Blood creatinine 591μmol/L may or may not need dialysis, depending on the cause of the disease and changes in condition. 1. Do not need dialysis: if the diagnosis of acute and chronic renal failure is confirmed, and the blood creatinine is 591μmol/L, but there is no obvious chest tightness, shortness of breath, dyspnea, edema and other manifestations, dialysis may not be needed for the time being, and the patient should be treated with symptomatic and causative treatments (e.g., using Jinshuibao, urealytic urea and so on), and the change of creatinine should be rechecked regularly. 2. Dialysis is needed: Generally, creatinine greater than 707μmol/L is required to start dialysis treatment, if the patient’s creatinine is 591μmol/L, there are respiratory difficulties, heart failure, etc., dialysis treatment is also needed. If the patient has been on dialysis in the past and still has a creatinine of 591 μmol/L after dialysis, he/she should also be on dialysis as prescribed by the doctor. Whether a patient needs dialysis treatment depends not only on the value of creatinine, but also on the comprehensive assessment of the patient’s condition and physical condition, and it is recommended that the patient go to the hospital in a timely manner and follow the doctor’s instructions to standardize the treatment.