When talking with colleagues, we feel that the common feeling of most domestic blood purification centers in recent years is: tiredness! New patients are entering dialysis one after another, and dialysis centers are expanding on the one hand, but on the other hand, patients are still overcrowded, two sets become three sets, or even four sets. I can’t help but wonder why our country has shown a “blowout” growth of dialysis patients in recent years? In fact, the reasons are as follows: 1, the incidence of chronic kidney disease and end-stage renal disease is increasing with the change of national lifestyle, the incidence of diabetes and hypertension is increasing, and these two diseases themselves will lead to damage to kidney function. This is evident from the changes in the disease spectrum, as the proportion of diabetic nephropathy and hypertensive kidney damage, especially diabetic nephropathy, in end-stage renal disease is gradually increasing. In terms of absolute numbers, the increase of patients with end-stage renal disease is already an indisputable fact. In clinical practice, we often see cases of uremia caused by taking “Gentian and Liver Pill”, “Guanxin Suhe Pill”, “Gynecological and Feminine Pill” and other Chinese medicines containing aristolochic acid. This “contribution” to our country’s end-stage renal disease is also not to be dismissed. So, why were there not so many dialysis patients in previous years? 2, the inevitable result of improved health insurance policy Many patients who enter dialysis and need dialysis treatment often give up treatment early because of financial reasons. The economic burden is significantly reduced, so that many patients living in the bottom of the society, even those who are on low income, can cope with the economic pressure caused by dialysis more comfortably. The result of the first two reasons is a gradual increase in the number of patients entering dialysis, but there is another reason for the increase in the number of patients on dialysis, namely the decrease in the number of patients dropping out. There are only a few ways for maintenance hemodialysis patients to drop out of dialysis: first, death; second, change to peritoneal dialysis; third, kidney transplantation. First of all, the mortality rate is on a downward trend due to the current increase in the regularity of dialysis treatment. 2010, the Ministry of Health promulgated the Standard Operating Procedures for Hemodialysis, which has now become a regulatory document for all hemodialysis centers nationwide. In the past two years, the evaluation of hospitals in the field of blood purification is basically checked by this document as a standard. Although there are some controversies after the promulgation of the protocol, and the level of implementation varies from unit to unit, especially in grassroots units, such as the recently exposed case of hepatitis C infection in Zhen’an County, Shaanxi Province, in general, it is better to have a law to follow than to have no law to follow and to fight a chaotic battle. Under this premise, it is clear that the degree of standardization of dialysis treatment is much better than before. Therefore, in general, it seems that the age of dialysis patients is increasing and the quality of life is improving. The annual mortality rate of maintenance hemodialysis patients in some first-tier cities in China is now even lower than the figure in the United States. In terms of switching to peritoneal dialysis, although the development of abdominal dialysis has progressed greatly in recent years, there is still a significant gap compared to hemodialysis. Another reason for dialysis patients to withdraw from dialysis is to receive kidney transplant treatment. Since 2015, China has completely abolished death row inmates as organ sources and replaced them with organs donated by society. At present, although the public organ donation system has been established, the rate of social donated organs is too low resulting in the organ source is still in a very tight state. Therefore, the path of kidney transplantation is still very narrow. On the one hand, more and more patients are entering dialysis; on the other hand, very few patients are withdrawing. It is just like that classic math problem, a big pool, one inlet and one outlet. If there are more in than out, the pool is of course getting fuller and fuller. All of these things eventually lead to the current situation of overloaded dialysis centers and more and more dialysis patients. Is this a good thing or a bad thing? From the perspective of discipline development, blood purification is definitely facing an opportunity to flourish, and after the number goes up, the rest is bound to be the improvement of internal quality; from the perspective of economic investment, blood purification is definitely a “sunrise” industry; from the patient’s perspective, it is also a good thing, it is better to receive formalized treatment than to go to From the patients’ point of view, it is also a good thing to be able to receive formalized treatment than to go to the society to get those unreliable prescriptions and so on.