The possibility of living 40 years with renal insufficiency is very small, but it may exist. It takes about 10 years or so for the kidney to start from renal failure to enter uremia, and about 10 years from uremic hemodialysis to the death of the patient. Therefore, from the discovery of renal insufficiency to the death of the patient, it is about 20 years or so, and the possibility of living 40 years is very small. Because the removal of toxins by hemodialysis is not very adequate, the vast majority of toxins are still in the body, causing damage to various organs, which limits the survival time of patients. Of course, this is not absolute, if the patient is given a kidney transplant after entering the uremic phase, the transplanted kidney is more adequate for toxin removal, and long-term, regular anti-rejection drugs are taken, regular review, and the concentration of anti-rejection drugs is controlled within the effective range. At the same time, avoid infection and avoid taking nephrotoxic drugs, then the survival time of the transplanted kidney may be longer, the possibility of patients living 40 years is greater. Therefore, if patients with renal insufficiency want to live for 40 years, it is recommended to perform kidney transplantation, which will have a higher possibility.