When it comes to kidney disease, many people feel fear, mainly because once the kidney disease enters the continuous progression stage, it cannot be reversed, but can only be delayed, and eventually progress to kidney failure and uremia. At this time, for the patient, on the one hand, Life changes, various health problems appear, and on the other hand, dialysis treatment may be required several times a week. This decline in quality of life makes patients miserable.

In fact, people’s fear of dialysis mainly stems from their lack of understanding of kidney dialysis. Today, we will talk to you about kidney dialysis. Under what circumstances does the kidney need dialysis? What are some health signals to watch out for? Is dialysis required for life, and what issues should be paid attention to in dialysis?

Everyone is afraid of dialysis. What are the conditions of renal function that require dialysis, and what are the abnormal symptoms that should be paid attention to? How can I avoid going into dialysis?

More than half of the people who need dialysis in China are suffering from high blood pressure and diabetes. These diseases can cause abnormal vasoconstriction, stenosis or blockage of blood vessels, and the decline of kidney function. Moreover, some people overuse drugs , It is often seen that long-term use of painkillers, unknown over-the-counter medicines or Chinese herbal medicines, etc., may cause damage to renal function.

There are no obvious symptoms in the early stage of kidney disease. When symptoms appear, most of them have entered the third or fourth stage. Further, chronic kidney disease is clinically divided into five stages (the glomerular filtration rate of the first stage is greater than 90, the second stage is 60-90, the third stage is 30-60, the fourth stage is 15-30, and the fifth stage is 15-30). less than 15), the following symptoms may occur only when renal function deteriorates to a glomerular filtration rate below 10:

High levels of toxic substances in the body (nausea, vomiting, weakness, poor appetite, weight loss); neurological symptoms (lethargy, convulsions, etc.), fluid imbalances (edema, uncontrolled blood pressure, asthma, hydropulmonary, hydropericardium) , heart failure, etc.) and metabolic acidosis or hyperkalemia (arrhythmia), then dialysis treatment is required , and in some places it is called kidney dialysis.

If you want to avoid entering the dialysis stage, it is best to regularly measure blood pressure, and regularly test urine and kidney function every year to know whether there is kidney disease and injury, and control the three highs (hypertension, high blood sugar, high cholesterol) , The diet should also be specially controlled, and a low-salt, low-protein diet should be adopted to prevent deterioration; moreover, drugs that can damage the kidneys, such as painkillers, contrast agents, and Chinese herbal medicines containing aristolochic acid, should be avoided.

What is the difference between hemodialysis and peritoneal dialysis?

Among domestic dialysis patients, about 90% are treated with hemodialysis . This method is to open an artery and vein in the arm or implant an artificial blood vessel, so that the blood flows out of the pipeline and enters the artificial kidney installed on the hemodialysis machine to make toxins. Clearance and exchange of substances before sending clean blood from the vein back into the body.

However, this hemodialysis treatment must be carried out in the hospital’s dialysis center or a special dialysis room, and it needs to be carried out 2-3 times a week for about 4 hours each time. Arterial and venous openings or artificial blood vessels in hemodialysis may increase the burden on the heart, so they are not suitable for chronic kidney disease patients with poor cardiac function or severe myocardial hypoxia.

Another type of dialysis is peritoneal dialysis, which requires a dialysis tube to be implanted in the abdominal cavity. Peritoneal dialysis can be operated by patients at home, which is more free in life and more suitable for people who work; usually only need to change the medicine 3-4 times a day, or directly use the machine to automatically change at night according to the setting, and move more freely during the day. However, because it needs to be operated on its own, it is easy to cause peritonitis if the operation is not careful, so people with poor self-care ability are not suitable.

What are the complications of dialysis patients?

At the beginning of hemodialysis, acute complications may sometimes occur. For example, the metabolites in the patient’s body are too high. During acute hemodialysis, the toxins will drop too much all of a sudden, causing too much difference in the concentration inside and outside the brain cells. It causes cerebral edema, nausea, vomiting, coma and other symptoms. It is recommended that patients not wait until the toxins in the body are too high before starting dialysis.

In addition, long-term chronic dialysis patients are most likely to experience low blood pressure and cramps during normal hemodialysis, which often occurs when a large amount of water needs to be removed from the body during hemodialysis, such as when a hemodialysis needs to dehydrate more than 3-4 kg. .

As for chronic complications, the most common ones are hyperphosphatemia and hyperparathyroidism, both of which may cause calcium and phosphorus imbalances in the body, resulting in chronic problems such as cardiovascular disease and osteoporosis.

Once on dialysis, is dialysis required for life?

This is not necessarily. Generally speaking, if the chronic kidney disease has entered the terminal stage, and there are obvious symptoms, dialysis needs to be started. In this case, the patient generally needs long-term dialysis treatment to maintain life; Sexual acute kidney injury, such as kidney injury drugs, blood pressure too low or too high, sepsis, heart failure, etc. If these acute kidney injury can be controlled as soon as possible, and the kidney function has a chance to recover, dialysis is not necessary, but dialysis The situation needs to be judged by a doctor and cannot be stopped on its own.

For patients with chronic renal failure, who have entered the end-stage or uremia stage, if they have the opportunity to receive kidney transplantation, long-term dialysis may not be required. I will also recommend everyone to donate organs. In fact, it is “everyone for me, I for everyone”. In addition, there is currently a so-called implantable artificial kidney in the United States. Although clinical trials have been completed, it will take some time before it can be widely used. As for the effect, it depends on the subsequent clinical application.

What should dialysis patients pay attention to in their diet?

If the kidney function is not good, it is necessary to control the intake of salt and water and a low-protein diet first in the diet. In daily life, you need to control your weight, limit your daily increase to no more than one kilogram, and measure your blood pressure frequently to keep your blood pressure stable.

When the kidney function is severely weakened to the 4th and 5th stage of chronic kidney disease, the intake of potassium ions should be very careful, otherwise hyperkalemia may lead to arrhythmia, and fruits with high potassium content must be avoided, such as: coconut, kiwi fruit, Grapes, cherries, citrus, etc. Be careful with phosphorus intake, otherwise it is easy to produce hyperphosphatemia. Many processed foods contain phosphorus, including coffee, milk, tea, preservatives, foaming agents, artificial sweeteners, dried fruits, soups, etc. avoid. It is also strictly forbidden to eat carambola with high oxalic acid content, gastric medicines containing aluminum, and medicines containing magnesium ions.