Mr. Cui, who is in his 50s, has been suffering from diabetes for many years. He was found to have diabetic nephropathy a few years ago. In the past two years, the nephropathy has progressed rapidly, and his physical condition has declined seriously. This year, he went to the hospital for examination. In the case of sexual acidosis, the doctor decided that he was best treated with dialysis. Originally, Mr. Cui was worried about his own kidney disease. When he checked related diseases online, he mentioned kidney failure and dialysis, and said that his life expectancy would be greatly shortened after dialysis, which made him reject dialysis.

According to Chinese statistics, about 10.8% of the population with chronic kidney disease, that is to say, at least 1 in every 10 people suffers from chronic kidney disease . In fact, chronic kidney disease includes chronic kidney failure in a wide range, but most people think that kidney disease The end stage is renal failure, which is equivalent to uremia. This is actually a misunderstanding.

Generally, it has entered the terminal stage of kidney disease, when the kidneys can no longer bear the function of the human body, and generally enter uremia. At this time, dialysis treatment is required. According to the latest data, the number of dialysis treatment in China exceeds 800,000, and some patients are due to various Dialysis was not carried out for various reasons, among which there are reasons like Mr. Cui.

With the number of people on dialysis increasing year by year, many people have various questions about dialysis and renal failure, such as how long does it take to die on dialysis, how long you can live without dialysis, and how long you can live without dialysis. The key point is also what patients need to know urgently. For this reason, I will tell you about the impact of renal failure and dialysis on people’s life expectancy.

Do you need dialysis for chronic kidney disease, or your life expectancy will be shortened?

Kidney functions include regulating blood pressure, water, electrolyte and acid-base balance, and removing metabolites and toxins from the body. Chronic kidney disease, including chronic renal failure, means that kidney function is impaired and decreased, but it does not mean that the kidneys have completely lost their function.

In fact, chronic kidney disease can be divided into 5 stages according to age, gender, serum creatinine, and after comprehensive calculation of glomerular filtration rate (GFR), only stage 5 end-stage renal disease (GFR less than 15% : why is it? Below 15%, it is generally believed that the glomerular filtration rate is lower than 15%, and the kidneys cannot maintain the normal function of the human body. Of course, it varies from person to person. Some patients may have a low glomerular filtration rate, but the human body Dialysis treatment is recommended only for those who can not normally remove metabolic wastes and water from the body.

The focus of treatment in the first four stages will be to maintain kidney function through diet, blood sugar and blood pressure control, and delay the deterioration of kidney disease into the end stage.

Another condition that requires dialysis is “acute renal failure”. Acute renal failure is mostly caused by other diseases. As long as the cause is identified and treated, and kidney function is restored through dialysis, patients usually do not need to continue dialysis treatment.

Based on the above information, we have learned that not all chronic kidney diseases require dialysis, but in the terminal stage, dialysis must be performed, otherwise various symptoms may occur, such as oliguria, anuria, severe hypertension, hyperkalemia , severe metabolic acidosis, heart failure, etc. In the case of these complications, the patient’s lifespan will definitely be affected and greatly shortened.

End-stage renal failure, even on dialysis, life is not long?

According to statistics, the survival rate and life expectancy of end-stage renal failure will vary according to age, disease and physical condition, according to the following reference data:

20-44 years : The chance of 5-year survival on dialysis is higher than 80%, which increases life expectancy by 15-20 years.

45-64 years old : The chance of surviving 5 years on dialysis is about 60%, which can prolong life by 10-15 years.

65-74 years : The chance of 5-year survival on dialysis is higher than 50%, which increases life expectancy by 6-8 years.

Over 75 years old : The chance of 5-year survival on dialysis is about 30%, which can prolong life by 2-5 years.

However, if the dialysis patient also suffers from multiple chronic diseases, such as hypertension, diabetes or cardiovascular disease, or if the elderly over the age of 75 has some chronic diseases, the survival years after receiving dialysis treatment are generally shorter.

According to the above data, if you receive dialysis treatment at the age of 50, the estimated life expectancy can be extended for a long time, and you can also try kidney transplantation at this time, which can even achieve a normal life expectancy. Therefore, for Mr. Cui’s situation, dialysis is preferred. treat.

Dialysis is painful, how long can I live without dialysis?

When patients enter end-stage renal failure, it is difficult for the kidneys to continue to excrete metabolites, toxins and excess water from the body, and uremia symptoms such as nausea, vomiting, loss of appetite, physical weakness, and difficulty breathing are prone to occur.

If they do not receive active treatment, some patients may also have complications such as acute pulmonary edema, acute myocardial infarction, heart failure, and sepsis, and the mortality rate is extremely high. Therefore, once the doctor diagnoses end-stage renal failure, they should receive dialysis treatment according to the doctor’s instructions. or kidney transplant surgery.

Receiving dialysis treatment can significantly improve the health status of patients and prolong the life of patients with end-stage renal disease; if the dialysis patients discontinue treatment, the average number of days to survive is 8-10 days, and the longest is no more than 30 days.

Foreign institutions have also tracked kidney disease patients without dialysis, and found that depending on the patient’s physical condition, if they do not have dialysis, patients with poor health will die within 1-3 months, while patients with better health can last for more than 1 year. about. Of course, this statistic is not rigorous enough, but it also shows that if dialysis treatment is not performed at the end stage of kidney disease, life expectancy will be greatly shortened.

The elder in his 80s has complications and has experienced dialysis for many years. During this period of time, he has rejected dialysis, can he stop it?

This problem does exist. There are indeed some dialysis patients in clinical practice. They are older, generally over 80 years old, suffering from a variety of chronic diseases, cancer or Alzheimer’s disease. Bedridden on a ventilator and intubation, so often feel repulsed by frequent hospitalizations, continued dialysis treatment, and a desire for palliative care.

At this time, family members will be faced with considering various medical possibilities, doctor’s recommendations, and the patient’s own mood and wishes. This is a major challenge for family members.

If you continue to receive active treatment, even if the patient’s lifespan is prolonged, he will be physically and mentally traumatized when he dies, or may be in extreme pain; on the contrary, receiving palliative care will ease the patient’s pain, allow the patient to have more time to talk and accompany the patient, and finally be in a calm state. Would it be the best arrangement to leave?

Here, I can’t give you the answer. It is best for family members to communicate with doctors and patients more, understand the burden that continued treatment may bring to patients, and solve this problem from the perspective of respecting the patient’s wishes.