/Is creatinine more than 700 necessary for dialysis? What con

Is creatinine more than 700 necessary for dialysis? What con

author:admin       pubdate:2017-08-22 11:55

When kidney disease develops into uremia, many people choose dialysis treatment to control the rise of creatinine, but some people are afraid of the side effects of dialysis, such as anemia, hypotension, and so on, so they do not want to dialysis

What kind of circumstance must be dialytic then, what circumstance can be dialytic temporarily?

These three aspects can be considered: the symptoms of the patient, the condition of renal function and the rate of the decline of the renal function

Here, we first understand the four stages of chronic renal failure and the rate of creatinine clearance (Ccr, units: ml/min) and creatinine (Scr: units moI/L) during each period:

In general, as long as the patient to uremia can dialysis, is to achieve the following indexes: serum creatinine of more than 708 moI/L, the creatinine clearance rate is less than or equal to 9ml/min. but this index is not absolute, because each condition development degree and the situation is different, the need for comprehensive consideration, to determine the best time to start dialysis patients.

Such as diabetic nephropathy caused by renal failure, because of the late progress rapidly, hypertension, retinopathy and renal microvascular disease and other complications are common, usually earlier than other types of dialysis, Ccr without prior to 9ml/min will arrange according to the patient's dialysis, is generally Ccr less than 15ml/min when the choice for dialysis patients;

Although some patients have less than 707 of serum creatinine or the rate of creatinine clearance is not completely up to the standard of dialysis, there is a high degree of edema, urinary failure, heart failure, or complicated with pulmonary edema and cerebral edema, and dialysis should be carried out immediately;

There are middle-aged and elderly patients with kidney disease in the late accumulation of a large number of toxins, due to the decline in their metabolic capacity, coupled with the decline in renal function, can not successfully discharge toxins outside, but also can only rely on dialysis to expel toxins

Is the earlier the better?

Not long. We are late to dialysis for dialysis, dialysis time, patients can help the body to excrete excess toxins, reduce creatinine, reduce complications, and improve the quality of life of patients.

In the early kidney damage, and the residual kidney can play their own "heat", if premature dialysis, is not conducive to the protection of renal function, the remaining on the contrary, the late dialysis is not good, prone to serious complications and complications, affect the survival of treatment, a serious threat to life.

How to protect the remaining kidney function?

Refers to the residual renal function in patients with chronic renal failure, to end-stage renal function, part remains, although these have little residual renal function (the function of less than the normal 10%), not even enough to sustain life, but the toxin in the body of patients and a clear excess water, and nutrition control to maintain the blood pressure and still have a great effect, thus protecting residual renal function is very important!

How to protect the residual renal function?

1. control the protein intake in your diet

2. control blood pressure within an ideal range: ACEI or class ARB antihypertensive drugs are available

3. control blood sugar: use hypoglycemic agents or insulin to control blood sugar in the normal range

4. avoid drug use renal toxicity, such as aminoglycoside antibiotics, contrast agent etc.

5., avoid infection, anemia, calcium and phosphorus metabolism disorders and other complications

6. consider the choice of a better dialysis modality for the preservation of residual renal function, such as peritoneal dialysis



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