If chronic kidney disease enters the end stage, dialysis will be a must-do thing like eating. However, because they do not understand, many friends will be afraid and run away.
Dr. Clove visited Aunt Wang, who has been dialyzed for nearly ten years, and sorted out her experience. I hope Aunt Wang’s story can encourage patients to face the disease bravely and treat it scientifically.
Ten years ago, the doctor said: Dialysis treatment is recommended.
In 2003, Aunt Wang found out [chronic glomerulonephritis] and actively adjusted her lifestyle and medication, but the disease finally progressed to uremia.
A renal examination in 2006 showed that Aunt Wang’s blood creatinine count had reached 730 mol/L. The doctor told her that dialysis was needed.]
Dr Clove said:
Dialysis is a method of renal replacement therapy.
According to the guidelines for the treatment of chronic kidney disease: when chronic kidney disease enters the end stage, dialysis treatment is recommended. According to the common clinical treatment standards, dialysis should be considered when the serum creatinine of patients with chronic kidney disease is greater than 700 mol/L.
Doctor, is dialysis necessary?
Aunt Wang said, in fact, at that time, already had psychological preparation. But when I learned that I really wanted to start dialysis, it was a lie to say that I was not afraid. The first reaction was to escape.
Doctor, can you not do dialysis first? Is it okay to maintain medication, control blood pressure and electrolyte level?
Dr Clove said:
When the serum creatinine of some patients is more than 700 mol/L, they can still maintain a daily urine output of about 2,000 mL without obvious discomfort.
For this kind of situation, doctors generally advise patients to prepare before dialysis.
For example, patients who choose hemodialysis should first establish arteriovenous fistula (a minor operation on the elbow to facilitate later operation and improve dialysis efficiency); Patients who choose peritoneal dialysis should prepare for abdominal catheterization. Contact the hospital for long-term dialysis and adjust the psychological conditions of patients and their families.
However, it should be noted that dialysis must be started immediately once any of the following situations occur:
- Accompanied by severe congestive heart failure or acute pulmonary edema; Blood potassium is more than 6.5 mmol/L, and drugs cannot be controlled. Nausea, vomiting and consciousness disorders occur in acidosis beyond drug control. Accompanied by severe pneumonia, myocardial infarction, etc.
It is not as difficult as imagined.
Hemodialysis, feel this blood flow in and out, fear is there.
But the doctor patiently explained the meaning of dialysis to me and described the general process. At that time, my family also gave me a lot of encouragement and supported me through the period of psychological disorder.
After doing it once, I found that it was not as terrible as I imagined. About 4 hours, a sleep passed, my heart function was good at ordinary times, and I didn’t feel flustered or nauseous or vomiting in the process.
Dr Clove said:
No matter hemodialysis or peritoneal dialysis, dialysis patients should have no obvious pain during dialysis.
Some patients show bone headache, muscle pain, fatigue, poor appetite or unstable blood pressure, etc., which are related to insufficient dialysis on the one hand and poor dietary control or drug use effect outside dialysis treatment on the other.
These problems can be solved through changes in one’s own lifestyle and doctors’ adjustments to dialysis and drug therapy.
In terms of expenses, I can still afford it.
At first, I was also worried about the economy. My family has already taken great pains to take care of me. If my illness causes too much financial burden again, I really feel sorry for my wife and children.
I am from Beijing. Hemodialysis is around 480 yuan every time. According to the reimbursement rate of Beijing’s medical insurance, the monthly cost is generally 500 ~ 800 yuan. Fortunately, for me, it is still affordable.
Dr Clove said:
Generally speaking, hemodialysis needs to be done 3 times a week. The specific price and medical insurance reimbursement ratio vary slightly from place to place, but the difference will not be particularly wide. The cost of peritoneal dialysis will be lower.
As Aunt Wang shared, as long as regular dialysis is carried out to ensure that the relevant indicators meet the standards, except that they cannot engage in heavy physical labor, they are the same as ordinary people in other aspects.
Dialysis itself will not shorten the life span of patients.
Clinically, it is not uncommon for patients with dialysis age of more than 20 years. And with the improvement of technology, the quality of life of patients will get better and better.
Nearly ten years, alive, good
I told the health headline about my experience, hoping to give more confidence to the patients and their families.
Uremia is not an incurable disease. If it can be properly treated, it can live for a long time.
You see, can’t I still share my story here? Thanks to the doctor and my family, I have been able to persist in fighting the disease until now.