Recently, a piece of news has aroused widespread public concern. Due to the inability to afford the high treatment cost, a uremic patient in Hunan underwent dialysis at home for three years. He thought that his condition could be relieved, but it backfired and his condition tended to deteriorate.
With poor equipment, difficult conditions and serious illness, the experience of this uremic patient really makes people sympathize. Can uremic patients have dialysis at home? What good suggestions do nephrologists have for such patients? Clove Garden kidney moderator, senior nephrology experts put forward their own views.
Uremia is not a rare disease.
Uremia is not a rare disease in our country. The latest survey shows that the prevalence rate of chronic kidney disease in our country is about 10.8%. According to this proportion, the number of patients with chronic kidney disease in our country exceeds 120 million, i.e. One in 10 people on average suffers from chronic kidney disease.
What is the proportion of uremic patients who need dialysis? According to the prevalence rate of uremia in Europe, America, Japan, Thailand and other countries, there are about 200-250 people per 1 million people. It is estimated that the current number of uremia patients in China is about 1-2 million, and the actual number of dialysis patients is about 400,000.
Kidney transplantation is not the only option.
At present, there are three mature methods to treat uremia: peritoneal dialysis, hemodialysis and kidney transplantation. With the progress of dialysis technology, uremia patients can completely survive for a long time and even have a high quality of life, including engaging in some work within their capabilities. Female dialysis patients also have reports of successful pregnancy.
Dialysis is the most important way to treat uremia, and there is no one. People cannot live without heart, liver or lung, but they can still live without kidney because of dialysis.
There is no denying that, If conditions permit, kidney transplantation is also a very good choice. However, the lack of kidney source and the relatively high cost of treatment make kidney transplantation the most common choice for uremic patients. For example, when buying a house, you can’t all stare at the villa. A set of suitable ordinary residential buildings can also live in warmth.
If media reports all regard kidney transplantation as the only way to treat uremia, it may backfire and delay the treatment of patients in the end.
Peritoneal dialysis does not need to be done in a hospital.
Peritoneal dialysis and hemodialysis are both effective means to treat uremia. Peritoneal dialysis has been widely used in the treatment of uremia worldwide. Hong Kong, China, even implements the priority policy of peritoneal dialysis, that is, uremia patients are generally preferred to do peritoneal dialysis if there are no special reasons.
Peritoneal dialysis is performed by patients at home, which is one of its characteristics. Therefore, [dialysis at home] should not become a gimmick, but a popular science common sense: peritoneal dialysis itself does not need to be completed in a hospital.
There is only one tube for peritoneal dialysis, one end inside the stomach and the other end outside the body. Dialysate enters the abdominal cavity from this tube and stays for a period of time. After that, it will absorb metabolic waste of the human body and then be released in the same way. It is not reported [two transparent rubber tubes inserted into the body can be clearly seen].
Peritoneal dialysis has many benefits,
Compared with hemodialysis, peritoneal dialysis has its own advantages. For example, patients are more free and not limited to hospitals. For example, the risk of hepatitis B, hepatitis C and other infectious diseases in peritoneal dialysis is lower than that in hemodialysis. For example, dialysis at home saves travelling expenses between the hospital and the residence and dining out.
In addition, there is a very important point, the cost of peritoneal dialysis is lower than that of hemodialysis. Research by the National Health Development Research Center shows that the annual cost of peritoneal dialysis is 93,500 yuan, while the annual cost of hemodialysis is 103,400 yuan.
Precautions
1. The prescription of peritoneal dialysis is not static, This is not to say that the doctor asked to do this at the beginning and has been doing it ever since. The disease condition will change and the treatment plan should be changed accordingly. For patients with long-term peritoneal dialysis, regular evaluation should be carried out and the treatment plan should be adjusted according to the actual situation. If it is really not suitable for peritoneal dialysis, it can also be changed to hemodialysis.
2. The home environment for peritoneal dialysis requires a relatively independent room with ultraviolet lamps installed for regular disinfection. The room should be kept clean, dry, ventilated and well lit, and others should be prevented from walking around when changing liquid.
3. Not that peritoneal dialysis alone can solve all the problems of uremia, In addition to dialysis, it is also necessary to control blood pressure and treat anemia. Patients return to regular visits and evaluate all the above aspects. Only when all aspects meet the standards can dialysis be a good one. This [standard] can be achieved as long as patients and doctors work together. On the other hand, if they do not work hard, treatment will be in trouble.
4. Our country still pays more attention to uremia, Especially in recent years, The Health Planning Commission has successively issued many policies, Vigorously promote peritoneal dialysis nationwide. And uremia is one of the 8 major diseases covered by medical insurance, and its expenses go through special medical insurance reimbursement for serious diseases. The new rural cooperative medical system, which began to be implemented in 2012, has now covered more than 95% of the population, and the reimbursement rate of expenses is at least 70%. If it is urban workers or residents, it can generally reach 90% of the reimbursement rate.
To sum up, uremic patients can survive for a long time after receiving professional medical guidance and peritoneal dialysis treatment at home.
References:
1. Xueqing Yu, Xiao Yang. Peritoneal Dialogue in China: Meeting the Challenge of Chronic Kidney Failure. Am J Kidney Dis. 2015; 65 (1): 147-151.
2. Zuo L, Wang M. Current burden and probable increasing incidence of ESRD in China. Clin Nephrol. 2010; 74 (suppl 1): S20-S22.
Editor: Fei Fei
By xiaospring
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