Chronic Renal Failure Replacement Therapy

Written by Wang Fei Long
Nephrology
Updated on August 31, 2024
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Chronic kidney failure is the irreversible loss of nephron units and kidney function caused by the progressive progression of chronic kidney disease, leading to a clinical syndrome characterized by the retention of metabolic products and toxins, disturbances in electrolyte and acid-base balance, and endocrine disorders. Chronic kidney failure often progresses to end-stage kidney disease, and the late stage of chronic kidney failure is called the uremic stage. After entering the uremic stage, renal replacement therapy is often required, with the main methods being hemodialysis, peritoneal dialysis, and kidney transplantation.

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Is stage five chronic kidney failure serious?

Strictly speaking, there is no condition called "chronic renal failure stage five," but there is a term "chronic kidney disease stage five." Chronic kidney disease is divided into five stages based on the glomerular filtration rate (GFR). Stage five chronic kidney disease indicates that the patient's GFR is less than 15 milliliters per minute, which is about 15% of normal kidney function and is essentially equivalent to uremia. Therefore, chronic renal failure or chronic kidney disease stage five is very dangerous and can cause many complications. Moreover, this type of kidney failure is irreversible and incurable, and the patient may need to undergo dialysis or a kidney transplant.

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Can chronic renal failure become pregnant?

Although patients with renal failure are not absolutely unable to become pregnant, pregnancy is ultimately a burden on the kidneys. Pregnant patients with renal failure may experience further deterioration of kidney function and may face numerous complications during pregnancy, such as heart failure, severe anemia, etc., which may pose some risks. However, there are still very rare case reports, including successful pregnancies in patients on dialysis for uremia, but the probability of this is extremely small, and the risks involved are too great. Generally speaking, it is not recommended for female patients with chronic renal failure to become pregnant.

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Written by Pan Wu Shan
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What is good to eat for chronic renal failure?

Dietary aspects of chronic kidney failure should be divided into two parts. Firstly, for patients who have not reached the uremic phase and have not undergone dialysis, it is important to maintain a low-salt, low-fat, high-quality low-protein diet, limiting salt intake to no more than three grams per day and avoiding fried and greasy foods. Lower-quality proteins like beans, soybeans, mung beans, etc., should be consumed in smaller quantities. Instead, more animal proteins should be consumed, such as lean meats, eggs, and milk. Once patients have entered the uremic phase and have started dialysis, a low-salt, low-fat, high-quality high-protein diet is necessary, as dialysis requires a significant amount of energy. Additionally, it is crucial to restrict fluid intake; consuming too much salt or water can easily lead to generalized edema and cardiovascular complications.

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Chronic Renal Failure Treatment Plan

The treatment of chronic renal failure primarily requires a clear understanding of the cause, and treatment targeting the cause is essential to slow the progression of chronic renal failure. The most common causes of chronic renal failure are diabetes, hypertension, and chronic nephritis. Therefore, for patients with chronic renal failure caused by diabetes, insulin is often needed to control blood sugar. For patients with hypertensive kidney disease, antihypertensive drugs are certainly necessary to control blood pressure. However, in the early stages of renal failure, ACE inhibitors or ARBs are the preferred choices. For patients with chronic nephritis in the early stages, corticosteroid medications are required for treatment. However, if the serum creatinine has already exceeded 256 micromoles per liter, treatment then focuses mainly on managing complications, and corticosteroids are no longer used. (Please use medications under the guidance of a doctor.)

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early symptoms of chronic renal failure

Patients with chronic kidney failure often do not have any specific discomfort or noticeable symptoms in the early stages. However, some patients may exhibit clinical signs, such as edema, due to the kidneys' reduced ability to excrete water, or hypoproteinemia, which leads to a decrease in plasma colloid osmotic pressure, resulting in edema in the lower limbs or eyelids, and facial swelling. Patients may also experience visible blood in the urine, increased urinary foam, and chronic kidney failure often accompanies high blood pressure. Such patients may also suffer from mild renal anemia, hyperkalemia, and other clinical manifestations.