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What is end-stage renal disease?

When renal function declines to below 10% of the normal capacity, the kidney can not  handle metabolic wastes and water efficiently. Then uremic symptoms, such as edema, nausea, vomiting, fatigue and dyspnea would appear. In addition to diet modification and medical treatment, renal replacement therapies are eventually mandatory for maintenance of homeostasis and prevention of life-threatening complications.

 

What treatments are available for ESRD?

Conservative treatment

Symptomatic treatment with medication and diet restriction offluid, salt, protein and some electrolytes are simple and easy to carry out, but may not be enough for those with advanced renal failure.

Renal replacement therapies

Renal transplantation：After renal transplantation, lifelong use of immunosuppressant is necessary to prevent rejection. In addition to cadaveric kidney, kidney from a living related donor is also an option.

 

Hemodialysis

Advantages	Disadvantages
• clear waste and water rapidly and efficiently • procedure operated by professional people • frequent contact with medical staff	• suffering due to vascular puncture • more discomfort during and after the treatment • waste and fluid accumulation between the treatments • more strict restriction of diet needed • more adverse effect to cardiopulmonary system • more likely to be anemic for blood loss during the treatment • the schedule of the treatment cannot be changed freely

 

Peritoneal dialysis

Advantages	Disadvantages
• continuous removal of wastes and water • more room for self control • less restriction of diet • no need for puncture • less anemia • less effect to cardiovascular system • better preservation of residual renal function • more flexible treatment schedule	• possibility of peritonitis and catheter related infection • body weight gain and lipid profile abnormality • more protein loss during treatment

1. Accept the condition of renal failure and try to adapt for it, discuss with your physicians about your feeling and planning.
2. Think about what kind of lifestyle you want after initiation of dialysis.
3. Discuss with nephrology specialists about what is the most suitable choice for you.