What Can We Do Besides Dialysis When Diagnosed with Uremia?

Article Translation: Uremia is a colloquial term for end-stage chronic kidney disease, where severely impaired kidney function fails to meet the body’s metabolic needs. This leads to the accumulation of toxins—normally excreted through urine—in the bloodstream.

While dialysis remains the conventional treatment for uremia, are there truly no other options?

When Is Dialysis Necessary?
Though no kidney patient wishes to undergo dialysis, it becomes critical in certain high-risk situations. For instance:

• If the glomerular filtration rate (GFR) drops below 10ml/min, dialysis is required even if urine output appears normal.
• Severe hyperkalemia or metabolic acidosis also necessitates dialysis.

Dialysis helps the kidneys remove excess blood toxins but is not a cure—it’s a temporary relief measure.

Are There Alternatives to Dialysis?
The answer lies in the body’s natural mechanisms.

Humans constantly replenish energy (e.g., through food), a process that inevitably introduces harmful substances. Additionally, metabolic waste is produced internally. These toxins must be expelled promptly, primarily through three pathways: stool, urine, and sweat.

While kidneys manage urinary excretion (supplemented by dialysis), other methods include:

1. Colon Dialysis (Herbal Enema): A growing trend, this affordable and low-risk approach aids detoxification via the intestines, though less effective than hemodialysis.
2. Sweat Therapy: Using medications or physical methods to promote sweating and toxin elimination.

Beyond these, adjusting the patient’s mindset is vital in uremia management.

The Truth About Uremia Treatment
Many patients—and even some doctors—believe treatment is futile at the uremic stage. Some physicians advise patients with creatinine levels around 500 to “wait for dialysis,” which is highly irresponsible.

While kidney disease is incurable, abandoning care is not the answer. Just as we don’t resign ourselves to death despite its inevitability, proactive management matters.

In uremia, azotemia severely impacts organs/systems, causing debilitating complications exacerbated by dialysis. Treatment’s value lies not in lab metrics but in alleviating suffering.

If uremic patients face only cold dialysis machines and incomprehensible reports, what is the point of care?

In my view, all medical treatment—uremia included—is a collaborative exploration between doctor and patient. Physicians must address physical pain while educating patients to understand their bodies and conditions.

Like teachers who guide students to learn rather than merely pass tests, doctors should empower patients to navigate their health challenges.