Is it possible to avoid dialysis with a blood creatinine level of 1000 μmol/L?

Generally, whether dialysis is necessary when serum creatinine reaches 1000 μmol/L depends on a comprehensive evaluation of the underlying cause, kidney function status, and systemic symptoms. If any discomfort occurs, timely medical consultation is recommended. Detailed analysis is as follows:

The normal serum creatinine range is typically 53-106 μmol/L for males and 44-97 μmol/L for females. A level of 1000 μmol/L significantly exceeds the normal range, suggesting that the glomerular filtration rate may have fallen below 15 ml/min/1.73 m². If the cause is acute kidney injury, such as dehydration or drug toxicity, kidney function may partially recover after removal of the triggering factor. In such cases, conservative management, including fluid replacement and correction of electrolyte disturbances, may be initially considered without immediate dialysis.

However, if the condition is due to chronic kidney disease progressing to the uremic stage, such as diabetic nephropathy or end-stage chronic glomerulonephritis, patients often present with severe uremic symptoms including nausea, vomiting, pulmonary edema, and hyperkalemia. In these cases, withholding dialysis may lead to worsening toxin accumulation, potentially causing life-threatening complications such as arrhythmias and coma.

Regardless of whether dialysis is chosen, close monitoring of the patient's condition and adherence to medical advice are essential. Patients should also maintain healthy lifestyle habits and avoid consuming spicy or irritating foods such as pepper, chili peppers, and garlic, as these may hinder recovery.