Whether it is a daily physical examination or a routine examination for nephropathy treatment, to determine whether the kidney function is good or bad, you need to do some kidney-related examinations. Through the examination results, you can more accurately understand the condition of the kidney and the changes in the condition. Accurate examination results are the basis of treatment. There are many nephropathy examination items. Some patients have symptoms of discomfort for the first time, but the examination is not comprehensive, and the disease is not found in time, or the treatment is not timely, resulting in more and more serious illness and missed the best treatment. Time makes it difficult to reverse the condition. Nephropathy examination mainly includes two aspects: one to check blood and two to check urine, and different indicators reflect different kidney functions. Some inspections need to be reviewed multiple times, and some indicators can judge the results only once. Kidney function is not good, these three tests must be checked, no need to struggle! The three major examination items of urine examination are the routine urine examination. The indicators in the routine urine examination mainly reflect two aspects, inflammation and kidney problems. Nephropathy treatment-related indicators mainly include urinary red blood cells, white blood cells, urine protein, and urine specific gravity. High red blood cells and white blood cells indicate inflammation, specifically kidney inflammation or urinary tract inflammation, which needs further examination. The changes in urine protein and urine specific gravity can directly reflect the condition of the kidney. The presence of urine protein + is positive, and the increase in urine specific gravity indicates a problem with the kidney. Of course, the problem of transient urine protein should also be ruled out, that is, physiological factors such as eating too many high-protein foods, vigorous exercise before examination, etc. cause abnormal urine tests. Some patients in the early stage of kidney disease have no obvious symptoms, and there are often obvious abnormalities in the examination indicators, which are of great significance for the early treatment of kidney disease. Compare and see what happens to your test order? Urine morphological analysis sounds very high, what tests are they? Many kidney friends look at the test sheet and may have seen these indicators: tube type, crystal, bacteria, epithelial cells, etc. These tests have an important role in further determining the condition of kidney damage, such as a high rate of urine red blood cell deformation, mostly kidney The damaged glomerulus indicates glomerulonephritis. Urine protein in-depth inspection routine examination can find the presence of urine protein + sign, to clarify the situation of protein leakage, the degree of glomerular damage, the degree of impaired renal function, further urine related examinations are needed. Mainly include: 24-hour urine protein quantification, urine total protein creatinine ratio, urine albumin creatinine ratio and so on. The first two indicators have similar functions and can be replaced with each other, just check some of them. A large amount of protein leakage mainly reflects the impaired glomerular filtration function and the degree of glomerular lesions. In general, the more proteinuria, the more severe the damage to kidney function. The urine albumin creatinine ratio test is more accurate than the previous two tests. It can detect patients with kidney damage, but only mild proteinuria symptoms, such as diabetic nephropathy and hypertensive nephropathy. If you have a long history of sugar friends and high blood pressure patients, you will find that there is foam in your urine and no symptoms, but you can’t find any problems in urine routine. Remember to check this indicator. Two routine blood tests include blood creatinine, uric acid, and urea nitrogen. The kidneys are detoxifying organs. The increase in these indicators is a manifestation of increased levels of toxins in the body. It also indicates that the kidneys’ detoxification function is reduced. It’s half over. Hemoglobin Hemoglobin mainly plays the role of loosening blood oxygen to ensure normal blood flow rate. If abnormality occurs, most of them indicate anemia. In the middle and late stages of kidney disease, erythropoietin production decreases and spinal cord hematopoiesis decreases, and renal anemia occurs. A small number of patients often detect anemia first, and eventually diagnose kidney disease. Anemia will cause the degeneration of various functions of the body, in particular, it will cause a decline in immunity, which is not conducive to the stability and treatment of the disease. Renal function test In addition to the above tests, to further understand the examination of renal function, there are glomerular filtration rate, memory creatinine clearance rate, renal B ultrasound, electrolyte-related tests, etc. The abnormality of these indicators further indicates changes in renal function, and is particularly critical for the prevention of renal failure. More attention should be paid to the treatment. My name is Yang Yanfang. I am good at various glomerular diseases, such as IgA nephropathy, membranous nephropathy, hematuria, proteinuria, lupus nephritis, and treatment of chronic renal insufficiency. I have more than 40 years of clinical experience. Welcome to pay attention to this account. For related questions, you can leave a message or private message. After reading it, I will answer your confusion in detail.
The human body has 2 kidneys, each kidney has 1 million nephrons, a total of about 2 million. When they are destroyed, the kidneys are destroyed. What is a nephron? A glomerulus filters the blood into raw urine, and a renal tubule filters the raw urine into final urine. As shown in the figure: a glomerulus + a renal tubule, connected together, is a renal unit with renal function. 2 million, sounds like a lot? But be aware that destroying them is actually very simple. These 2 million nephrons are non-renewable. The five intrinsic cells of the kidney have been highly differentiated and are destined to be non-renewable cells. Unlike the liver cells next door, they can also be regenerated. 2 million nephrons, only one-third of the nephrons are needed for daily work. Does it look good? In fact, the kidney is nothing more than to cover up its non-renewable vulnerability. How to kill nephron? 1. Eating outside, the daily intake of sodium for people with exhausted nephrons should not exceed 1500mg, otherwise it will significantly increase blood pressure and urine protein. However, according to the monitoring of nutrition and health status of Chinese residents in 2012, we found that our daily sodium intake was as high as 5706.7 mg, which is 3.8 times the appropriate intake, mainly because of eating too much salt (table salt is sodium chloride). In order to grasp the stomach of diners, restaurants usually put a lot of salt and oil in food and takeout. Some people like to order a lot of meat to eat, and they will unknowingly exceed the protein intake. Excessive salt, oil and protein will increase the burden on the kidneys. Some nephrons are overwhelmed and will be exhausted. Kidneys like you to go home to eat and make healthy meals yourself. 2. Stay up all night, the lack of sleep of the necrosis unit, the body will be in a state of tension for a long time, causing abnormal vasoconstriction, easy to induce continuous increase in systemic blood pressure and intrarenal pressure, and induce and aggravate kidney disease. Compared with people who sleep 7 hours a night, people who sleep less than 6 hours have a 70% increased risk of proteinuria. Proteinuria can cause nephron sclerosis, fibrosis and die completely. Smashed by a mobile phone or tablet in the middle of the night? It hit not only your face, but also your kidney. 3. Snacks, eat pickle of dead kidney unit, do you have much sodium? More, you can taste it with a lot of salt, very salty. Snacks, do they contain more sodium? Most people don’t know. Let’s take a look at the leader of sodium in snacks: the sodium content of plum. 100 grams of plum, containing 7660mg of sodium (remember the daily limit is 1500mg?), the total salt is 19.15g, “a bag of plum 1/5 is salt” is well-deserved. In addition, snacks such as spicy strips, dried beef, shredded squid, seaweed, ham sausage, potato chips, soda crackers, and melon seeds and peanuts are killers of large sodium-containing households and kidney units. 4. Sedentary, feeding the kidney unit thanks to the productivity development brought about by technology, modern people can eat and drink without much physical labor, and at the same time brings a drawback: sedentary. There are more and more patients with diabetes and hypertension in my country, and sedentary, lack of exercise, and obesity are important causes. In today’s nephrology wards, the most common type of kidney disease is diabetic nephropathy, and the number of patients with hypertensive nephropathy is also increasing year by year. Hyperglycemia and high blood pressure can hit the glomeruli and tubules at the same time, eventually causing irreversible necrosis of the nephron. 5. To hold urine, hold the bacteria in the urinary tract of the dead kidney unit to multiply one generation every 20 minutes, and to multiply nine generations in 3 hours, one bacteria can become 512 bacteria. There are 20 bacteria in 1ml of urine, which will reach more than 100,000/ml after 3 hours of reproduction, which may cause urinary tract infections such as “acute urethritis” and “acute cystitis”. Especially for women, due to physiological structure, urinary tract infections are very common, often from acute urinary tract inflammation to chronic nephritis, and then nephrons are killed one by one. 6. Tonic kidney, kidney kidney unit waist, sheep whip, collagen, soup, irregular medicinal diet, etc. People think that “big food” actually contains too much cholesterol, inferior protein, phosphorus, potassium, purine, As well as nephrotoxic substances, harm the nephrons. These so-called supplements not only do not supplement the kidney, but also damage the kidney. Both patients with kidney disease and healthy people must stay away. In our daily life, there are too many kidney-damaging behaviors, which are not listed one by one. Staying up all night and losing dozens of nephrons; eating a meal and drinking, and losing dozens of nephrons; coupled with sedentary, smoking, drinking, snacking, and wrongly nourishing the kidney, so much damage to the kidney Behavior, day after day, year after year,
Whether it is a daily physical examination or a routine examination for nephropathy treatment, to determine whether the kidney function is good or bad, you need to do some kidney-related examinations. Through the examination results, you can more accurately understand the condition of the kidney and the changes in the condition. Accurate examination results are the basis of treatment. There are many nephropathy examination items. Some patients have symptoms of discomfort for the first time, but the examination is not comprehensive, and the disease is not found in time, or the treatment is not timely, resulting in more and more serious illness and missed the best treatment. Time makes it difficult to reverse the condition. Nephropathy examination mainly includes two aspects: one to check blood and two to check urine, and different indicators reflect different kidney functions. Some inspections need to be reviewed multiple times, and some indicators can judge the results only once. Kidney function is not good, these three tests must be checked, no need to struggle! The three major examination items of urine examination are the routine urine examination. The indicators in the routine urine examination mainly reflect two aspects, inflammation and kidney problems. Nephropathy treatment-related indicators mainly include urinary red blood cells, white blood cells, urine protein, and urine specific gravity. High red blood cells and white blood cells indicate inflammation, specifically kidney inflammation or urinary tract inflammation, which needs further examination. The changes in urine protein and urine specific gravity can directly reflect the condition of the kidney. The presence of urine protein + is positive, and the increase in urine specific gravity indicates a problem with the kidney. Of course, the problem of transient urine protein should also be ruled out, that is, physiological factors such as eating too many high-protein foods, vigorous exercise before examination, etc. cause abnormal urine tests. Some patients in the early stage of kidney disease have no obvious symptoms, and there are often obvious abnormalities in the examination indicators, which are of great significance for the early treatment of kidney disease. Compare and see what happens to your test order? Urine morphological analysis sounds very high, what tests are they? Many kidney friends look at the test sheet and may have seen these indicators: tube type, crystal, bacteria, epithelial cells, etc. These tests have an important role in further determining the condition of kidney damage, such as a high rate of urine red blood cell deformation, mostly kidney The damaged glomerulus indicates glomerulonephritis. Urine protein in-depth inspection routine examination can find the presence of urine protein + sign, to clarify the situation of protein leakage, the degree of glomerular damage, the degree of impaired renal function, further urine related examinations are needed. Mainly include: 24-hour urine protein quantification, urine total protein creatinine ratio, urine albumin creatinine ratio and so on. The first two indicators have similar functions and can be replaced with each other, just check some of them. A large amount of protein leakage mainly reflects the impaired glomerular filtration function and the degree of glomerular lesions. In general, the more proteinuria, the more severe the damage to kidney function. The urine albumin creatinine ratio test is more accurate than the previous two tests. It can detect patients with kidney damage, but only mild proteinuria symptoms, such as diabetic nephropathy and hypertensive nephropathy. If you have a long history of sugar friends and high blood pressure patients, you will find that there is foam in your urine and no symptoms, but you can’t find any problems in urine routine. Remember to check this indicator. Two routine blood tests include blood creatinine, uric acid, and urea nitrogen. The kidneys are detoxifying organs. The increase in these indicators is a manifestation of increased levels of toxins in the body. It also indicates that the kidneys’ detoxification function is reduced. It’s half over. Hemoglobin Hemoglobin mainly plays the role of loosening blood oxygen to ensure normal blood flow rate. If abnormality occurs, most of them indicate anemia. In the middle and late stages of kidney disease, erythropoietin production decreases and spinal cord hematopoiesis decreases, and renal anemia occurs. A small number of patients often detect anemia first, and eventually diagnose kidney disease. Anemia will cause the degeneration of various functions of the body, in particular, it will cause a decline in immunity, which is not conducive to the stability and treatment of the disease. Renal function test In addition to the above tests, to further understand the examination of renal function, there are glomerular filtration rate, memory creatinine clearance rate, renal B ultrasound, electrolyte-related tests, etc. The abnormality of these indicators further indicates changes in renal function, and is particularly critical for the prevention of renal failure. More attention should be paid to the treatment.
Beer is a very popular drink for men, especially when the weather is hot for supper or friends gathering, they will drink a few glasses. However, drinking too much beer is harmful to the body. Especially for people with kidney disease, how to drink beer will increase the burden on the kidneys, and it may lead to kidney failure. Drinking too much beer leads you to kidney failure. Beer contains alcohol. Alcohol will increase the burden on the kidneys during the metabolic process. At the same time, the hops in beer have a diuretic effect and also increase the burden on the kidneys. At the same time, the liver will also be injured. After the liver is injured, the toxic substances cannot be used, which further increases the burden on the kidney. If you already have kidney disease, and often drink a lot of beer, it will cause uric acid deposition and block the renal tubules, causing kidney failure. Symptoms of early renal failure: Symptom 1: The cardiovascular system usually has symptoms of high blood pressure or heart failure, and often feels palpitations or wheezing. It is often impossible to lie down flat, and the heart rhythm is also prone to arrhythmia. Pericardial effusions can also occur, and sometimes they can become clogged. Symptom 2: After the disease occurs in the nervous system, there will be insanity, headache, dizziness, and some patients will have a sudden drop in memory. Symptoms such as insomnia and dysuria are also often seen. Severe patients will also experience coma. . Symptom 3: Digestive system After the disease occurs, patients often feel anorexia, nausea, vomiting, diarrhea, etc., often feel the smell of urine in their mouth, or gastrointestinal bleeding. Symptom four: When the skin shows that the disease occurs, there will be scaling. The skin will often feel dull, and sometimes there will be pigmentation of the melanin, the skin color will appear darker, edema or skin infection And other undesirable phenomena. Symptom 5: Respiratory system When the disease occurs, it also affects our respiratory system. I often feel the smell of urine in my mouth, and there is also gas breathing from metabolic acidosis. . How to treat the primary disease and inducement treatment of chronic renal failure For the first diagnosis of CRF patients, we must actively pay attention to the diagnosis of primary disease. For chronic nephritis, lupus nephritis, purpuric nephritis, IgA nephropathy, diabetic nephropathy, etc. Maintain long-term treatment, at the same time, we should actively look for various inducing factors of CRF, and correct these incentives reasonably may reduce the lesion or tend to stabilize and improve renal function to a greater extent. Dietary Therapy Chronic renal failure dietary therapy has been regarded as its basic treatment for many years, and it has been respected by scholars from various countries. The previous diet therapy is generally limited to the application of low-protein diets, but long-term low-protein diets will affect the nutritional status of patients. Studies have shown that the incidence of chronic renal failure malnutrition is as high as 20% to 50%. Severe malnutrition is now considered to be independent of CRF The risk factors are directly related to the morbidity and mortality. Therefore, the current diet therapy is more inclined to formulate more reasonable nutrition treatment programs for patients. Alternative therapy includes hemodialysis, peritoneal dialysis, and kidney transplantation, which have the highest quality of life. When the blood creatinine is higher than 707μmol/L or GFR10ml/min (15ml/min in diabetic patients), and the patient begins to develop clinical manifestations of uremia that cannot be relieved by treatment, dialysis treatment should be performed. Prior to this, patients should be prepared for their thoughts in order to make decisions about hemodialysis, peritoneal dialysis, or kidney transplantation. Dialysis should usually be performed for a period before considering kidney transplantation. Dialysis therapy can replace the excretory function of the kidney, but not the endocrine and metabolic functions. Hemodialysis (referred to as hemodialysis) and peritoneal dialysis (referred to as peritoneal dialysis) have similar therapeutic effects, each has its own advantages and disadvantages, and can complement each other in clinical application. 1. Hemodialysis should be done in advance (several weeks before hemodialysis). Arteriovenous fistula (vascular access); dialysis time ≥ 12h per week, usually 3 times per week, 4 ~ 6h each time. Adhere to adequate and reasonable dialysis , Can effectively improve the quality of life of patients, many patients can survive for more than 20 years. 2. Peritoneal dialysis, continuous ambulatory peritoneal dialysis therapy (CAPD) has the same effect on hemodialysis as uremia. CAPD is especially suitable for patients with cardio-cerebrovascular comorbidities, diabetic patients, the elderly, pediatric patients or those with difficulty in performing arteriovenous fistula. CAPD is continuous
Recently, several kidney friends with diabetes and hypertension consulted, asking when can the medicine be stopped? In fact, diabetes and hypertension are incurable diseases, and the chronic renal failure caused by them is also incurable, requiring lifelong treatment. The following types of kidney disease cannot be eradicated: 1. Diabetic nephropathy Diabetes cannot be cured, and kidney disease caused by diabetes cannot be eradicated. 2. Hypertensive nephropathy Essential hypertension requires taking antihypertensive drugs for life, so hypertensive kidney damage cannot be completely cured. 3. Lupus nephropathy treatment of lupus nephritis is very long, most patients need to take small doses of glucocorticoid maintenance treatment for life to avoid recurrence. 4. In the literature statistics of hepatitis B related nephropathy, there are very few hepatitis B related nephropathy. However, this is just because patients with hepatitis B and kidneys rarely perform renal puncture. 5. Chronic renal failure includes the stage in which various kidney diseases develop into chronically impaired renal function. Because the kidneys have already hardened and necrotic cells cannot be regenerated, chronic kidney failure cannot be cured. There is no cure, is it worthless? No, incurable ≠ the end point is uremia. In fact, after middle age, anyone’s kidney function will gradually decline, but the kidney function of patients with kidney disease will decline faster. Even for incurable kidney disease, treatment can be used to delay the decline of kidney function and make it as close as possible to the decline of kidney function in normal people. Although the above nephropathy is incurable, it does not mean that the treatment has failed. When the patient is old, and near the end of life, renal function is still sufficient, is it not a success? My name is Bai Zhicheng. I am good at various glomerular diseases, such as IgA nephropathy, membranous nephropathy, hematuria, proteinuria, lupus nephritis, and treatment of chronic renal insufficiency. I have more than 40 years of clinical experience. You are welcome to pay attention to this account. For related questions, you can leave a message or private message. After seeing it, I will answer your confusion in detail.
Hemodialysis is an alternative treatment to save lives after chronic renal failure enters the uremia stage. A reasonable and accurate diet can not only prevent or reduce the occurrence of complications, but also maintain a good nutritional state, thereby improving the quality of life and survival rate of patients. However, many kidney friends who are on dialysis do not know how to eat. Let me introduce you to “Dietary considerations during hemodialysis”. Let’s take a look. 01. Low-salt diet maintenance hemodialysis patients should be given a low-salt diet, salt intake should be controlled at 3-5g/d. Excessive salt intake, excessive sodium ions in the body are likely to cause increased blood pressure, edema, ascites, hydropneumonia, and heart failure. The sodium ions mainly come from the sodium salt in food. In addition to table salt, common high-salt foods include soy sauce, monosodium glutamate, ketchup, sand tea sauce, soda crackers, noodles, and preserved products. So, in daily life, how do we judge the salt content of food? The table below shows the table of salt content (6g) for common foods. Such as: 27g of lamb meat, the salt content is 6g. 02. Low potassium diet Hemodialysis kidney friends have inadequate kidney function and cannot effectively discharge excess potassium in the body. Too high blood potassium will cause severe cardiac conduction and contraction abnormalities, and even death. Hyperkalemia is the most serious complication of end-stage renal disease, so a low potassium diet should be used. While choosing low-potassium foods, you can also reduce the potassium content in foods by soaking, boiling, and ultra-low temperature refrigeration. Foods with high potassium content are mainly vegetables and fruits. Common high-potassium foods are garland chrysanthemum, potato, yam, spinach, amaranth, rape, banana, jujube, etc. 03. The main function of phosphorus in a low-phosphate diet is to strengthen bones, and excess phosphorus needs to be excreted through the kidneys. For hemodialysis friends, the kidneys cannot work properly, and excess phosphorus will accumulate in the blood, causing hyperphosphatemia, which can lead to skin itching, soft tissue calcification, renal bone disease, and secondary hyperparathyroidism, etc. . The Guidelines for Improving the Global Prognosis of Kidney Disease (KDIGO) guidelines suggest that a low-phosphorus diet is the first-line treatment for reducing blood phosphorus levels. Therefore, hemodialysis patients should choose low-phosphorus foods, the daily intake of phosphorus should be limited to 600 ~ 1000mg. Almost all foods contain phosphorus, and daily diets should avoid high-phosphorus foods such as egg yolks, whole wheat noodles, animal offal, dried beans, nuts, milk powder, chocolate, cola, and processed meat. 04. Long-term hemodialysis with a low-fat diet is often accompanied by disorders of fat metabolism. The intake of fat and cholesterol should be restricted to prevent aggravation of hyperlipidemia and arteriosclerosis. Fat intake accounts for less than 30% of daily calories (50-60g), mainly edible vegetable oils, such as corn oil, soybean oil, olive oil, etc. Avoid the intake of saturated fatty acids and trans fatty acids such as butter, shortening, lard (pork belly), and butter. 05. Appropriate protein diet Before dialysis, nephropathy needs a low-protein diet; after dialysis, protein loss will increase, and it is easy to cause malnutrition. Therefore, according to the frequency of dialysis to increase protein intake. Usually dialysis 1-2 times a week, daily protein intake per kg body weight is 1.0g; while dialysis 3 times a week, daily protein intake per kg body weight is 1.2g, and ensure that at least 60% of the protein is high-quality protein, Such as lean meat, fish, eggs, milk and soy products such as tofu or Qian Zhang.  . Hemodialysis is performed intermittently, and diet is directly related to the effect of dialysis treatment. Because it does not filter waste from the body like a kidney, it means that waste will accumulate in the blood during the dialysis interval. Therefore, we must establish the correct concept of dialysis diet!
The scorching sun is hot, and the scorching heat is hard to stop. Summer feels like this. Don’t say that you are sick. It is not easy for normal people to comfortably spend the summer. For patients suffering from nephrotic syndrome (renal syndrome), we should pay more attention to all aspects of life. Patients with kidney syndrome in the hot summer have such illness in the “kidney”, and sleep is better. The main symptoms of most patients with kidney syndrome are puffiness and fatigue, so adequate sleep and rest are necessary. Patients should adapt to the changing laws of the weather and develop good living habits. It is best to have a 30 to 40-minute nap every day. A lunch break is very beneficial for physical recovery. If conditions permit, walk in the evening. Rest early in the evening to reduce physical exertion. Nowadays, air conditioners have entered thousands of households, making summer seem to be much better than in the past, but because of the disease in the “kidney”, you must be careful when using the air conditioner. The temperature should be adjusted to 5-6 degrees Celsius lower than the outdoor temperature. Pay attention to avoiding cold caused by cold and overheating, leading to aggravation or relapse. Patients with kidney syndrome in the hot summer have had watermelon in this way. There are many varieties of vegetables and fruits in summer, which attracts appetite, especially cold drinks-“no pain, not enough to be addictive.” Of course, for patients without edema, the water intake can be appropriately relaxed, but patients with obvious edema must control the water intake. For example, eating watermelon can diuretic and reduce swelling, heat and heat, but for patients with kidney syndrome who need to limit water intake, eating more watermelon will cause water retention in the body, aggravate the condition, and induce cardiovascular complications. In addition, excessive urine excretion will increase the loss of protein and other nutrients in the body. Patients with kidney syndrome can try the following diet therapy: ① Black fish winter melon soup: one black fish, eviscerated, without salt, and served with winter melon soup. ② Amomum steamed crucian carp: one crucian carp, gutted, 6 grams of amomum, 3 grams of licorice, into the belly of the fish, stitched with thread, and taken after stewing. ③ Astragalus stewed hen: one hen, 120 grams of astragalus, stewed to eat meat. In the hot summer, patients with kidney syndrome have been swimming like this, and taking as little exercise as possible can help to restore physical fitness and relieve the condition. However, it is necessary to pay attention to mastering the amount of exercise, as long as there is no feeling of fatigue. Although swimming is a good summer sport, but because swimming requires a lot of physical strength and the sanitation of the swimming site is not guaranteed, it is recommended that patients with kidney syndrome do not go swimming. Patients with serious illnesses should minimize outdoor activities, especially those with obvious puffiness, should stay in bed as much as possible. To a certain extent, bed rest not only helps diuresis, but also reduces dangerous complications such as heart failure and hypertensive encephalopathy, and prevents the deterioration of renal function. However, it should be noted that in bed in summer for a long time, there is more sweating, and patients with kidney syndrome are in a hypercoagulable state. The probability of venous thrombosis is very high. Therefore, it is necessary to pay attention to maintaining proper bed and bedside activities while staying in bed. In addition, due to the loss of a large number of proteins in the kidney, patients with kidney syndrome are relatively weak and vulnerable to infection. Try not to go to public places to avoid infection of respiratory diseases. Avoid sun exposure to prevent skin inflammation, especially in patients with obvious puffiness. The skin is thin and delicate due to puffiness, so you should pay more attention to it. As long as the kidney patients pay attention to the above points and take appropriate measures, it is safe to spend the summer.
1. The air conditioner is not always open on hot summer days. Everyone likes to stay in a cool air-conditioned house, but many people do not know that it is easy to breed bacteria and microorganisms in the environment where the air conditioner is turned on for a long time. For those with weak resistance, It is easy to cause various diseases. Such as throat, tonsil inflammation (streptococcal infection), etc., need immediate treatment, and antibiotics should be taken thoroughly, not halfway (by the doctor), otherwise streptococcus is susceptible to kidney disease, especially for children. But in the process of using antibiotics, we must pay attention to the appropriate amount and appropriate to avoid antibiotic poisoning. 2. Overeating Nowadays, more and more people like to have dinner together. They often eat too much big fish and meat and seafood without restraint. Some people ask, how can you eat kidney disease? Seafood is high-purine food, uric acid is the end product of purine metabolism, disorder of purine metabolism or reduced excretion of uric acid by the kidneys can increase blood uric acid. When the concentration of urate in the blood is supersaturated, urate precipitation crystals can be deposited in the kidneys, causing renal parenchymal damage. This is “uric acid kidney neck, also known as “hyperuricemia kidney neck. And eat Potato chips, instant noodles, etc., can make people unknowingly absorb excessive salt, leading to increased blood pressure, which can lead to kidney disease. As for soft drinks and sports drinks, they are generally highly acidic. The pH of the body changes significantly after drinking. Increased probability of damage due to increased burden. 3. The most direct injury to the kidneys caused by high temperature is the high temperature in midsummer, and high temperature has direct damage to the kidneys of the human body, which can lead to dehydration of the human body and low urine output, resulting in increased kidney load and loss of water and salt metabolism in the body. , Affecting normal physiological functions, causing abdominal pain, nausea, vomiting and other symptoms. The best way to protect the kidneys in summer is to drink a small amount of cold boiled water many times to promote normal metabolism and protect kidney health. 4. How to replenish water? Kidney is the main place for excretion of metabolic wastes and medicines. Summer heat is prone to sweating a lot, so the water lost through the skin every day greatly increases, up to more than 1000 ml. Urine is concentrated when there is a lack of water, and the concentration of these substances in the urine is significantly increased, which is easy to cause kidney damage. If water is not added in time, it is easy to cause water shortage and kidney damage. Therefore, some kidney patients should pay special attention to supplement water. For the elderly, they often have no obvious thirst when the water is obviously lacking. When the weather is hot, the elderly have decreased appetite and increased sweating. In addition, the kidneys have poor water retention capacity and often have no thirst when they lack water. It is easy to cause severe water shortage and lead to damage to kidney function. The elderly must develop the habit of drinking water in moderation without being thirsty. Proper drinking before bed also helps prevent plasma concentration and thrombosis. The elderly have reduced kidney concentration and more urine at night, so they should drink water before going to bed. So how much water should each person replenish each day? This varies from person to person. The general principle is to maintain 24-hour urine output at 2000-3000 ml. We should pay attention to drinking water reasonably and develop the habit of drinking water daily. The best time to drink water is between meals and in the evening and early morning, but avoid drinking large amounts of water within half an hour before meals and immediately after eating to avoid diluting stomach acid, affecting appetite and digestion. As for what kind of water is best to drink, don’t pay too much attention, ordinary drinking water will do. 5. Periodic inspection is very important. Lastly, it is mentioned that kidney function tests are often done. It is best to stipulate that you must do routine urine screening and blood pressure tests every six months. Almost half of kidney patients undergo kidney damage unknowingly, so when the body feels unwell, it may be the end of kidney disease (uremia)-it is time to rely on the dialysis machine to survive. Summer is a splendid and beautiful season, don’t let the disease take advantage of bad habits. The kidney is very important for a person. The normal operation of the kidney function ensures the stability of the environment in the body and allows the metabolism to proceed normally. We can protect it so that it can better solve problems for us. Finally, I wish all my friends good health and stay away from disease!
Hello everyone, I am a nephrologist, concerned about lung health, nephrology is in action. Some friends may have questions. Isn’t uremia not a kidney problem? Does it have any bad influence on the “lung”? Indeed, it’s not that I’m here today, and we call it uremic lung edema. Although it sounds unfamiliar to me, the clinical incidence can reach 50%-80%. It is chronic Pulmonary complications in patients with renal failure progressing to the uremic stage. As the dialysis technology becomes more mature, the survival rate and survival time of uremic patients are greatly prolonged, so this complication is getting more and more attention. Today I will come to do a science explanation for everyone on “Uremic Lung Health”. Why does uremia cause lung disease? I think it can be explained in the clinic with monism, just like the heart-kidney syndrome and liver-kidney syndrome. ● From the heart: I believe friends who have read my popular science articles should be clear, I’m talking about uremia, Chronic renal failure will repeatedly emphasize the need to actively prevent complications such as renal hypertension, renal anemia, excessive capacity load, malnutrition, and toxin accumulation. Today I want to tell you that this is not groundless. All of the above factors may cause heart failure such as heart failure, pericarditis, myocarditis, cardiomyopathy, and calcification of the heart. These heart disease changes can increase the pressure of the left atrium of the heart, so that the capillary pressure of the lungs increases, and then there is pulmonary edema. In the long run, the compliance of the lungs decreases, and the pressure of the blood vessels and small airways of the lungs increases. Changes in lung function and structure. ●Explained from the blood: a number of studies have confirmed that after entering the stage 3 of chronic kidney disease (a total of 5 stages, the last stage is uremia), the human body will gradually begin to develop renal anemia, and the consequences of anemia are caused by The alveolar capillary blood flow is reduced, which affects the diffusion function of the lung. This is one of them; like malnutrition, hypoproteinemia (a complication of chronic renal failure) will make our body’s plasma colloid osmotic pressure drop, thus Causes pulmonary edema, which is the second; if it is a diabetic nephropathy patient, the high blood sugar state in the body will cause the crystal osmotic pressure of our human plasma to increase, causing body fluids to enter the blood vessels from the cells, resulting in further increase in blood pressure and cardiac output Blood volume drops, causing heart failure and pulmonary edema, which is the third. ● From the perspective of disease: uremic patients are prone to azotemia. In this case, it will lead to toxic hyperemia and increased permeability of pulmonary capillaries, causing a large amount of fluid in the pulmonary blood vessels to penetrate into the lung tissue, causing lung Lesions. Interpretation of common clinical manifestations of alveolar uremic lung ● The most common is cough and sputum, the incidence rate is greater than 50%, followed by dyspnea, the incidence rate is about 30%-50%. In particular, the shortness of breath will be more obvious when lying on the ground. The degree of severity varies, and some patients may also show “hemoptysis”, but most of them will be accompanied by unilateral or bilateral pleural effusion, which is the common pleural effusion. Too. Note that the nature of its effusion is mostly “slurry cellulose exudation”. ●In imaging, the most typical chest radiograph of the uremic lung is “butterfly wing-like or bat-like exudation of the bilateral lungs”, which means that it is centered on our hilum, forming a butterfly or Bat-like shadow, as shown below. We can roughly divide its imaging characteristics into 5 stages, namely alveolar pulmonary edema, pulmonary congestion, interstitial pulmonary edema, pulmonary interstitial fibrosis, and cardiac enlargement. Uremic lung, prominent ooze in the image, uremic lung, prominent uremic lung in the image, significant ooze in the image ●But from personal experience, clinically still with alveolar edema and heart The expansion period is more common, because these two types of heart failure will occur, but this is a significant difference from ordinary lung infection. If the dialysis and dehydration can be fully clinically, this butterfly or bat-like exudation can quickly disappear. Therefore, it is essential to ensure the sufficiency of dialysis and increase ultrafiltration, which is also the core treatment plan for this complication. How should uremic patients respond to the “lung” complication? This is the point I want to talk about. The above theory may sound a bit tedious, but I think I have to say it again, because only if the principle understands the doctor’s explanation and the adjusted treatment plan can you better cooperate, this can also Improve patient compliance. ●I believe that the experienced kidney friends should know that the uremic patients
Foam urine is the inexplicable bubbles in urine. Many people equate foamy urine with proteinuria, and the result is white tension for a long time. Foamy urine of patients with kidney disease A large amount of proteinuria can show a large amount of foam in the urine of patients, often in different sizes. The foam in these urines cannot be washed by the toilet at a time. The foam can continue for more than 30 minutes if it is not continuously flushed. The cause of foamy urine is not directly caused by urine protein, but the protein in urine changes the structural composition of urine, causing the surface tension of the liquid to change, so a large amount of foam is generated. Therefore, a lot of protein urine can have many urine bubbles, but foam urine is not necessarily protein urine! Foam urine of normal people Normal people also have foam urine in the following cases, but this foam is small and can be quickly washed away by the toilet. 1. When the urine is concentrated (less drinking water, more sweating) 2. Urinary urination, force, when men stand to urinate (high position, instant foaming, generally the foam can disappear quickly after standing urine). 3. There are many sexual components in urine (such as male semen, prostate fluid, urethral mucus, female leucorrhea, menstruation, urethral mucus, etc.). 4. Healthy people after ingesting large amounts of protein, or staying up late, overworked, and degraded physical function. In a word: there is no need to panic when there is foam in the urine, but you need to check the urine to rule out accidents to prevent accidents.
According to past kidney biopsy statistics, membranous nephropathy accounts for about 15% of chronic kidney disease in my country. However, with the improvement of people’s living standards, overnutrition is becoming more and more common; coupled with the promotion of PM2.5 and other pollutants, the incidence of membranous nephropathy is rising. According to the pathological statistics of the Second Affiliated Hospital of Hebei Medical University, the incidence rate has reached 30% in the central and southern Hebei Province, and the proportion of new-onset membranous nephropathy has exceeded 50%. Today, it has become a dark horse and should not be underestimated. A dark horse in the family of nephropathy: membranous nephropathy, three methods can be treated. The disease originates from a layer of membrane. The main function of the kidney is to turn blood into urine, how to do it? Let the blood pass through its capillary wall, filter it, and the blood becomes the original urine. This blood vessel wall is like a sieve, with 3 layers, including 2 layers of “fences”, and a membrane between the two fences. This membrane is called the basement membrane, and it is an important layer that can filter out the waste in the blood. If the basement membrane changes (immune complex deposition, spike formation, etc.), it is called membranous nephropathy. At this time, the fence was broken, and the protein that normally couldn’t see through this membrane leaked out of the fence, and it was eliminated together with urine, and urine protein increased. When urinary protein passes through the kidney, it will cause fibrosis, sclerosis, and atrophy of the kidney. If it continues for a long time, it will gradually progress to uremia. Membranous nephropathy is a pathological name that provides guidance for the treatment plan and does not have much effect on the severity. There are stages of membranous nephropathy: stages 1-4. The later the stage, the greater the possibility of serious, but it is not strictly corresponding, and there are too many exceptions. Whether the condition of membranous nephropathy is serious depends on whether the urinary protein has been relieved after medication. The prognosis varies greatly. About one-third of the patients can relieve themselves, and about one-third of the patients are ineffective in treatment. 1. Conventional treatment If the 24-hour urine protein of membranous nephropathy is below 3.5g; or between 3.5g-8g, and the renal function is normal and there is no high-risk phenomenon, usually immunotherapy is not used, but Chinese medicine, Puly drugs and satanic drugs reduce urine protein, and give diuretic, antihypertensive, anticoagulant and other supportive treatment. 2. Hormone combined immunosuppressive agents If the 24-hour urine protein of membranous nephropathy exceeds 3.5g and is accompanied by decreased renal function, or urine protein exceeds 8g, immunotherapy should be applied. Hormone alone is not effective for membranous nephropathy, and it needs to be combined with hormone + immunosuppressive agent. It is recommended to combine Chinese medicine treatment to achieve better results. 3. Monoclonal drugs If the hormones and immunosuppressive drugs are not effective, monoclonal antibodies can be used, such as rituximab and belidomumab, which can often achieve better therapeutic effects.
Can a bus driver pull the handbrake to stop to ensure passenger safety a second before coma? Can such a thing be avoided? Tianjin TEDA Hospital & Li Qing On June 22, Song Mou, a bus driver in Zhoukou, Henan, felt uncomfortable while driving. He stopped the car and pulled up the handbrake before being comatose, allowing all passengers on the car to get off safely. The passenger and the passing driver dialed 120. Song was diagnosed with brain stem hemorrhage after being sent to the hospital. After a few days of treatment, he had recovered weak spontaneous breathing, but he was still in a deep coma and was in critical condition. I simply searched online, and such cases occur every year, even more than one. These drivers are competent drivers, kind and nice people, and used instinctive kindness to stop the car before coma to avoid traffic accidents. However, while we like these drivers, have we considered the psychological feelings of many passengers? Have you considered whether such thrills can be avoided? This driver’s cerebral hemorrhage and other hero drivers’ myocardial infarction and other accidents were definitely not caused for no reason, nor did they happen overnight. They were all caused by long-term hypertension, hyperlipidemia, diabetes, smoking and other factors. result. Clinical practice has found that regular medical examinations, improved lifestyles, and rational use of medicines can completely prevent the occurrence of heart and cerebrovascular diseases and even such thrills if these risk factors can be controlled. These hero drivers are all in front-line sports cars, and they are not very old. What is the reason why people of this age have such serious diseases? Does the bus company arrange medical examination for them every year? Do you urge or arrange for treatment when problems are found? Has the physical condition recovered to the standard after treatment? Are there any physical standards before going to work? Are there any rules that must be forced to rest after driving for several hours? Has the bus company considered labor protection for drivers? These issues are worth thinking about. These hero drivers must be the pillars of the family, otherwise it is impossible to work so hard. Although they used their life’s efforts to be shocked and did not form a disaster, for their family, there must have been a disaster since the top beam collapsed. When driving a bus in the city, the mental pressure is relatively high, and the prevalence of hypertension among bus drivers should be relatively high; there are no regular meals, and there should be no fewer diabetic patients. According to the occupational characteristics, bus companies should give these hard drivers special labor protection . I respect and praise the drivers of these heroes, and I don’t mean to blame the bus companies. What I want to express is not to “make” such heroes because of imperfect management. It’s better to have less tears!
Hello everyone, I am a nephrologist. With the rapid development of mobile Internet, the media has risen rapidly in recent years. But the Internet is a big dye tank, no, I saw a so-called health master on the Internet the other day, and introduced on the Internet, “If your urine is yellow or turns yellow, what is wrong with you, What to use to soak in water…” In this regard, as a nephrologist, you must stand up to tell the truth and tell the truth. Please note that the normal color of our human urine should be yellowish or transparent or colorless and transparent. Next, I will explain my reasons. First look at where our urine comes from? ●Urine is actually composed of excess water, electrolytes, and toxins. Every moment our body has a large amount of blood entering the kidney through the renal artery, and then filtered by our glomeruli to form raw urine. This is the first process. This raw urine adds up to about 180L a day, and the original The electrolyte composition in urine is the same as plasma, and 99% of it is water. ●After the first process is completed, the contents of these raw urine (which contains glucose, amino acids, electrolytes, bicarbonate, etc.) will be reabsorbed back into the blood when they reach the renal tubules and collecting tubes, so the final Urine is about 1.5L. This is also the urine output of a normal adult. Of course, this amount is only an approximation. If you intake less water today, your urine output will naturally decrease. If you consume a lot of water, your urine output will naturally be more. The ins and outs of our human urine. ●Note that if our urine is less than 400ml a day, it is oliguria, and if it is less than 100ml, it is anuria, which indicates that the body may be in a disease state, and the kidney may be damaged because if our urine is less than 500ml/d, The waste produced by our body’s metabolism cannot be completely discharged from the kidneys. The opposite is also true. If our body’s urine is more than 2500ml a day, we call it polyuria. If it is more than 4000ml a day, it is diarrhea. This kind of polyuria often suggests that the body may be in a disease state or take some Special drugs. Why is urine yellow? ●Under normal circumstances, our fresh urine is colorless or clear, light yellow or amber, the focus is coming, because the color of urine is affected by urogenogen, urobilin, and urinary porphyrin, so it appears pale The yellow color is normal. If there is little water intake within a day, and the urine may show a deep yellow color after a lot of sweating, this is actually a normal phenomenon, because the urine is concentrated. However, if the urine color changes abnormally under pathological conditions, as follows: ①Red: This is more common is hematuria, the reason is that there are red blood cells in the urine, which can be roughly divided into gross hematuria and microscopic hematuria Two kinds. The most common diseases of hematuria are urinary stones, glomerular diseases, urinary tumors, etc. In this case, it is best to go to the hospital in time to find the cause of hematuria. ②White: I have also introduced to you that in general, urine does not appear white, so the most common type of urine is purulent urine and chyluria. The purulent urine is more commonly a urinary tract infection, and the common way people talk about it is purulent. Chyluria is mainly caused by diseases such as filariasis, tuberculosis, etc. This is due to the fact that the chylous fluid absorbed by the intestine fails to flow into the blood through the normal lymphatic vessels and flows back into the urine. The appearance may look like white milk. If the urine chyle test can be positive, it is also necessary to go to the hospital in time for such urine. ③Blue-green: There are more factors affecting the urine color, such as food pigments, urinary tract infections caused by Pseudomonas aeruginosa, obstruction of the biliary tract, some special drugs or chemical reagents (such as propofol , Methylene blue, phenol, boric acid, etc.), if it appears for a short period of time, you can drink more water and urinate to observe. If there is no relief, it is more indicative of pathological factors, and you need to go to the hospital in time to determine the cause. To sum up, don’t look at a little urine, it can not only reflect the metabolism of our body, but also the related auxiliary examination of urine can effectively guide clinical medication and treatment. Therefore, we must not only know why the urine is yellow, but also know that when there is abnormal urine color, we should go to the hospital in time to find out the relevant reasons, so as not to delay the treatment of the disease. Please note: when the body has
After many people have kidney disease, they become uremia indistinctly. It is even unclear when the kidney started to be “injured”. Uremia is not a single-onset disease, it is the end stage of the development of chronic kidney disease, that is, the state of kidney failure. So where does chronic kidney disease come from? Chronic kidney disease is mainly divided into two categories, one is primary kidney disease, and the other is secondary kidney disease. 1. Primary nephropathy Primary nephropathy refers to a disease that originates inside the kidney, such as glomerulitis, pyelonephritis, occult nephritis, and kidney stones. If it does not recover after more than 3 months, and the relevant examination indicators are always abnormal, or the effective glomerular filtration rate is less than 60%, it can be regarded as “chronic kidney disease”. 2. Secondary kidney disease is caused by other diseases. The secondary kidney disease, such as high blood pressure, is like pressing a mountain on the kidney. It is likely to cause excessive blood vessel pressure, protein leakage, and structural effects on the filter. The destruction eventually leads to hardening of the kidneys. Another example is diabetic nephropathy, which has become the second leading cause of uremia. Excess blood sugar will produce a large amount of glycosylation end products, which are deposited in the kidneys, block the renal tubules and blood vessels, cause various inflammatory reactions or microvascular lesions, and eventually “stretch” the glomeruli. In addition, gout, lupus erythematosus, and hyperlipidemia are all high-risk factors. If it cannot be cured or contained effectively, it can easily develop into uremia.
The initial symptoms of kidney disease are often hidden and difficult to find. This requires us to do regular physical examinations, especially urine tests. If the following 4 signs appear, it is likely that kidney function has been damaged. Signs of impaired renal function. Early detection of 4 signals 1. When the eyelid and lower extremity edema and renal insufficiency, the metabolic capacity for sodium is reduced, which easily leads to the retention of water and sodium metabolism. Excess water accumulates in the subcutaneous tissues, and symptoms such as eyelid edema in the morning and edema of the lower limbs after fatigue can appear. Press and hold the skin of the ankle with your hand. If you press one pit and the elasticity is very poor, it is usually edema. 2. Proteinuria and hematuria When the kidney is damaged, the ability to recover protein is reduced, which makes protein easily appear in urine. People who already have kidney disease also need to regularly test urine protein levels to assess kidney function. If inflammation, stones, tumors or blood vessels rupture in the kidneys, red blood cells will be excreted in the urine to form hematuria. Some foods or medicines may also cause urine to turn red, which is pseudo-hematuria, so it cannot be judged by urine color alone, and a urine test is required. Urine test is positive, the urine contains a lot of non-dissipating foam, which is proteinuria. If the number of red blood cells in the urine exceeds the standard, it is hematuria. 3. Increased creatinine Creatinine is a product of muscle metabolism, which is mainly filtered through the glomeruli and excreted from the body. When the muscle is not consumed vigorously, the amount of creatinine produced by the human body is relatively constant. Urine creatinine is 7-18 mmol/d for men and 5.3-16 mmol/d for women; blood creatinine for men is 53-106 μmol/L for men and 44-97 μmol/L for women. Increased blood creatinine and urinary creatinine for unknown reasons may indicate impaired renal function. 4. Fatigue, weak waist and knees From the perspective of traditional Chinese medicine, the kidneys contain the body’s yang and energy. Chronic kidney disease can easily make the kidneys weak, causing fatigue, weakness in the waist and legs, frequent nocturia, and cold limbs. It is also easy to affect the spleen and lungs, leading to phlegm and stasis, at the same time causing chest tightness, shortness of breath, loss of appetite, indigestion and so on.
On August 27, 2017 (Lunar Calendar), this day was originally a happy day, because this day is my birthday, but the facts are not there. On this day, I was medically identified as chronic suicide-uremia. On the day of the diagnosis, I felt that it collapsed in just a day. This birthday gift came too abruptly and could not be refused. I have since embarked on the path of dialysis. I used to work on site at the construction site, and the work was heavy and tiring. Since I became ill, I could only retreat to the second line and go to the office to do some relaxing work. The company has staff quarters, but in order to have a better dialysis environment In order to avoid infection, I rented a house next to the construction site and returned to rent a house to change my water after eating. Both work and life were correct. During the dialysis time of nearly 3 years, my small problem was constant, but the big problem never happened. I immediately consulted the doctor and the doctor adjusted the medication, and it took 3 years. With the support of family, relatives and friends this year, I am going to have a kidney transplant. At the beginning of the year, I went to major hospitals to line up for matching. Maybe the goddess of fortune saw me pitiful, and gave me good luck. I queued for a month and received The hospital’s phone said that the matching was successful and the transplant operation was possible. Upon hearing this news, I was so excited that I couldn’t speak. I thank my family and relatives and friends for giving me a chance to be reborn. On the day of the operation, I was nervous and excited. I was nervous because it was a major operation or there was a certain risk. I was excited because my quality of life would improve a lot after the transplant. On August 13, 2019, on this day, I successfully completed the transplant operation. The operation was very successful, and the recovery was very good after the operation. There were no adverse reactions. In order to facilitate the postoperative examination, the family rented a house around the hospital and let me live when I was discharged. I have just been discharged from the hospital and now I feel that everything is in good physical condition. The six months after transplantation is a very special period. I must listen carefully. Doctor, protect my kidney baby, because this is my rebirth! Since the transplantation has just finished, the living environment should be ventilated and the air is good. Try not to go to a densely populated place. You must wear a mask when you go out. So after transplantation, I have been resting at home, not working, and it takes about six months to a year of rest. Life starts again from now on, and hopes that the future will get better and better.
Many patients with nephritis often blindly forbid eating salt and make the condition worse, because they think that nephritis without salt will be better and faster. This is a misunderstanding. To make this clear, we must first understand that table salt is a necessity for our body’s physiological functions. Without table salt (mainly sodium chloride), not only will we feel that the diet is tasteless, but it will also seriously affect the entire body. For a long period of salt, hyponatremia can occur, showing signs of fatigue, lack of energy, and laziness. If you have kidney disease, it is very important to properly control the intake of salt, which is beneficial to treatment and health. The sodium ions in the human body mainly exist in the extracellular fluid, which is the main component to maintain the osmotic pressure of the extracellular liquid crystal. This is very important for the liquid balance inside and outside the cell, and inside and outside the body. Generally speaking, when the content of sodium ions in the body fluid increases, more water can be retained, and at the same time, the sodium excretion and drainage will be increased through physiological effects, thereby maintaining the balance of sodium in the body. Patients with kidney disease generally have no problems with low-salt diets or ordinary diets. When clinical edema and hypertension occur, salt should be restricted, because when the kidneys are diseased, the kidneys’ sodium regulation function is affected, and sodium excretion function is impaired. Increased blood sodium and water retention often show signs of edema and high blood pressure. Therefore, according to the specific circumstances, patients with kidney disease are divided into: (1) general diet. For example, patients with kidney disease have never had edema, hypertension, or disappeared after treatment. If you don’t repeat it, you don’t have to strictly limit the salt, but the amount of salt should not be too much, because excessive sodium intake is not in line with physiological requirements, it is an important factor leading to high blood pressure, not to mention patients with kidney disease, diet It is better to eat light and eat more vegetables and fruits. (2) Low-salt diet. It is suitable for patients with mild edema and hypertension and edema and hypertension just subsided. In the recovery period of acute nephritis, chronic nephritis and nephrotic syndrome, people with chronic renal failure without edema and high blood pressure can use low-salt diet. Low-salt diets require a daily intake of 3 to 6 grams of sodium. Patients can also consume low sodium salts. But also can’t eat pickles, curd sauce, pickles, salted duck eggs, etc. (3) No salt diet. When patients with kidney disease have obvious edema or elevated blood pressure, salt should be banned, even salty foods (salted dumplings, salty biscuits, etc.), baking soda, soy sauce, etc. are among the taboos. This situation is seen in the early stage of acute nephritis, the acute onset of chronic nephritis, primary nephrotic syndrome, chronic renal failure accompanied by moderate to severe hypertension and edema. Salt-free diets often affect appetite, and can be seasoned with unsalted soy sauce or sugar, vinegar, ginger, garlic, etc. to increase appetite. The length of the salt ban period should be determined according to the specific situation, mainly to see the two major symptoms of edema and hypertension, if these two symptoms are not obvious or basically disappeared, you can change to a low-salt diet, can not strictly ban salt for a long time.
This year is my third year with membranous nephropathy, and there have been too many in the past three years: I left a world-famous financial company due to illness and took a blood test every month to see the doctor, endocrine disorders for a long time, sudden weight gain, and immediately A series of complications… I saw many people on the Internet saying that the epidemic was going crazy for 3 months at home, and I have been sick for 3 years, 36 months, and 1095 days, constantly fighting the impact of illness. , Challenge the physical and psychological endurance, but fortunately, I haven’t retreated on my way forward… These 3 years are very long and seem to be very short At the age of 25… At the mid-autumn festival at the age of 25, I joined this favorite financial company. I always thought that I would get better and better in the future and bring more material wealth to my family. future! However, soon after I joined the company, during a routine company physical examination, I found that the urine protein had a plus sign. At that time, I didn’t know what it meant, but I was fully happy and dedicated to the work I love. It was not until New Year’s Day that I went back to my hometown and talked about the medical examination. My mother accompanied me to the local hospital for an examination. At that time, I was diagnosed with membranous nephritis. At this time, I really realized that the neglected medical examination was abnormal. , Regret not careless. The local doctor suggested that I start taking hormone therapy. If I don’t pay attention, it may develop into uremia later. I was ashamed, and our entire family was ashamed, and my sky collapsed. I am young and soft, why do I get this disease, I have no desire to cry, I am dumbfounded. Sickness has become a fact. Although this incident has hit me a lot, the family members who have always been with me have given me support. The whole family quickly discussed and decided to go to Beijing to start medical treatment. After making this decision, the whole family spent a very short period of time. On the road to treatment, after contacting more patients, I realized how correct this decision was. Many patients actually believed in various remedies. Or, it was a pity that the condition was delayed by the small hospital. So look back and find the best medical resources within the scope of your abilities, and don’t believe any remedies. Because I work in Beijing, I also chose to seek medical treatment in Beijing. If you are in the field, I also recommend going to a provincial specialist hospital for treatment. At this time, nothing is more important than your health, including your dreams, because these are based on you having a healthy body. Without this, everything is nonsense or mirage. . And you are like a meteor, quickly traversing the sky, fleeting. On that day, the doctor took many pages of the treatment plan confirmation and asked me to sign it. Treatment requires long-term use of hormones. Although these drugs can treat kidney disease, they will cause a series of complications: high blood pressure, renal bone disease, hyperlipidemia, and I may become a big fat man. This idea I can never Never had. Although there may be 20 or 30 hidden dangers in choosing a treatment plan, there is no way. For a positive life, I signed. I believe this is the right choice. After taking the medicine for one year, the indicators have improved significantly. However, due to the company’s business adjustments, overtime has increased, and the indicators of improvement have returned to the state of a year ago. The abnormality of the indicators made me have to pay more attention. After consulting with my family, I chose to leave this financial company with frequent overtime work. After that, it was three years of treatment, monthly blood tests, urine tests and other index results, see the doctor to adjust the medicine, such a day can not be finished in a few words, compared to physical discomfort, psychological torture is the real challenge. Recently, due to the epidemic situation, everyone has spent a lot more time at home than in previous years. Sometimes they even feel locked in their homes, and they may hear some complaints from time to time. In fact, for me, these days have lasted for three years. But these three years are also the three years I think about the most. Although I am limited by illness, I also have more time to study and not be driven by this society, which also calms my heart. In the past three years, I have experienced psychological exhaustion, torture of illnesses, torture of complications, and torture of psychology. I have learned that we people never know how strong we are and how much our mental tolerance is. Strong, our bravery is really beyond our imagination, many things that were previously impossible, have become possible after these 3 years. It’s painful to be sick, and it’s painful to continue life after being sick, just like just born
Hello everyone, I am a nephrologist. When it comes to hormones, nephrologists probably have the right to speak, because many nephropathy patients are hormone users. For the special drug “hormone”, some say it is good, some say it is bad. Our sayings are good, we have real knowledge in practice, and the more we use and the more we see, the more experienced we are. As a nephrologist who has been dealing with hormones for a long time, today I will unveil the mysterious veil for everyone. What are hormones? ●Many rumors on the Internet say that hormones are life-threatening, @头条开谣, saying what will happen if you eat it. In fact, I might as well tell you that many of them don’t even know “what is a hormone”, just because there is a rhythm. If I think that “hormones” are just a class of drugs, I can only say that the understanding is too superficial. Hormones are actually secreted by our body all the time, like parathyroid hormone, growth hormone, glucagon, and cortisol are all “hormones” secreted by the body itself, it plays an important role in our life activities, and we also Use it. Due to the relatively large space, today I focus on explaining “glucocorticoid” and its application in kidney disease. ●The adrenal glands of our normal people (a small organ of the human body) can secrete about 10-20mg of cortisol (also known as glucocorticoid) every day. It has a characteristic of secretion, that is, it is released in a pulsating manner, with obvious day and night laws. It is the lowest during sleep at night. It begins to rise after 3-5 hours of falling asleep. It wakes up in the morning and reaches its peak, and then begins to decline again. It is such a cyclic process that its secretion is mainly affected by our high-level center (hypothalamus- Pituitary-adrenal) control. ●What are the types of glucocorticoid preparations of the drug? The classification of the drugs is mainly based on the half-life of the drug. According to its pharmacological characteristics, it can be divided into three types: short-acting, medium-acting and long-acting. Short-acting half-life is about 6-12 hours, more representative drugs such as cortisone, hydrocortisone; medium-acting half-life is about 12-30 hours, more representative drugs such as prednisone , Prednisolone, methylprednisolone, etc.; long-acting half-life is about 48-72 hours, more representative drugs such as dexamethasone, betamethasone, etc. How to use hormones in patients with kidney disease? ●According to the pathology of renal puncture, nephrotic syndrome can be divided into multiple types. Like effective pathological types of glucocorticoid alone: minimally diseased nephropathy (more common in children), mesangial proliferative nephritis (more common in adolescents, including IgA nephropathy), focal segmental glomerulosclerosis FSGS (child More common in adolescents); the type of cytotoxic drugs that need to be combined (such as cyclophosphamide CTX): idiopathic membranous nephropathy & nbsp. (This is only a general division, and may be slightly different in clinical practice) ●However, hormone therapy is not Speaking of nephropathy, it is all right. According to the response after treatment, it can be roughly divided into three categories, that is, sensitive type: that is, clear pathology. After active and sufficient medication, the symptoms of nephrotic syndrome (edema, proteinuria, etc.) are quickly relieved; Dependence: that is, the effect is good during the treatment, and it begins to relapse after the reduction. (We talk about recurrences can be divided into 2 subcategories: infrequent recurrence: that is, once in the first 6 months and less than 3 times in 1 year. Frequent relapse: more than or equal to 2 times in 6 months and more than 3 times in 1 year) ● The last one is the hormone resistance type. Simply put, it is useless to use hormone therapy. Our evaluation standard is that the puncture is in accordance with a certain type of nephrotic syndrome, but you use it regularly and reach the treatment cycle of 8-12 weeks without remission. , Need to actively find the cause, such as whether it is complicated by infection, thrombosis, unspecified medication, gastrointestinal edema, etc. If there is no above-mentioned predisposing factors, consider adding immunosuppressive agents or other special treatment options. Personal experience of using hormones in patients with primary kidney disease ●For patients with kidney disease who need to use hormones, this medication principle must be followed. First, the starting amount should be sufficient. I take methylprednisolone as an example. The general therapeutic dose is 0.8-1.0mg. kg.d, roughly 40-60mg/day, mainly oral, and some slower reactions such as FSGS can reach 16-24 weeks (some people are afraid of side effects of hormones and reduce their doses by themselves. ) ● Second, reduce the drug slowly, that is to say, it will start to decrease every 2 weeks after reaching the time of full use
Hello everyone, I am a nephrologist. As everyone knows, the incidence of diabetes in my country has been increasing in recent years. This has a lot to do with economic development, Westernization of lifestyle, aging population, and obesity rate. Relevant data show that the number of adult diabetes patients in my country reached 109.6 million in 2015, ranking first in the world. An epidemiological investigation and analysis pointed out that about 60% of the diabetic patients in my country are not diagnosed. Although many people have heard of the term “diabetes”, the science about diabetes and other chronic diseases is far behind. Therefore, the National Health and Health Commission has also been advocating the theme of “Healthy China Trip”, which aims to enable diabetes patients to receive disease treatment better, earlier and more regularly. Today I’m going to chat with you about diabetes medication. Dispelling rumors ● Although the author is engaged in nephrology, but I tell you that the nephrologist is half an endocrinologist, don’t believe it, because diabetes has a major complication of diabetic nephropathy, so many kidney functions appear due to diabetes After the problem will be followed up and treated in our department. After contacting these patients with diabetes, I found that some patients and their families are still affected by some rumors of diabetes. ●Two days ago, our department admitted an old lady with diabetic nephropathy. She had had creatinine and proteinuria for 2 years. The reason for coming to hospital this time is that creatinine is more than 100 higher than last year’s review, and blood sugar control is also very poor. I wonder if the old lady and his wife didn’t take it seriously. They often disappeared after checking the room, and the blood sugar could not be measured for several days. According to her specific disease and blood sugar level, she decided to use home insulin therapy. This said, the old lady and her wife were very excited, saying: Insulin is harmful and can not be beaten. Once beaten in this life, it will not be able to escape, and the body will become worse after being beaten. This is useless. My neighbor is…………, so it is better to take medicine. A brief introduction to diabetes ●In fact, diabetes is not unique to these decades. In ancient times, our traditional medicine classified it as the category of “diabetes”. This has been discussed in the Yellow Emperor’s Internal Classic in the second century BC. In the view of modern medicine, it is considered to be a group of metabolic diseases characterized by chronic hyperglycemia caused by multiple causes, rooted in defects in insulin secretion and/or utilization. Diabetes can be divided into type 1 diabetes and type 2 diabetes, of which type 1 diabetes is relatively rare in Asia. Therefore, most of the diabetic patients in my country are mainly “type 2 diabetes”, which can account for 95% or more. ●Combined with the case I talked about above, if you are in pre-diabetes (impaired fasting blood glucose, impaired glucose tolerance), you can adjust it by diet and exercise therapy. If the blood sugar is still not well controlled, it is necessary to add suitable hypoglycemic drugs according to insulin secretion, utilization and blood sugar level. However, please note that although oral medicine is the preferred choice for diabetes, the disease after diabetes has been still progressing, and it will have various complications, so the treatment methods and treatment drugs must follow the disease course and complications The situation is dynamically adjusted. What are the characteristics of insulin secretion in diabetic patients? ●Insulin secretion in patients with type 1 diabetes is actually a complete lack or severe deficiency. Their pancreatic islet function is very poor, so the insulin secreted is very little or no. Type 2 diabetes is slightly different. It is a progressive disease. It can be manifested as delayed β-cell response to glucose in the early stage, and it is prone to increased blood glucose after meals and hypoglycemia before the next meal. ●As the disease progresses, the function of β cells will further deteriorate, and the number of functional β cells in diabetic patients will also decrease. It can be manifested as a serious lack of insulin secretion, fasting and postprandial blood sugar are increased, and we are eating three meals a day, it is certainly not possible to control blood sugar without insulin, so at this time the patient needs to resort to exogenous Insulin supplement or replacement therapy. When do people with diabetes need to start insulin therapy? ● Here I tell you that if it is type 1 diabetes, then insulin should be used at the beginning of the disease (decided by its disease characteristics, if you don’t understand, you can look at my introduction to the principle of type 1 diabetes above), and need to Lifelong insulin replacement