Hello everyone, I am a nephrologist. When it comes to high blood pressure, I think many people should understand that it is the most common and frequent chronic disease in my country. The factors that cause high blood pressure are different. Today I focus on introducing “renal hypertension”. Let’s be straightforward, that is to say, the increase in patients’ blood pressure is inseparable from “kidney problems”. Such patients often have very difficult blood pressure control, and may need to combine three or even four or more antihypertensive drugs to Regulate blood pressure. Why is blood pressure in patients with kidney disease so difficult to control? How to effectively solve this problem? Today I am going to do a popular science explanation for everyone on “renal hypertension”. Foreword ● Hypertension is a common complication of chronic kidney disease. There are epidemiological data showing that 80%-85% of patients will develop hypertension during the progression of chronic kidney disease. And as the glomerular filtration rate decreases linearly increases (that is, the worse the renal function, the greater the proportion of people with hypertension). There was a special scientific research team to investigate and follow up on this. One report from the MDPD showed that when the glomerular filtration rate dropped from 85ml/(min.1.73㎡) to 15ml/(min.1.73㎡) The prevalence of hypertension increased from 65% to 95%. ● I found a phenomenon, some people have this idea, thinking that my blood pressure is high, but I do not have headaches and dizziness, eating the smell of sleeping, the high point will be high, and it will not hinder me. Too much hurt the body. Note that hypertension is not only one of the important risk factors that cause the progression of chronic kidney disease, but also the risk factors for cardiovascular and cerebrovascular complications in patients with chronic kidney disease (such as myocardial infarction, coronary heart disease, cerebral infarction, cerebral hemorrhage, etc.). According to incomplete statistics, the current control rate of renal parenchymal hypertension in my country is 46% (140/90mmhg) and 20% (130/80mmhg). It can be seen that effective blood pressure prevention and control is still a long way to go. Causal analysis of hypertension and kidney damage ● Here I tell you that under normal circumstances, our kidneys have their own regulatory mechanisms. That is, the glomerular internal pressure and the average arterial pressure are in an “S” shape, that is, in the range of average blood pressure of 80-160mmhg, it regulates the contraction and relaxation of the small arterioles by the intrinsic muscle (this small artery constitutes the kidney Important blood vessels), so that the glomerular blood flow and glomerular filtration rate can be maintained stable. ●But when you suffer from chronic kidney disease, this self-regulating mechanism will be damaged, and this “S”-type regulating mechanism will slowly turn into a nearly “linear” type. Therefore, in patients with chronic kidney disease, even if the system blood pressure is slightly moderately increased, it can cause the internal pressure of the glomeruli to increase, resulting in the three high states of high pressure, high perfusion and high filtration in the glomeruli. And this “three highs” will cause progressive kidney damage. The common understanding is that “hypertension” and “kidney damage” will always hurt each other, causing the disease to progress in a bad direction. ●Compared with essential hypertension (more than 90% are clinically essential hypertension), this kind of renal hypertension will show such characteristics: ① blood pressure is difficult to control, and it is easy to develop into malignant hypertension, It is often necessary to combine several antihypertensive drugs, and the blood pressure compliance rate is still low. ②The incidence of cardiovascular complications is high, and its impact on cardiovascular disease has its own characteristics. A scientific research team has conducted a follow-up study of more than 20,000 community population. The results show that the relationship between hypertension and stroke in patients with chronic kidney disease is ” “J-shaped”, the systolic blood pressure is the lowest at 120-129mmhg, while the incidence of stroke below 120mmhg and above 130mmhg is significantly increased. How to effectively regulate renal hypertension? ●Pharmacological treatment ① For patients with chronic kidney disease, if proteinuria <1g/d, then blood pressure is recommended to be controlled at 130/80mmhg; if proteinuria>1g/d, then blood pressure is recommended to be controlled below 125/75mmhg. However, I personally think that blood pressure is not lower, the more beneficial it is, and everything is about one degree, because too low blood pressure will affect the blood perfusion of the kidney. Hypoperfusion is not a good thing for the kidney, so it is recommended to avoid low systolic blood pressure. At 110 mmhg, the diastolic blood pressure is below 60 mmhg. ②It is found in the clinic that in fact, many elderly people not only suffer from hypertension, but some people also have diabetes and other chronic diseases.
With the rapid development of the Internet, all kinds of news in our circle of friends are overwhelming, but these true and false content are mixed with many rumors, which makes people ridiculous to dry mouth, the liver is rising, it is really “a mouth for rumours.” , Break the rumors and break your legs” Ah! Today, the editor will tell you what are the rumors about kidney disease. Rumor 1: Kidney disease is kidney deficiency. Do you want to make up? The truth! A commercial that is often broadcast on TV, “He is good, I am good”, causes many people to confuse kidney disease with kidney deficiency in the absence of medical knowledge. In fact, kidney disease and kidney deficiency are not the same thing. Kidney disease is a disease of Western medicine. The kidney itself has a problem. The nephropathy mentioned by Western medicine must be diagnosed with evidence of kidney-related damage, such as proteinuria, increased blood creatinine, kidney puncture, and kidney pathological changes. Kidney deficiency is a concept in Chinese medicine, and Western medicine does not say “Kidney deficiency”. People diagnosed with “Kidney Deficiency” by Chinese medicine are likely to have no problem with this organ of kidney in Western medicine diagnosis. Therefore, you must not treat kidney disease as a kidney deficiency, especially some health products. If you eat it randomly, it will not only be of no benefit to the condition, but may also delay treatment and aggravate the condition. Rumor 2: Western medicine has great side effects, and Chinese medicine nourishes the kidneys. There is indeed a unique role for Chinese medicine in promoting blood circulation and activating Qi, and activating kidney function, but it cannot be denied because of this effect. Western medicine is active in anti-inflammatory and eliminating symptoms Effective. To blindly worship a treatment aspect will only drag on the condition. Therefore, whether it is to see Chinese medicine or Western medicine, the doctor is the most important. The kidney friends must follow the professional treatment principles when treating kidney disease, and do not exclude or defame any treatment. In particular, you should not believe in small recipes. Myth 3: Is it good for kidney disease to eat “low sodium salt”? Both healthy people and patients with kidney disease need to pay attention to a low salt diet, but the reason why “low sodium salt” is low in sodium is because 30% of potassium is incorporated. Although the intake of sodium is reduced, the potassium content is high, which can lead to hyperkalemia. Hyperkalemia is one of the most common and dangerous complications in patients with kidney disease, and acute attacks can be life-threatening. Therefore, patients with kidney disease want to control sodium intake. It is not the right way to consume “low sodium salt”, or they must reduce salt intake from the diet. Myth 4: The lower the blood creatinine, the better? Creatinine is one of the important indicators of kidney disease, but not the lower the better. Common causes of low blood creatinine include weight loss, muscle loss, and malnutrition. Low creatinine does not mean that this person has better kidney function than others. Therefore, kidney friends should not blindly pursue the reduction of creatinine value. Rumor 5: Corn whisker can cure kidney disease? Corn whisker does have a certain diuretic effect, but it is not so magical. There is no reliable evidence that corn whisker has a therapeutic effect on any kidney disease. If you like to drink corn whistle water, it is okay to drink, but it must be clear that these diets cannot replace regular treatment. Myth 6: Drink more water for kidney disease? Many people think that drinking more water is beneficial to maintaining kidney health. The more you drink, the better. In fact, drinking too much water can lead to lower blood sugar. For people with healthy physique, drinking plenty of water is of great help to health. However, in patients with renal failure and uremia, most of the metabolic capacity of kidney function is lost, relying on the dialysis machine to maintain the balance of the body environment, so the water intake should be limited. And drinking water is only one of the ways to maintain kidney health. Therefore, although drinking water is good, it should be consumed according to the situation. In fact, kidney disease is not so terrible, what is terrible is to avoid eating, to take medicine blindly, and to believe in remedies. Therefore, when faced with various opinions on the Internet, kidney friends must keep their eyes open and act “kidney”. If you have any questions that you do not understand or have questions, you can ask the doctor directly. My name is Yang Yanfang, a doctor of Chinese medicine, and more than 20 years of clinical and experimental research on kidney disease in Chinese and Western medicine. I am good at Chinese medicine for glomerulopathy (hematuria, proteinuria), renal vascular disease and chronic kidney injury (chronic renal insufficiency, chronic renal failure). Integrated Western medicine treatment. Everyone is welcome to pay attention to this account. If you have any relevant questions, you can leave a message or private message. After seeing it, I will answer your doubts in detail.
As we all know, diabetes is a very common chronic disease in clinic. Diabetes can cause many complications, including macrovascular complications, such as coronary heart disease, cerebrovascular disease, lower extremity vascular disease, and microvascular complications, such as diabetic nephropathy, diabetic retinopathy. Among them, diabetic nephropathy is one of the most common and difficult complications of diabetes. According to statistics, diabetes is currently the number one cause of chronic kidney disease in my country. Therefore, how to avoid the occurrence of diabetic nephropathy has become the top priority of diabetic patients. Here are four suggestions: 1. Strict control of blood sugar. Hyperglycemia is an important factor that causes kidney damage. Therefore, blood sugar must be controlled at an ideal level for a long time. Fasting blood glucose <6.1 mmol/L, two hours postprandial blood glucose <8.0 mmol/L, glycated hemoglobin <6%. By strictly controlling blood sugar, the chance of kidney disease can be greatly reduced, and at the same time, most early diabetic nephropathy (microalbuminuria) can be reversed or delayed. In the early stage of diabetic nephropathy, hypoglycemic drugs excreted mainly through the biliary tract, such as Nuohelong, Tangshipingping; insulin therapy should be given when renal insufficiency occurs. 2. Strict control of blood pressure and abnormal hemodynamics can lead to glomerular sclerosis. Compared with high blood sugar, hypertension has more damage to the kidneys of diabetic patients. Strict control of blood pressure can significantly reduce protein filtration in patients with diabetic nephropathy and delay the process of renal impairment. 3. Lowering blood lipids and blood viscosity Abnormal blood lipids are also one of the risk factors for kidney damage. Therefore, blood lipids (especially low-density lipoprotein cholesterol) should be controlled within the normal range. 4. Properly restrict protein intake. A high-protein diet can increase the glomerular perfusion pressure and filtration rate, and increase urinary protein excretion. Therefore, to reduce the burden on the kidneys, protein intake should be limited in the early stages of diabetic nephropathy. The intake, protein intake in the diet should be 0.8g/kg body weight per day. Mainly choose high-quality animal protein (such as chicken, fish, lean meat, eggs, milk) to supply more essential amino acids. Vegetable protein (such as tofu, soy milk, etc.) will increase the burden on the kidneys, and at the same time can not be fully utilized by the body, it should be properly restricted. If you have edema, you should also limit salt intake (less than 5g per day). Early diabetic nephropathy (namely the first three stages) after active treatment, especially the combination of traditional Chinese and Western medicine, has obvious effects and can be completely reversed. However, since the onset of diabetic nephropathy is hidden, there are almost no symptoms in the early stage of the disease, so it is easy to be ignored by patients; and once the face and lower extremities are swollen and a lot of proteinuria, kidney disease has often developed to an irreversible stage, and the best treatment is lost opportunity. Therefore, once diagnosed with diabetes, whether or not there is edema, it is recommended to regularly check urine microalbumin and renal function to facilitate early detection and timely treatment of diabetic nephropathy. If you have any related problems such as kidney disease, you can directly [private letter] Professor Yang Yanfang
Diabetic kidney complications are one of the most common complications in the long-term course of diabetes. Whether it is type 1 diabetes or type 2 diabetes, if there is no active blood sugar control, the chance of diabetic kidney complications is very high. What are the symptoms of diabetes affecting kidney function? How to prevent the occurrence of diabetic nephropathy? Today we will briefly introduce this knowledge. First of all, it is important to emphasize that for diabetics, it must be recognized that the harm of high blood sugar to kidney health is huge, and it is also slow and gradual. Once you understand this, you should actively control blood sugar and regularly It is not scientific to check the kidney function without waiting for the symptoms to suspect that high blood sugar hurts the kidney or even when the kidney function is abnormal. Although it is not too late to make up for it, it is better if we can plan ahead. The pathogenesis of diabetic nephropathy is diversified and more complicated, which is related to genetic factors of personal constitution and hemodynamic changes of high blood glucose on the formation of small arterial arteries of the kidneys, resulting in the sclerosis of small arteries of the kidneys. At the same time, abnormal glucose metabolism , It also causes abnormal metabolism of various substances in the kidney area, which also affects the health of the kidney. In addition, diabetes combined with high blood pressure is also an important risk factor for kidney disease. Under the function of these factors, our kidneys Health is gradually affected until renal function is impaired, and eventually it will eventually develop into renal failure. Diabetes-related clinical manifestations of kidney damage. Diabetic hyperglycemia can damage kidney health and cause gradual changes in kidney function. The most common sign of diabetes affecting kidney health is the appearance of trace proteinuria. However, it should be understood that the occurrence of trace proteinuria is not the initial stage of diabetes damage to the kidneys, but that diabetes has a clear sign of damage to the kidneys. From the occurrence of diabetes, it is pointed out that high blood sugar has begun to affect kidney health The health of the ball is affected, and it is not that the symptoms of proteinuria will occur at once, and under the long-term influence of high blood sugar, when trace proteinuria occurs, usually from the stage, diabetic nephropathy has reached the level of stage 3. Another manifestation of diabetic kidney damage is the emergence of high blood pressure. Almost all the complications of diabetic nephropathy will eventually cause high blood pressure. High blood pressure itself is also a chronic disease that damages kidney health. If the diabetic person’s blood pressure is not high, but the blood pressure gradually begins to rise or even diagnosed as high blood pressure, it is necessary to actively investigate the changes in kidney function. Usually, high blood pressure in type 1 diabetic patients is often accompanied by trace proteinuria There are many types of diabetes in people with type 2 diabetes, and many high blood pressures appear before the abnormal kidney function. However, no matter whether it is the increase in blood pressure caused by diabetic nephropathy or primary hypertension combined with diabetes affecting kidney health, it is worth noting that it should be As early as possible, actively regulate the problem of hypertension. If there are problems such as trace proteinuria and elevated blood pressure, you still do not pay attention to actively control blood sugar and protect kidney function. The kidney damage caused by diabetes will increase further. At this time, it will show continuous proteinuria and glomerular filtration The rate also began to decline, kidney function began to decline, and most patients will show symptoms of edema, and about 20% of patients will have problems with nephrotic syndrome. The most serious complication of diabetic nephropathy is renal failure, manifested by the loss of function of most nephrons, uremia symptoms, glomerular filtration rate of less than 10, and accompanied by increased blood creatinine, such a situation belongs to Diabetes end-stage renal disease, kidney failure, is generally maintained by dialysis or organ transplantation. How to reduce the risk of diabetic kidney complications If you want to reduce the health hazards of diabetes to the kidneys and reduce the risk of kidney complications caused by diabetes, the first thing to do is, of course, to be active and control your blood sugar levels as early as possible. Again, it is too late to control blood sugar when there are symptoms of kidney damage or a decline in kidney indicators. You should be aware of the rise in blood sugar and actively control blood sugar when new diabetes develops. If you can control the blood sugar as early as possible, you can greatly reduce the occurrence of diabetic nephropathy complications
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.
Now more and more people will suffer from kidney disease. The causes of kidney disease are more complicated. Patients with kidney disease will have symptoms of low back pain. Patients with kidney disease will have symptoms of kidney deficiency. A few patients will not have obvious symptoms. , These claims about kidney disease are wrong. These claims about kidney disease are wrong. 1 Low back pain indicates kidney disease. Most of the causes of low back pain are orthopedic or peripheral soft tissue diseases, and many patients with kidney disease do not have low back pain symptoms. 2 Kidney deficiency is kidney disease. Kidney deficiency is a concept of traditional Chinese medicine. The diagnosis of kidney disease requires blood tests, urine, etc. If you have urine protein, hematuria, increased blood creatinine, and decreased glomerular filtration rate, you can diagnose kidney disease. 3 Puffiness is kidney disease. It is clinically found that nephropathy has relatively special edema sites, such as eyelid swelling in the morning, but this is not absolute, and some patients with kidney disease will not have eyelid swelling. Edema can also occur in other diseases, and a few idiopathic edemas are functional. 4 Kidney disease is difficult to detect early, and it will be late as soon as it is detected. Actually, otherwise, although the onset of nephropathy is hidden, a routine urine test every year can detect the symptoms of the disease early, and then go to the nephrology specialist to see the doctor, which can kill the disease in the cradle. It is recommended that young and middle-aged people also pay attention to blood pressure. Many young and middle-aged people’s stubborn hypertension stems from kidney disease. 5 Kidney disease cannot be cured. Through personalized integrated Chinese and Western medicine treatment, many patients with kidney disease can be cured clinically and avoid renal dialysis. The key is to reasonably diagnose and treat, seize the opportunity, and avoid indiscriminate medical treatment. 6 Kidney wear is terrible. Pathological examination is the “gold standard” for diagnosing kidney disease. Only when the diagnosis is clear can we formulate the most suitable program for the patient, and truly make the right medicine, otherwise it will become a big luck. In regular hospitals, operated by experienced specialists, kidney wear is safe. In many cases, refusing kidney wear is the only chance to heal. These claims about kidney disease are wrong. Patients with kidney disease will have symptoms of low back pain and symptoms of kidney edema. Kidney disease is mainly caused by unhealthy living habits, and the correct treatment method should be selected.
Kidney disease is a common disease that affects the kidney function of the human body, which can lead to a decline in patient function and induce various diseases. Nephropathy can be divided into many types, according to the cause can be divided into primary nephropathy and secondary nephropathy. Kidney disease has become one of the killers of people’s health. Many people’s health has been destroyed by kidney disease. Most people do not understand the cause of their kidney disease, which brings many difficulties to the treatment of kidney disease. Therefore, we must first determine the cause of nephropathy and see what kind of nephropathy patients belong to. The treatment and prevention of nephropathy has become a subject of in-depth clinical research. To be frank: People with kidney disease are basically calculated by these three “killers” 1. Genetic factors cause some kidney diseases to be closely related to heredity, such as polycystic kidney disease, Alport syndrome, etc. It is more or less a genetic factor, and even heredity only plays a catalytic role. Clinically, the occurrence of diabetic nephropathy is closely related to diabetes, but the occurrence of diabetic complications is also very closely related to heredity. 2. Drug abuse Since the pharmacy, people are reluctant to go to regular hospitals to buy targeted drugs for treatment when they have kidney disease. However, due to the lack of knowledge about pharmacology, many people frequently abuse drugs. Not all drugs will bring certain toxicity to the kidneys. Such as non-steroidal anti-inflammatory drugs in Western medicine, drug abuse will only cause a slight decline in kidney function. To be frank: People with kidney disease are basically calculated by these three “killers”. 3. Daily behaviors lead to kidney disease. Daily behaviors may also lead to kidney disease, such as holding urine, long-term drinking water, poor hygiene, If you wear too little, don’t look at the details and have nothing to do with the cause of kidney disease. In fact, holding back urine, long-term lack of drinking water, and poor hygiene habits can easily lead to pyelonephritis. In addition, long-term lack of drinking water is likely to increase the risk of kidney stones. The cause of people suffering from kidney disease is also related to their body structure. In fact, the cause of nephropathy is directly related to obesity. If they are overweight, they are susceptible to obesity-related kidney disease. I am afraid that many people have never thought of the cause of this kidney disease. Female friends are more likely to have kidney disease than men, and they will be accompanied by hematuria and proteinuria. Severe diseases will directly cause kidney function damage. To be frank: People who suffer from kidney disease are basically secretly reminded by these three “killers”. If people usually like salty, greasy and spicy food, they must be restrained. Because salty foods are high in sodium, eating food is more likely to cause blood pressure to rise. Fat and cholesterol in greasy foods are high, which can easily cause hyperlipidemia. Spicy foods are irritating, such as chili peppers, causing qi deficiency and decreased immunity.
For kidney disease, people have been talking about discoloration. If you think you have a kidney problem, you must have dialysis. Kidney disease can be comparable to a terminal illness like a flood. In fact, this is an incorrect idea, and it is precisely because of these cognitive misunderstandings that the prevention and treatment of kidney disease in my country is difficult. To prevent and treat kidney disease, the first step is to get rid of these misunderstandings about kidney disease. Regarding kidney disease, these four misunderstandings should be clarified as soon as possible, do not delay treatment! 1. Kidney deficiency means kidney disease. Kidney deficiency is a term in the category of traditional Chinese medicine. It refers to deficiency of kidney qi and is divided into kidney yang deficiency and kidney yin deficiency. Kidney deficiency in traditional Chinese medicine and kidney disease in modern medicine are not a concept. Therefore, there are different ways to treat it. Kidney deficiency can be cured by dietary conditioning and traditional Chinese medicine treatment. However, nephropathy in modern medicine can only become more and more serious if it depends on conditioning, and it must go to the hospital for systematic treatment. Therefore, kidney deficiency does not mean that you have kidney disease, everyone must be different. 2. Low back pain must be caused by kidney disease. Chinese medicine often says that kidney deficiency will cause back pain. In fact, back pain is only a symptom of kidney deficiency, and kidney deficiency is different from kidney disease, so back pain does not necessarily mean that you have kidney disease. Low back pain is related to many reasons, the most important of which is a problem with the lumbar spine or waist muscles. Therefore, don’t think that you have kidney disease as soon as you get back pain. 3. Kidney disease cannot be cured, and dialysis can only be used to treat severe kidney disease such as uremia. Renal dialysis is required to maintain normal kidney function, usually due to kidney failure, which cannot be used to metabolize human waste and toxins. treatment method. People are always too demonized of kidney disease. Although it can attract people’s attention in prevention, it is a long-term plan to strengthen people’s correct understanding of kidney disease in the long run. Kidney disease is not a terminal illness, and not all kidney diseases need to rely on dialysis treatment. Therefore, the first time you know that you or your family have kidney disease, you must go to the hospital for a systematic examination and actively cooperate with the doctor’s treatment after the diagnosis. Do early detection, early treatment, and go to a regular hospital for treatment. Never believe any remedies. Only in this way can patients with kidney disease be cured as soon as possible. 4. Renal puncture is too harmful to the kidney. Renal puncture is a traumatic examination for the kidney. It is a method of taking a kidney sample for laboratory testing by puncture. Many people immediately refused as soon as they heard the doctor’s introduction. In addition, the accusation was too serious, leading to serious deviations in the knowledge of renal puncture. In fact, renal puncture is a very effective method of examination. For kidney diseases with unknown causes and unclear causes, a correct diagnosis can only be made by renal puncture. Therefore, if the doctor advises the patient to have a kidney puncture, it means that a kidney puncture is necessary. In order to allow the kidney disease to recover soon, it is better to cooperate with the doctor to do this test. Kidney disease poses a great threat to national health, and everyone should put kidney disease prevention on the agenda. In addition, we must have an accurate understanding of kidney disease. Only by eliminating the above misunderstandings about kidney disease can we effectively prevent and treat kidney disease.
Hello everyone, I am a nephrologist. I think I should be able to insert a few words about kidney health and abnormal urination. As the title says, what abnormalities do people with kidneys have when urinating? I can only say too much, because there are many types of kidney disease, it may be a disease of nephrology, or it may be a disease of urology. It is possible that a kidney disease has multiple manifestations, and it is possible that multiple kidney diseases have the same manifestation. Since the subject does not specifically describe how the kidney is not good, so here today I will comprehensively talk to you about my views. What role does the kidney play in the formation of urine? This mainly depends on the glomerular filtration function and the glomerular reabsorption and secretion function! ●The glomerular filtration function ① Everyone’s understanding of urine must not simply be understood as “simple water composition”. In fact, urine contains water and various metabolic wastes in the body. Our glomerular filtration function is the main way of excretion of human metabolites. Some nitrogen-containing wastes such as urea and creatinine can be filtered by the glomerulus, and some organic acids such as hippuric acid and benzene Formic acid and various amines can be partially filtered by the glomeruli. ② From a microscopic point of view, our kidney is actually composed of millions of glomeruli, and the glomerulus is composed of many small arteries to form a spherical shape. When the average arterial pressure of our body fluctuates in the range of 80-160mmhg, the self-regulating mechanism of kidney blood flow in our body is at its best. On the one hand, it can ensure that the glomerular filtration rate can still run steadily when the body changes in hemodynamics, so that the metabolic waste in the body can be discharged, on the other hand, it also ensures the balance of body fluids. ●The reabsorption function of renal tubules involves the formation of original urine. Everyone, please note that our daily urine filtered by the glomerulus can actually reach 180L, and this raw urine cannot be excreted temporarily. Because it contains water, glucose, amino acids and other substances that our body still needs, these raw urine will be reabsorbed into the blood by the renal tubules and collecting tubes. Therefore, the resulting urine is about 1.5L a day, which is also a normal urine output range for a day. What kind of kidney disease (bad kidney) will be abnormal when urinating? ●Urinary tract infections ① When it comes to urinary tract infections, professional explanations are infectious diseases caused by the growth and reproduction of various pathogenic microorganisms in the urinary tract. Let’s say the popular point is that the urinary tract infection and inflammation. Clinically, it can be divided into upper urinary tract infection and lower urinary tract infection, and the most common upper urinary tract infection is “pyelonephritis”, which is plainly a kidney problem. ②If it is pyelonephritis, what abnormalities will occur during urination? Here I tell you that the most common are frequent urination, urgency, and painful urination. I always want to relieve urination. Every time there is not much urination, it may be just a few drops. After urination, there is burning and pain in the urethra. So this pyelonephritis (poor kidney) can occur when urinating these abnormalities. ●Acute renal failure ① This is actually a comprehensive concept. We generally call it acute kidney injury. It refers to the clinical appearance of a sudden decrease in kidney function caused by various causes in a short time (a few hours to a few days). Syndrome. There are many causes, such as special drugs, poisons, infections, burns, insufficient capacity, and urinary obstruction. However, please note that no matter what kind of cause you cause, everyone can see that the kidney is damaged. ② What are the abnormalities of acute renal failure in terms of urination alone? The most common are oliguria, anuria, and dark urine. In the opening chapter, I talked to you that urine is formed by the metabolism of the kidneys. Now, if the kidneys have problems, it will inevitably lead to “urine production obstacles.” As the so-called kidneys have problems, how can you metabolize urine, so this type of urination may be reduced urinary tract or anuria (oliguria is less than 400ml in 24 hours, less urine is less than 100ml in 24 hours ). ● IgA nephropathy specific pathogenesis of the disease I will not repeat them here, it is a kind of kidney disease. The root cause is “IgA-based immune complex deposition” in the mesangial area of our kidneys and hyperplasia of the mesangium of the glomeruli. To put it bluntly, it means that this mesangial area does not have these inexplicable things under normal circumstances. Now that this abnormal situation occurs, it will inevitably lead to
I used to be the son of a farmer. Although he was not wealthy and rich, he lived freely and happily. Like many patients, thinking that they are young and have no physical problems, even if there is a problem, it will always be a minor disease, which is not a problem. I never thought that one day, such bad news would happen to me. Until 2018, I started to feel dizzy and vomited, and my face and legs were swollen. I couldn’t even walk. I ended up in a ward and became a patient. One check is renal failure, creatinine 780. I spent a lot of money and took a lot of medicine, and I have been on the verge of fear and collapse. “Everything is over, I can only continue to breathe, I have no hope!” At that time I was decadent and desperate. The persuasion of my relatives and friends was obviously very weak, because in the world of ordinary people, getting a terrible disease is equivalent to collapse. . At that time, I always wanted to die. Misfortunes are not alone, they are right. After being diagnosed with kidney failure, I was dissuaded by the unit, my wife also left me, and she was just pregnant, and her family suggested that she remarry. Whenever I think of the birth of a child, I may not be there anymore. Even if I am alive, watching my child call someone else’s father, I must be heartbroken. The story in a whole set of TV scripts is lively interpreted in me, and I am also quietly waiting to leave this world. Later, it was only found in the process of seeking medical treatment that there were many patients with kidney disease in various situations in the world. Everyone had decadence and despair. From the common sorrows, complaints, complaints, and regrets at the beginning, I slowly discovered that the vast majority of patients with kidney disease, through active treatment and maintaining an optimistic attitude, will greatly improve their condition and quality of life, and enjoy a better life again! In the course of continuous treatment, I gradually adapted to the dialysis life twice a week. Everything seemed so regular, and slowly, I adapted. And I, like the protagonist of the inspirational movie, broke through the obstacles and found my own job. And, I got love with a patient. A difficult journey in life, from despair to numbness to hope, with a little confidence, and I feel that everything has become less difficult. Once, I dreamed into the abyss in countless nights, screamed loudly, and no one ignored it… When I woke up, I was always cold and sweating. When I was lonely, I cried in a low voice. I like to be in the middle of the night when I was awakened, I silently looked at the small river beside my house, thinking quietly, but I didn’t seem to know what I was thinking about… Slowly, my dream woke up, gradually Yes, my heart lightened up. This is a small poem I wrote: Ye Si didn’t lose it. Chaos woke up at the beginning of his life. Now life and death have gone through an open mind. No one can guess how many days and nights of suffering and despair I have experienced. Now my heart is like a mirror, and my heart is deep. , Everything is relieved. In fact, many kidney friends are more fortunate than me. They were found to be in the early stage of kidney disease, and there are many opportunities to control the disease, which can delay the further deterioration of kidney disease. I hope to use my experience to warn the world and Yu Shi, and inspire and inspire all the partners who are struggling on the road of kidney disease!
Hello everyone, I am a nephrologist. Regarding the problem of creatinine, I can tell you that for a value of more than 100 creatinine, it is actually within the normal range in our hospital, because in our hospital, it will only prompt an increase if it is greater than 133umol/l, and In fact, the standard value of different detection methods for creatinine is also different. Today I will talk about my views on creatinine and uremia related issues. Why are the reference values of creatinine different in different hospitals? ● First talk about the source of human creatinine. In fact, the sources of our blood creatinine mainly include two kinds of endogenous and exogenous. Endogenous creatinine is a product of creatine metabolism in the body, which is mainly related to muscle volume and muscle activity. However, exogenous creatinine is mainly derived from the skeletal muscle of food animals in the diet. It is the “meat dish, lean meat” we eat. ●You come to the laboratory with a tube of blood. How did the staff of the laboratory measure your creatinine value? Currently, there are two main clinical creatinine detection methods, namely alkaline picric acid method and enzymatic method. For example, the alkaline picric acid method has a characteristic of poor specificity, such as acetone, pyruvic acid, folic acid, ascorbic acid, glucose, acetoacetic acid, cephalosporin, etc. in the blood can be colored in this reaction, so it is called “Non-creatinine chromogen”. ●Note that due to these limitations, the application of this determination method has been gradually reduced or even eliminated, and the application of enzymatic analysis is more and more widely used due to its high specificity and can be automatically analyzed, although the cost is relatively high. Higher, but still popular, so this explains to me why sometimes the reference values detected by different hospitals are different. How long does it take for creatinine to reach uremia? ●In fact, I think this is a pseudo-proposition. Due to the different detection methods, some hospitals are actually the upper limit of the normal value, but our hospital is 133umol/l is the upper limit of the normal value, so if you put a hundred The creatinine value of Lingji is put in the reference value of our hospital, it is completely normal. What is the reason for uremia? In addition, even if the reference value elsewhere is more than one hundred, it should not be too tight if it is slightly higher. As I said earlier, creatinine is not necessarily accurate because it is subject to fluctuations in creatinine levels in the body and renal tubules. The excretion of creatinine is related to the extrarenal excretion of creatinine and muscle volume. So if it is a single result, I suggest to check again after a few days or find another hospital for a test. ●Let me make a hypothesis, that is to say, the creatinine result of more than one hundred is indeed reexamined many times, and it is an elevated and abnormal result. For this mildly elevated situation, as a nephrologist , I want to say that we need to pay attention, but it is still far from uremia, what should I do, I have the following suggestions: ① Finding the cause of the increase in creatinine is the key, because if creatinine is indeed a pathological increase , That mostly suggests kidney damage, the following is to find out the internal cause of kidney damage, such as nephritis? Nephrotic syndrome? Primary kidney disease? Secondary kidney disease? Hereditary kidney disease? Infection-related kidney disease? Tumor-associated kidney disease? …….and many more. ②There are too many specific inspections and tests to be done, and they need to be selected according to the specific situation, so I will not repeat them one by one here. If they are basically good, it is naturally the best and only need to be reviewed regularly. That’s it. If it is found that it is caused by a primary disease, it is to treat the primary disease, thereby delaying the progress of renal function, which is actually delaying the further rise of creatinine, such as the control of blood pressure by hypertension and the control of blood sugar by diabetes. Wait. ● Let’s talk briefly about uremia. If creatinine must be measured, then creatinine needs to be >707umol/l. What’s more, after the age is old, the kidney function is slowly decreasing. Like the elderly in our department, the creatinine also slightly increased, but this is purely normal. The creatinine value does not fluctuate significantly after several years of review. What about uremia? So don’t be afraid of not being far from uremia as soon as you see elevated creatinine. This is a wrong concept. Comprehensive summary So for this question of “creatinine”, I am actually more of a guide, don’t hold on to a laboratory indicator. Let me give you an example. Some patients with IgA nephropathy and nephrotic syndrome have normal creatinine.
When it comes to uremia, many people will not feel unfamiliar. In recent years, whether it is a short chat between parents or a traditional authoritative newspaper and news media, there will be questions about “Xu is suffering from uremia and his parents/wife donate kidneys”. Kind of article. But the editor asked everyone a question: What exactly is uremia? Who can answer me? I am afraid that few people can answer me, and few people can correctly say the cause and prevention of uremia. Today, I will reveal the past life and life of uremia for everyone. I will take you to understand uremia: Is uremic really a mysterious, word-of-mouth urine of some aunt gods? Is it poisoning yourself? Haha, the answer is of course No, uremia is actually a disease without urine. Once a person suffers from uremia, the frequency and volume of urine will decrease, and finally there will be no urine at all. This sounds good, and is not used to go back to the toilet, but the question is where is the water we drink? What is uremia? In-depth explanation is smart! This is the key to the problem. The most terrible part of uremia is that it completely cuts off the “road” of the body to eliminate toxins from the body. Humans eliminate excess toxins and wastes in the body through urination, sweating, defecation and other methods. Urination is one of the most important “roads”. Here the editor wants to do one thing for everyone. When we eat and drink water, the nutrients and water taken from the water and food will enter the blood. When blood flows through our body continuously, when it passes through the kidneys, excess water, toxins, wastes and other substances that are toxic and harmful to the human body are filtered out through the kidneys. These substances are eventually eliminated from the body through urine to maintain normal body health. Once a person is unable to urinate normally, or there is no urine at all, okay pro. There are a hundred ways to tell the truth at this time, so you can’t survive but you can’t: you must drink water when you are alive, and you need to urinate to drink the water to remove excess water from the body. If there is no urine/no urine, the water will be discharged stay home. The water that cannot be drained out will stay in your body, and the excess water in your body will cause problems such as edema. What exactly is uremia? In-depth explanation of edema is not just to make a certain part of your body swell so easily, excessive edema will lead to excessive capacity load, and it is easy to cause major diseases such as hypertension, left heart dysfunction, and cerebral edema. There are also those who need to eliminate toxins and waste from the body through urine, these things are not a joke. Once these things accumulate in the human body for a long time, they will follow the blood flow to various parts of the human body, causing continuous poisoning and damage to various organs of the human body. When the values of these toxins and wastes reach a certain level, they will even directly threaten human life! In this way, uremia can’t be taken lightly. It can already affect urine alone. So how is uremia caused by patients? What kind of disease is it? Uremia is not a disease, but a clinical syndrome common to all kidney diseases to the late stage, when chronic renal failure enters the end stage Syndrome composed of a series of clinical manifestations. At this stage, the human kidney has basically lost all its functions, and toxins, waste, and excess water in the human body cannot be normally eliminated. What exactly is uremia? An in-depth explanation means that if a person has kidney disease, such as nephrotic syndrome, nephritis, etc., no effective method is used to treat kidney disease, or the treatment effect is not ideal. His kidneys will gradually lose their functions. After a few years, ten years or even decades, they will completely lose all their functions-uremia! It is worth noting that uremia is not a disease that travels alone. Once appeared, there were “shadows” of kidney disease behind. It’s just that most of the time, because kidney disease itself is “dumb disease”, it is not noticed by us. Speaking of which, everyone should have an intuitive understanding of the past life and harm of uremia. How to do it specifically is that the benevolent sees the benevolent and the wise sees the wisdom. I don’t want to say extra words, what to do to keep my body healthy, I believe everyone knows it, but it’s just not doing it.
When we urinate, especially when men urinate, we can often observe the color of urine and whether there is foam. When the urine is found to have foam, some people will worry: Is there a kidney problem? 1. Normal urine: Normal urine is usually light yellow or colorless. When human urine is formed when blood flows through the glomeruli, uric acid, urea, water, inorganic salts and glucose in the blood pass through the glomeruli. Filtration, filtering into the renal capsule, forming the original urine. Normal urine: water: 95%, protein: 0%, glucose: 0%, urea: 1.8%, uric acid: 0.05%, inorganic salts: 1.1%. That is, normal urine has no protein or glucose. If there is protein or sugar in the urine, it means that there is disease. Urine generally does not appear to be foamy. Of course, foam that is impacted by men during urination has a short residence time. This is a normal phenomenon and does not belong to foamy urine. If the foam lasts longer, consider foaming urine. So is foam urine protein? Is it kidney disease? 2. Causes of foamy urine: 1. Foam disappears quickly, and short-term foamy urine is generally a physiologically common cause. For example, due to increased mucus secretion by the urethral bulb, the surface tension of urine increases, and more bubbles in urine may also appear. In urgency, the pressure of urination increases, and the rate of urination increases, so that the surface tension of urine increases, and bubbles can also be seen. This situation may also occur after strenuous exercise, long-distance march, and high temperature environment. If it occurs only occasionally and has a short duration, you generally do not need to worry. 2. The theory of foamy urine that may be caused by disease is that if you have long-term foamy urine, you should go to the hospital for a routine urine test, so that you can accurately determine whether it is proteinuria, and whether there are any specific problems. The most common diseases that cause foamy urine, the most common is kidney disease. After kidney disease, there will be protein in the urine, which will cause the surface tension of the urine to decrease, and more bubbles may be generated during urination. In addition to kidney disease, liver disease may also lead to increased urine bilirubin or protein content; cystitis, bladder cancer, etc. produce foamy urine; diabetic patients, increased urine sugar, urine pH changes, urine surface tension Increased, can also cause foamy urine. 3. If the urine test is routinely followed by proteinuria, what is the reason? Under normal circumstances, urine does not contain protein or only a small amount of protein, but when the kidney develops disease, the kidney’s filtration function is reduced and the protein runs into the urine. Higher urinary protein indicates poorer kidney filtration function, which is an important indicator of kidney function. All kinds of kidneys, whether it is primary or secondary kidney disease, may have proteinuria, such as: various nephritis, lupus kidney, diabetic nephropathy, hypertensive nephropathy, purpuric kidney, renal arteriosclerosis, renal venous thrombosis , Renal artery embolism, etc. Proteinuria may also occur in other causes such as fever, heart failure, malignant tumors, and urinary tract infections. Therefore, bubble urine is not necessarily due to protein in the urine, nor is it necessarily caused by nephropathy; but if you find a large amount of foamy urine for a long time, you must go to the hospital to find the reason to see whether it is proteinuria and whether it is the kidney Something went wrong.
Hello everyone, I am a professional nephrologist. To be honest, there are many kinds of diseases in nephrology, and different diseases have different clinical characteristics. When it comes to fruits, I understand it so much. I think that in a person’s life, compared to three meals a day, it is a must-have item. You can’t eat without food, but you can actually eat fruit for a period of time, so As far as the disease is concerned, I personally think that the status of fruit is not as important as the treatment and medicine. ● (1) What fruits are good for kidney disease patients and which are bad? Fans often leave messages. I can’t reply to everyone one by one because of the rush of time. I will reply to them here. In fact, I think that this view is an upside-down idea, because no matter what type of kidney disease you have, the prognosis of the disease is good or bad. The judgment comes from the clinical characteristics of the disease itself. ● (2) Some patients have a characteristic, which foods should be taken care of, but the medicines and treatments should be left behind. So my point is not to always think about what kind of fruit is better to eat faster. To put it bluntly, at most, it is a little auxiliary. Sometimes it may not even be able to talk about auxiliary. As long as a person eats a normal diet, in fact, the elements contained in the fruit are not missing as long as there is a balanced combination of three meals a day. Since I have talked about this content, let me give you a few simple examples. ● (3) The main ingredients in fruits are actually water, sugar, vitamins, potassium and other elements, so I personally think that if you are a uremia patient, no matter which type of fruit you eat, you must limit the amount because their kidney function is completely Loss, and the fruit is rich in water and potassium. If it is ingested in large quantities, it is very easy to cause excessive water in the body, potassium and sugar exceed the standard. Personally recommend that if uremia patients with hyperkalemia occur repeatedly, try not to Eat fruit, really want to eat can be eaten during dialysis, because potassium and water can be easily permeated during dialysis, which greatly reduces the risk of hyperkalemia. ● (4) Regardless of the type of kidney disease, there is no clinical statement about which kind of fruit can be used to maintain the kidney and how good the kidney is, so everyone should keep their eyes open early and don’t be given by some title parties. Deceived, if you are a diabetic nephropathy patient, I also mentioned earlier that fruits are rich in sugar, so be alert to fluctuations in blood sugar. For fruits, sum up is two major points, that is, pay attention to “potassium, sugar.” In addition, to expand a bit, patients with chronic kidney disease must pay attention to the “protein” intake standard. This has an absolute scientific basis, because patients with kidney disease if too much protein intake will often increase the burden on the kidneys, compared with my recommendation: chronic The protein intake of non-dialysis patients with kidney disease is about 0.6-0.8g/kg. body weight. If it is a uremic patient, the conditions can be relaxed at this time. The recommended protein intake is about 1.0-1.2g/kg. body weight. Author’s message: If you still have questions, welcome to leave a message, interact, and communicate in the comment area. If it is helpful, welcome to like, forward, and collect. If you like my creative content, please follow me. I will share health knowledge for you every day. Thank you for your patience. We will see you next time.
Although we are all saying that the kidney is not good, the kidney of traditional Chinese medicine is different from that of western medicine, at least not the same. Western medicine generally refers to an organ, which is a specific organ. For example, the kidney is the kidney. The kidney function is determined by laboratory blood drawing and B-ultrasound CT to determine whether the kidney is normal. The five internal organs and six organs of traditional Chinese medicine do not correspond exactly to the liver, heart, spleen, lung, and kidney of Western medicine. The five internal organs and six internal organs of traditional Chinese medicine include not only the specific organs of western medicine, but also others. 1. Western medicine thinks 1. What is the kidney of Western medicine? People have two kidneys. Everyone may understand that although we have two kidneys, a normal kidney is enough for us. The kidney is about 10-12 cm long, 3-4 cm thick, and weighs 120-150 grams. The left kidney is slightly larger than the right kidney. Each kidney is composed of more than 1 million nephrons. The kidney is relatively independent of other organs and has no direct correlation. 2. The role of the kidneys: 1) The kidneys detoxify the human body and metabolize them all the time. In this process, some wastes that are not needed or even harmful to the human body are inevitably produced. Excreted by the kidneys to maintain the normal physiological activities of the human body. 2) People who produce urine for kidney failure must finally go to dialysis to remove excess water and toxins from the body, because the kidneys produce urine. When the kidneys are bad or broken, they cannot produce urine normally. Excessive water and toxins can only be eliminated from the body through artificial kidneys, that is, dialysis. The normal person’s urine output is 1000-2000 ml per day, usually light yellow. 3) There is a certain relationship with blood pressure. We often talk about hypertension. A part of secondary hypertension is caused by kidney disease. Renin secreted by the kidney can increase blood pressure, while prostaglandins secreted by the kidney can also reduce blood pressure. . 4) Hematopoietic kidneys can secrete erythropoietin, participate in the bone marrow hematopoietic system, promote the differentiation and maturation of primitive red blood cells, and accelerate the production of hemoglobin and red blood cells. 5) Other functions maintain the ion balance of potassium, sodium, chlorine, calcium, magnesium, etc.; promote the activation of vitamin D. 3. Criteria and manifestations of poor kidney 1) Specific diseases: chronic glomerulonephritis, pyelonephritis, nephrotic syndrome, acute renal failure, chronic renal failure, kidney stones, renal cysts, diabetic nephropathy, hypertensive nephropathy, renal cancer Wait for various kidney diseases. 2) Blood test for renal function: creatinine: normal reference value: 44-115μmol/L. Increased creatinine may indicate renal insufficiency or renal failure. Urea nitrogen: normal reference value: 1.75-8.05mmol/L. In most kidney diseases, urea nitrogen increases. 3) Poor kidney performance: because there are many kidney diseases and different diseases, we will simply summarize some common symptoms: early fatigue, loss of appetite, backache, excessive or too little urine, anemia, edema, blood Increased potassium, high blood pressure, etc.; further possible depression, swelling of the lower limbs, itching of the skin, muscle twitching, etc.; the most serious may appear anuria, heart failure, mental abnormality, life-threatening, etc.; 4. Kidney is not good Because hyperkalemia may occur after kidney disease, potassium intake should be restricted, such as: winter mushrooms, seaweed, soybean sprouts, lotus root, spinach, leeks, celery, cauliflower, moss mushrooms, etc. to be controlled. At the same time, a low-salt diet, that is, limiting sodium intake, to avoid aggravating hypertension and edema, such as sodium chloride, soy sauce, various pickled products, and salty foods should be restricted. Severe kidney is not good, and certain protein intake needs to be restricted. Second, the kidney that Chinese medicine thinks is not good 1. What is the kidney of Chinese medicine? Chinese medicine thinks that the kidney is innate, the source of human growth, development, reproduction, and the root of life activities. The kidney is full of strength, the bones are strong and the teeth are strong; the kidney is the main source of qi, and the roots of the kidneys are the roots of the lungs; Healthy transport; kidney is water, and liver is wood, liver water is sufficient to support the liver. According to the five-element yin-yang theory, the kidneys mentioned in Chinese medicine are related to the liver, heart, spleen, and lungs. 2. The role of the kidney The kidney of traditional Chinese medicine is more complicated, and it is not easy to directly translate into the role of modern medicine. Simply put, the growth and development of the kidney and human, reproduction, reproduction, ear hearing, thick hair, firmness of teeth, and intellectual development The degree, even the relative lung gas is sufficient, the heart is normal, the liver is normal, the bladder is normal, etc. have a certain relationship. So Chinese medicine
Kidney disease is a disease that seriously endangers human health. Not only is it prone to relapse, but it will prolong the condition and be difficult to cure. Especially when kidney disease progresses to renal failure, it will be accompanied by some complications, such as diabetes, hypertension, heart disease and so on. In addition, a decline in liver hematopoietic function can also lead to a series of diseases, making it more difficult to treat. If the following symptoms appear, it means that there is a problem with kidney disease. 1. Nausea and vomiting: When kidney failure occurs in diabetic patients, the blood urea nitrogen increases, and the urease in the intestinal bacteria will break down the urea into ammonia, which can stimulate the gastrointestinal mucosa, causing nausea and vomiting. In addition, at this time, the kidney’s reduced concentration of urine will increase the patient’s nocturnal urine volume, and the body’s water will be lost at night, the blood will be concentrated, and the blood urea nitrogen level will rise relatively in the morning. Therefore, nausea and vomiting are more likely to occur in the morning. 2. Urinary tract infections: People who often have urinary tract infections for a long time may cause renal insufficiency. 3. Abnormal urination: Healthy people urinate about 4-6 times a day, and the urine volume is about 800-2000 ml. If you have too many or too few urinations, you should pay attention to it. 4. There is foam in the urine: There are many reasons for the foam in the urine, and kidney disease can also cause this phenomenon. If the protein leaks from the kidneys into the urine, the urine will foam a lot. 5. Gout and hyperuricemia: Gout and hyperuricemia are all caused by too much uric acid in the blood. In people with high blood uric acid, uric acid will be deposited in the kidneys and impair renal function. 6. Hypertension: Hypertension can cause hypertensive nephropathy, also called hypertensive kidney damage, so people with hypertension should pay more attention. Of course, kidney disease can also cause high blood pressure. 7. Anemia: Patients with anemia often go to the hematology clinic. In fact, in addition to excretion of waste and other functions, the kidney also has the function of secreting hematopoietic hormones, which is also a major signal of kidney damage. 8. Urine protein and urine occult blood: There is protein or occult blood in the urine, which is an important indicator of kidney disease, which can be detected by routine urine. But sometimes doctors who are not specialized in nephropathy will ignore this, and it is recommended that you consult a nephrologist. 9. Poor appetite: The patient will have a variety of gastrointestinal symptoms, especially because of gastrointestinal edema, and often have symptoms of digestive dysfunction such as diet and abdominal distension. 10. Weakness: When the kidney function is not good, many wastes are difficult to excrete from the urine, and there will be feelings of lack of energy, fatigue, fatigue, etc. Kidney disease, protein and other nutrients leak out from the kidneys and excreted through the urine, there will also be signs of weakness. Some patients think they are overworked, or for other reasons, and ignore kidney problems.
Nearly 40% of all patients with end stage renal disease are caused by diabetic nephropathy. So, diabetic nephropathy is terrible! is this real? The end-stage diabetic nephropathy is indeed terrible: most of the kidney’s tissue structure loses normal function, the kidney’s filtration function is low, the level of “waste” (such as creatinine, urea nitrogen, etc.) in the blood is increased, accompanied by increased blood pressure; In the end, you can only rely on dialysis or kidney transplantation. In fact, the lesions of diabetic patients and patients with early diabetic nephropathy can be reversed. Prevention and early intervention are the most important ones. 1 Reasonable dietary restriction of protein intake is an important means to delay the progress of diabetic nephropathy, such as no abnormal renal function, protein control at 0.8 grams / (Kg · day). If there is already renal impairment, the protein intake is reduced to 0.6 g / (kg · day), and compound alpha keto acid is supplemented daily. Be sure to eat less salt, because a diet less salt can help control blood pressure and edema. 2 Lifestyle changes include weight loss, smoking cessation, alcohol cessation, and appropriate activities. In the early stage of diabetic nephropathy, you can choose aerobic exercise based on fast walking, once a day after meals, half an hour each time, 5 times a week. If there is proteinuria, it is not suitable to exercise with greater intensity. 3 Control of high blood sugar Since the beginning of diabetes, high blood sugar should be actively controlled, and it must be strictly met. The better the blood sugar control, the lower the probability of suffering from diabetic nephropathy. Compliance value: Fasting blood glucose is lower than 6.1 millimoles / liter, postprandial blood glucose is lower than 8.0 millimoles / liter, and glycated hemoglobin is lower than 6.5%. 4 Control hypertension if there is no kidney damage and urine protein is less than 1.0 g / 24 hours, blood pressure is controlled below 130/80 mm Hg; urine protein is higher than 1.0 g / 24 hours, blood pressure is controlled below 125/75 mm Hg. Once microalbuminuria occurs, ACEI or ARB drugs should be taken under the guidance of a doctor, whether or not there is high blood pressure. Not only can lower blood pressure, but also reduce urinary albumin and delay the progress of kidney damage. 5 Controlling high blood fat, low density lipoprotein, and increased cholesterol are risk factors for proteinuria. Therefore, those with hyperlipidemia should also undergo lipid-lowering treatment. Compliance value: total cholesterol is lower than 4.5 mmol / L, low density lipoprotein is lower than 2.6 mmol / L, high density lipoprotein is higher than 1.1 mmol / L, and triacylglycerol is lower than 1.5 mmol / L. 6 Avoid using drugs that damage the kidneys Some drugs can damage the kidneys. Drugs that use the kidney as the main excretory organ should be used with caution in patients with renal insufficiency. Therefore, be sure to read the instructions or consult a doctor before taking the medicine. If you have any related problems such as kidney disease, you can directly [Private Message] Professor Mo Feifan
Chronic nephritis can cause patients with proteinuria, hematuria, hypertension and other symptoms. Due to the different ways of onset, the disease progresses slowly, so it will cause patients with varying degrees of renal dysfunction and eventually develop into chronic renal failure. Because the type of chronic nephritis and the period of disease are different, the clinical manifestations are also different, and the manifestations of the disease are also diverse. 1. Five signals before the onset of chronic kidney disease 1. Do not want to eat: anorexia, even nausea, vomiting, are also common symptoms of kidney disease. Some patients always think that this is a stomach problem, and feel that there is nothing wrong, so they leave it alone. I did not know that this might be a sign of nephropathy, and the result delayed the condition. 2. Polyuria and oliguria: Healthy people urinate about 4-6 times a day, and the urine volume is about 800-2000 ml. If the frequency and volume of urine are too much or too little, it may be kidney disease. 3. Dizziness: Insufficient sleep can cause dizziness, but when you find out how to rest, the dizziness can not be relieved, and when you have a headache, the examination is likely to find a high blood pressure. In fact, this is because of “renal hypertension” caused by kidney problems. 4. Eyelid edema, lower extremity edema: If sudden appearance of eyelid, lower extremity, and digital edema of the whole body, it is necessary to consider whether it is nephropathy. There is a problem with the kidneys, and if the water does not go out, there will be edema. Two places will be more prominent. One is the ankle. If the ankle is thicker than usual, there is a pit when it is pressed. It is called concave edema. The other is eyelid edema after getting up in the morning. 5. Anemia: When we have anemia, we will think of it as a blood problem. In fact, in addition to the function of excretion of waste, the kidney can also secrete hematopoietic hormones. When the kidney function is damaged, it can also cause anemia. 2. Three things to prevent chronic kidney disease First of all, patients with chronic kidney disease should have a physical examination awareness, regularly go to the hospital for urine, renal function and other physical examinations, to control the range of the disease can be controlled, and must not listen to non-professionals Of medication, to avoid overuse of medication to make the condition worse. Secondly, in order to prevent the emergence of uremia, patients with chronic kidney disease should pay attention to their eating habits, try to eat light, easily digestible food, and pay attention to nutritional balance. Finally, it is also important to maintain a good attitude. To be conscious, not all patients with chronic kidney disease will evolve into patients with uremia, and the current medical level is constantly evolving. We must believe that an optimistic attitude is an important factor in defeating the disease.
1. Severe edema, such as patients with nephrotic syndrome, a lot of proteinuria leads to heavier edema, need to drink less water. 2. Oliguria, such as uremia patients, and patients with severe renal failure, the urine volume will become less (day urine volume is less than 800ml), or even less than 100ml, need to limit drinking water. If these two types of kidney disease patients do not restrict drinking water, the water they drink cannot be discharged and accumulated in the body, which will increase the burden on the heart and severe heart failure. How much do you drink less water? Today ’s water intake = yesterday ’s urine output + 500ml. The 500ml of water is the water lost from urination such as breathing and sweating, which can maintain the body’s water balance. Note: Water intake includes not only drinking water, but also water in foods such as meals, milk, and rice porridge. If you only limit drinking water, but eat more fruits and foods with high water content, the water intake will be excessive. Finally, most patients with kidney disease can drink water normally, such as chronic kidney disease with normal renal function, no obvious edema, IgA nephritis, and patients with secondary kidney disease such as purpuric nephropathy and lupus nephropathy. Obviously, there is no need to worry about whether to drink more or less water.
Kidney disease or chronic kidney failure often has a long history, so building confidence in overcoming disease plays a decisive role in overcoming disease. With the progress of society, psychology is also gradually paid attention to. Medical psychology reminds us that human health and disease are not only related to their genetic factors and various environmental factors, but also to their personality characteristics, emotional states, psychological activities, Factors such as social and cultural background are also closely related. A large number of clinical facts tell us that not only do drugs have a good effect on kidney disease, but good psychological care is more conducive to the treatment of disease and physical rehabilitation, which should cause every The attention of a doctor and the patient’s family. Patients with kidney disease can directly affect blood pressure because of depression, nervousness, or emotional excitement, thereby increasing the burden on the kidneys and causing the disease to increase. Therefore, patients should learn to make psychological adjustments by themselves, to maintain a comfortable mood and emotional stability, and to avoid impaired kidney essence. Emotions are closely related to the organ function and pathological changes of the human body. The relationship between emotional factors and diseases has become one of the main theoretical pathogenic factors of traditional Chinese medicine. It is highly scientific and practical and has always been highly valued. Traditional Chinese medicine believes that human emotional activities are closely related to visceral functional activities. Good emotions are conducive to the adjustment of the body’s vitality and the normal functioning of organs. On the contrary, bad emotions can make the vitality of the organs unbalanced and the blood and blood running disordered, which can easily make the organs dysfunctional and aggravate the condition. Therefore, attention should be paid to emotional care.