Does it hurt to change kidneys?

Zhang Yuhai, Tian Ye, the host of CCTV's live programs "The Road to Health" and "Uremia and Kidney Transplantation", hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about uremia and kidney transplantation. Moderator: According to the survey, there are about 50- 100 uremia patients per million people in China every year, of which 80% are teenagers. What about uremia? The kidney in the field is a very important organ. Its main function is to produce urine, which will discharge the metabolic waste in the body, thus maintaining the balance of the body. If the kidney is damaged for various reasons and the degree is advanced, it is impossible to excrete toxins from the body. We call it uremia. Moderator: In addition to the function of excretion, what other functions does the kidney have? The foreign kidney has endocrine functions, such as producing renin, promoting the production of red blood cells in the body, maintaining blood pressure and promoting the hematopoiesis and growth of bones. Moderator: What effect does renal function have on the body? After renal function loss in other places, toxins cannot be excreted normally. If the toxin remains in the body, it will affect the digestive system (causing loss of appetite, nausea and vomiting, gastrointestinal bleeding, etc. ), cardiovascular system (leading to hypertension, arrhythmia, etc. ), blood system (leading to anemia, skin inflammation, etc. ), but also can cause damage to peripheral nerves. Moderator: What is the cause of uremia? Zhang Yuhai may be caused by diseases of the kidney itself, such as renal tuberculosis, kidney calculi's disease, renal tumor, chronic nephritis and congenital polycystic kidney disease. It may also be caused by diseases other than kidney, such as hypertension, diabetes, urethritis and ureteral obstruction. This will damage the function of the kidneys. Moderator: Is there any treatment for uremia? There are dialysis and kidney transplantation in Zhang Yuhai, peritoneal dialysis and hemodialysis. Peritoneal dialysis is to inject dialysate into the abdominal cavity and then excrete it through the peritoneum. Inject 2 liters of dialysate every time, 4-5 times a day. However, patients can do it at home, which is more economical, but they must pay attention to hygiene to prevent infection. Hemodialysis is to use artificial kidney to detoxify, introduce arterial blood into the dialyzer, and inject venous blood into the body after conversion, which is often called blood washing, 2-3 times a week, 4-5 hours each time. Moderator: Can taking medicine treat uremia? Uremia appears in other places, indicating that renal function has been completely lost, and it is useless to take medicine. If you want to prolong your life, you should choose dialysis replacement therapy or kidney transplantation. Moderator: Mr. Wang from Jiangxi Province has great side effects every time he comes back from dialysis in the hospital, such as nausea, vomiting and headache. Is there any good way to relieve these symptoms? Hemodialysis in Zhang Yuhai excretes a lot of toxins in a short time, so the body will be unbalanced. To solve this problem, it is necessary to shorten the dialysis time. It used to be 2-3 times a week for 4-5 hours each time, but now it is dialysis once a day for about 2 hours each time, which can reduce side effects. But if it is not suitable for a long time, it is best to have a kidney transplant. Moderator: Many people think that the original kidney should be cut off and replaced with a new kidney, don't they? In fact, this is not the case in this field. Kidney transplantation is to move someone else's healthy kidney to the lower abdomen of uremia patients, rather than to the original kidney position. Moderator: What preparations should be made before kidney transplantation? Zhang Yuhai should check donors and patients first, because not all patients are suitable for kidney transplantation, they must meet the requirements. First of all, they should choose the same blood type for tissue matching. The better the match, the higher the success rate of the operation. Moderator: Let's watch a video: First, clean the healthy kidney in the wild to remove excess fat and muscle, then cut the abdomen and sew the healthy kidney blood vessels together with the patient's blood vessels. At the same time, a bag will be placed to protect healthy kidneys. After the open circulation, the kidney will be filled with blood and then begin to urinate, indicating that the kidney transplantation is successful. Moderator: What is the difficulty of kidney transplantation? The difficulty in this field lies in vascular anastomosis and ureter connection. Moderator: Where else in China has this kind of operation been carried out? There are many places in China, Zhang Yuhai where this kind of surgery can be performed, including Beijing: Friendship Hospital, PLA General Hospital, Air Force General Hospital, 309 Hospital, Union Medical College Hospital, China-Japan Friendship Hospital, Chaoyang Hospital, etc. Shanghai: Shanghai First People's Hospital, Long March Hospital, etc. Guangzhou: Zhongshan Medical College, Nanfang Hospital, etc. There are hospitals in Chengdu and Chongqing; There is also an organ transplant center in Wuhan, and more than 50 hospitals across the country can do this kind of surgery. Moderator: Let's listen to the patient: 1. I have been on dialysis for nearly two years. I don't think I'm 100% sure about kidney transplantation now. It would be nice if the operation was successful. If it is not successful, the patient may suffer more. In addition, according to my own situation, to be honest, I am fine now, I can walk by bike, and I am recovering well. I have been on dialysis for more than a year. I think some patients want to do their own kidney transplantation, but the biggest worry now is the rejection after kidney transplantation. I think it will be better if the rejection after operation is reduced a little. I am hesitant now, because I am considering the survival rate. If the survival rate is good, it's ok. If the survival rate is not good, I will suffer. I think it's almost impossible to do it in my sixties. 4. 10 years ago, I had a kidney transplant, and my kidney was dead, which meant that I began to reject it the next day. High fever of 40 degrees, burning 7 1 day. As a result, I couldn't walk by myself for a whole year after I was discharged from the hospital, and my family has been helping me. Now that I think about it, I'm quite scared. If I do it again, I'm afraid I'll suffer again. There is also a cost problem. Moderator: What is the level of kidney transplantation in China in the world? It can be said that this field has reached a fairly high level, and this operation was carried out relatively late in China. According to statistics, our country has performed this kind of operation on more than 30 thousand people, and the survival rate has reached about 90%, so the success rate of the operation is still relatively high. Our hospital has done 130 cases this year, only 3 cases were unsuccessful, and the success rate has reached 97%, which is relatively high. Moderator: What is the youngest in your hospital? What's the biggest? How long is the longest survival after operation? The youngest in the field is 13 years old, the oldest is 73 years old, and the longest after operation has been 23 years, and has been married and has children. Moderator: Is dialysis the same as kidney transplantation? Field dialysis only replaces part of the function of kidney, and a large part of it is irreplaceable, such as endocrine function, so you have to supplement some drugs. Anemia requires injections, and calcium deficiency can also cause diseases such as high blood pressure. After kidney transplantation, patients can basically return to normal life. Moderator: Where do healthy kidneys come from? Kidney sources from other places are divided into corpse and living body. Biology is divided into blood and non-blood. In China, kidney transplantation is performed on cadavers, but some of them are indeed alive. Moderator: If a relative donates a kidney, what effect will it have on the body? The field still has some influence. There is no way to donate a kidney alive, and the donor will bear the risk of surgery. Therefore, the hospital will try its best to ensure the safety of donors. The survival rate of relative kidney transplantation is higher than that of cadaveric kidney transplantation, and it is possible to stop taking drugs after operation. Moderator: How much is the cost of kidney transplantation? The cost of field renal transplantation itself is not high, but the cost of taking immune drugs for a long time after operation is relatively high. The hospitalization period is about 1 month, and the cost is about 40 thousand yuan, but with the extension of time, the required (overall) cost should be lower than the dialysis cost. Moderator: Can Mr. Li from Shanxi have long-term dialysis without kidney transplantation? On-site long-term dialysis is possible, but it only plays a substitute role and still has some defects. Moderator: Mr. Yuan from Beijing, I had a kidney transplant five years ago, and the postoperative situation was very good. I felt like a normal person, so I stopped taking the medicine, but after stopping taking the medicine, I suddenly developed symptoms of renal failure. Now I start dialysis and prepare for the second operation. Why is this? There are still many cases on the scene. Many patients have successful kidney transplantation, but they don't follow the doctor's advice because they feel as if they have nothing to do. In fact, these drugs are to prevent postoperative rejection, so they should be taken for life. Moderator: Mr. Qian Ningxia uremia complicated with hepatitis B, Xiao Sanyang and low protein. Will this affect the treatment? Does it affect kidney transplantation? Patients with hepatitis B from other places can have kidney transplantation, but the long-term survival rate is lower than that of people without hepatitis B Moderator: Mr. Li from Gansu, I am a uremia patient. Through the treatment of Chinese medicine, I haven't been sick for 14 years. Is it possible to get sick in the future? He may be a chronic renal failure patient from other places, and he has not reached the advanced stage, so he has no symptoms. Drug therapy can achieve the effect of delaying the development of the disease, but in the late stage, drug therapy is ineffective. Moderator: Ms. Chen from Guangxi, can she still have children after kidney transplantation? It should be possible in other places, but taking medicine for a long time after kidney transplantation has an impact on children, and the burden on the kidneys is also great, and the position of the kidneys will also affect the development of the fetus, so it is necessary to go to the hospital regularly to avoid problems. Moderator: Ms. Liu from Beijing, I have kidney failure due to diabetes. Can I have a kidney transplant in this condition? Renal failure caused by diabetes in Zhang Yuhai can be operated now. Moderator: What other issues need attention? First of all, we should have a healthy attitude at the scene, don't always think that there will be rejection after operation, and also have good hygiene habits to prevent infection. This column is jointly sponsored by CCTV and Dr. Gamma Health Network.