Uremia is a general term for a series of symptoms that occur in the late stage of renal failure. Chronic renal failure symptoms are mainly reflected in the toxicity caused by the accumulation of harmful substances and anemia that occurs when kidney hormones are reduced. In the early stage, the most common are nausea, vomiting loss of appetite and other digestive symptoms. Into the late stage of uremia stage, the whole body system will be involved, the emergence of heart failure, mental anomalies, coma and other serious conditions, life-threatening .
Changes in urine volume in patients with uremia
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Acute renal failure oliguria 24-hour urine volume is less than 400m1, there may be a small amount of protein in the urine, urine weight grams of molecules of osmolality concentration is generally 280 to 300 milliosmolality / kg. Urinary sodium content is often greater than 40 ml equivalents/L, the normal concentration of urea in the urine is about serum urea concentration of 12 to 15 times, while the uremia is about the same. The normal urea concentration in urine is about 12 to 15 times the serum urea concentration, while in uremia it is only 2 to 3 times. Acute renal failure polyuria, urine volume up to 35L / day.
Chronic renal failure urine volume can be very little, can be normal, or even increased. The presence or absence of protein in the urine depends mainly on the primary disease. Urine weight grams osmolality concentration can be very low, urine sodium concentration can be 40 ~ 90 mEq / L, urine urea concentration is often less than 10 times the serum urea concentration. Chronic renal failure into the end stage, the urine protein content can be very little, urine volume is very little, or even no urine.
How to detect UTI early?
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Kidney research confirms that the kidneys have a strong potential compensatory capacity, and thus kidney function can still undertake the basic physiological functions of the human body when the disease is impaired, so the patient feels that "everything is normal". When the destruction of the kidneys is increasing, the compensatory capacity decreases, and finally overwhelmed by the load and "total collapse", life is already in danger.
While the occurrence and development of uremia has a long and gradual aggravation of the process, although this process is sometimes very secret, but there are many "clues" to look for, as long as you are good at discovering these inconspicuous signs, go to the hospital to check the urine and blood, you will be able to know the condition in detail.
How do you know if you have uremia? You can look for the following clinical features and go to the hospital when you experience one or some of these symptoms.
One, sleepiness and fatigue. This may be a very early manifestation, but it is most likely to be ignored, because there are indeed too many causes of sleepiness and fatigue. Especially those in the cause of "all-out fight" people, most of them will be attributed to the work of tension and fatigue. If the symptoms improve with a little rest, they are more likely to be ignored.
Two, yellowish color. This is due to anemia, due to the occurrence and development of this performance is very slow, and therefore in a period of not too short time will not appear obvious "contrast", just as people in the morning and evening meeting is difficult to find a variety of slow-developing changes.
Three, swelling. This is a relatively easy to detect the phenomenon. Is because the kidneys can not remove excess water in the body and lead to fluid retention in the body tissue interstitial, early only in the ankle and eyelid swelling, disappear after rest, if the development of persistent or generalized swelling, has been the disease is not light.
Four, urine volume changes. Due to the decline in renal filtration function, some patients with the progress of the disease will gradually reduce the amount of urine. Even if the urine volume is normal, due to the reduction of toxins eliminated from the urine, the quality of the decline in the body can not be discharged too much waste, so to a certain extent, the urine volume does not fully explain the function of your kidneys, good or bad.
V. High blood pressure. Because the kidneys have the function of sodium and drainage, sodium and water retention will occur in the body when kidney function is impaired, in addition, at this time, the kidneys will secrete some of the substances that elevate blood pressure. Therefore, uremia patients will have different degrees of hypertension in the early stage. If there is high blood pressure coupled with poor coagulation mechanism is prone to bleeding nose or gums, attention should be paid.
Sixth, poor appetite. This is due to urinary toxin retention, affecting the digestive function, most people do not think. To the development of the disease, there will be abdominal distension, nausea, vomiting, and even more frequent stools or stool thinning, at this time, the disease has been more serious, which is often an important reason why patients have to seek medical attention.
Drugs and dietary contraindications for patients with uremia
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Patients with uremia need to pay strict attention to medication safety and dietary safety. The following drugs and foods need to be strictly prohibited.
I. Chinese medicines: Cinnabar, Lei Gongteng, Houpu, Han Fangji, Mu Fangji, and Jinlian.
Second, Western medicine: steroids, tetracycline, anti-inflammatory painkillers (whether oral, injectable, and may be contained in a variety of cold medicines)
三、Food:
〈1〉 To the principle of light;
〈2〉 Low-protein diet, avoiding large fish and meat;
〈3〉 Avoid high-potassium foods: such as low-sodium salt, salt-free soy sauce, pickles, Processed canned food, ginseng essence, chicken essence, strong tea, etc.;
〈4〉Avoid high uric acid food: such as animal offal, seafood, small dried fish, and beans, etc.;
〈5〉Fruits: poppy seed (never eaten)、guava, melon, cantaloupe, oranges, bananas, grapefruit, etc..
Four, good blood pressure, blood sugar control, to avoid rapid deterioration of kidney function.
Fifth, if you have difficulty breathing, generalized fatigue, chest tightness, cramps, lethargy, persistent nausea, vomiting, hiccups, etc., please go back to the outpatient clinic or the emergency room for treatment.
What are the main features of uremia?
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Uremia is characterized by very high values of urea nitrogen (BUN), blood muscle liver (Scr), and gastrointestinal reactions such as nausea, vomiting, and loss of appetite .
The common clinical manifestations of uremia
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1.Symptoms caused by accumulation of toxins and metabolites:
(1)Digestive manifestations: digestive manifestations are one of the earliest and most common manifestations, which are mainly poor nativity and dyspepsia. In severe cases, there may be lingual inflammation and oral erosion. If the peptic ulcer involves blood vessels, there may be vomiting blood, blood in the stool.
(2) hematopoietic system performance: chronic renal failure patients have varying degrees of anemia, mostly caused by long-term malnutrition, erythropoietin reduction and hemolysis. Patients with renal failure have bleeding tendency, which is manifested as subcutaneous hemorrhagic spots, petechiae, bleeding gums, epistaxis, and in severe cases, gastrointestinal hemorrhage and death can occur. In addition, there can be white blood cell abnormalities, due to the role of "urotoxins", so that the production and function of white blood cells are impaired, the total number of white blood cells decreased (mainly lymphocytes decreased), neutrophils chemotaxis, phagocytosis and bacterial killing ability is also reduced.
(3) Cardiovascular system manifestations: common hypertension, uremic myocarditis and pericarditis, various arrhythmias and heart failure.
(4) respiratory system manifestations: respiratory system can generally appear in the presence of acidosis, dyspnea, can also be produced by uremia bronchitis, pneumonia and pleurisy and other manifestations.
(5)Skin manifestations: the skin may be pale, dry, itchy and "urea cream".
(6) Skeletal system: due to calcium and phosphorus metabolism disorders, can appear osteoporosis, bone softening or fibrous osteitis and painful pseudo-fracture.
(7) Neuropsychiatric symptoms: central manifestations of unresponsiveness, depression, irritability, excitement, convulsions, drowsiness and coma. Peripheral manifestations are manifestations of lesions such as peripheral neurodegeneration, with skin sensitization, burning pain, limb weakness and activity disorders.
(8) Endocrine function abnormalities:
1) Parathyroid dysfunction manifestations: mainly hyperparathyroidism manifestations, may appear calcium and phosphorus metabolism disorders, the appearance of the above uremic bone disease changes.
2)Thyroid dysfunction: due to the decrease of T3 and free T3 index, it is mostly manifested as the symptoms of hypothyroidism, such as weakness, easy fatigue, lethargy, dry skin, hearing loss, tendon reflexes are weakened, and body temperature is low.
3) Sexual dysfunction: women show irregular menstruation, decreased menstrual flow or even amenorrhea. Men mainly manifest as impotence and decreased sperm motility. Children show delayed sexual maturity.
2. Dysregulation of water, electrolyte and acid-base balance: the kidney is an important organ for regulating water, electrolyte and acid-base balance, and its damage can directly affect the normal conduct of these links, causing a series of clinical manifestations.
(l)Dehydration and edema: patients with renal failure can have edema or dehydration. This is due to the renal tubular function is impaired, the loss of concentration function, even without drinking water, can be discharged a large amount of dilute urine, the result caused by thirst, urinating and other dehydration manifestations, such as not pay attention to replenishment will make the renal blood flow decrease, renal ischemia, accelerate the damage to the kidneys, so the hydration of this case is more important than the medication. On the other hand, the excretory capacity of the kidney is very poor, if the water intake overload, water and can not be discharged, retention in the body, the performance of urination, weight gain, swelling, swelling of renal blood vessels and affect the renal blood flow, but also aggravate kidney damage. Therefore, weight should be measured daily and 24-hour urine output and other additional excretion should be recorded, which are important observation indicators.
(2) Changes in sodium and potassium: Hyponatremia is due to dysfunction of sodium reabsorption in renal tubules, and is also related to prolonged low-salt diet, application of diuretics and diarrhea. High sodium, on the other hand, is due to the high urine output without edema in uremia, thus not restricting salt intake, allowing sodium retention and exceeding the renal sodium excretion load. Weight gain and edema can occur, and even cause a decrease in urine output. Low-sodium manifestations such as fatigue, drowsiness, weakened tendon reflexes, as well as the aforementioned high-sodium manifestations, should be frequently observed, and the levels of various electrolytes in the blood should be frequently rechecked, so that timely adjustments can be made. Hyponatremia and long-term use of potassium-preserving diuretics are the most common causes of hyperkalemia. In addition, patients with uremia have decreased excretory function, and due to poor gastric appetite, insufficient caloric intake, resulting in accelerated tissue decomposition and the release of a large amount of potassium, coupled with acidosis, increased hydrogen-sodium exchange in the kidneys, decreased potassium-sodium exchange, etc., which can lead to a sudden rise in potassium, and clinically appear cardiac inhibitory manifestations, such as low heart sounds, slow heart rate, cardiac rhythm disorders and even sudden arrest; also common skeletal muscle symptoms, such as numbness of the limbs, Weakness, weakness and paralysis, paralysis, often from the lower limbs upward; fainting and mental disorders can occur; sometimes respiratory muscle inhibition can occur, leading to respiratory arrest. Hypokalemia occurs in two ways. On the one hand, dilutional hypokalemia occurs due to water retention in the body, at which time there is a hypokalemic manifestation, while the amount of potassium is not small, which is mainly due to the redistribution of potassium in the body; on the other hand, a true hypokalemia occurs due to a lack of potassium in the body caused by too little intake, the loss of vomiting and diarrhea, and the loss of diuresis. The manifestations of hypokalemia are similar to those of hyperkalemia except for the symptoms of digestive paralysis (e.g., abdominal distension, diminished bowel sounds).
(3) Acidosis: Mild acidosis may have no clinical manifestations. When the carbon dioxide binding capacity is lower than 15 mmol/liter, it can be manifested as deepening and accelerating respiration, loss of appetite, nausea, vomiting, weakness, irritability, and in severe cases, impaired consciousness, coma, etc.
What should be the tests when you suspect that you are suffering from uremia?
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Blood test, urine test, ultrasound of both kidneys, renal function test, combined with clinical symptoms can be initially diagnosed.
The effect of uremia on the cardiovascular system
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(1) Uremic pericarditis Previously, pericarditis in patients with uremia was often a sign of dying, and since the availability of dialysis therapy, patients have been able to survive for a long time. However, pericarditis can occur with inadequate dialysis or severe malnutrition.PABICO reports that viral pericarditis, which is associated with adenoviral infection, can occasionally complicate patients on better dialysis therapy. Uremic patients are immunocompromised, and individual patients with immunodeficiency are more susceptible to adenoviral infections. The application of anticoagulants in dialysis patients can induce pericardial hemorrhage and accumulation of fluid in the pericardium, called pericardial tamponade, which can compress the heart and cause serious consequences.
(2) uremic cardiomyopathy Uremic cardiomyopathy is relatively rare, clinical manifestations: extreme enlargement of the heart, severe heart failure. This kind of myocarditis often occurs in patients with severe malnutrition, but also can not simply link special vitamins and nutritional deficiencies with the pathological changes in cardiomyopathy, there may also be other causes to be explored.
(3) Arrhythmias Arrhythmias are usually associated with an imbalance of potassium. Sudden hyperkalemia caused by dietary inadvertence, surgery, or severe infection can lead to cardiac rhythm disturbances, and changes in blood potassium are more dangerous in patients already on digitalis, as can a sharp decrease in blood potassium.
(4) Metastatic myocardial calcification In some patients with prolonged hyperkalemia, metastatic calcification of the myocardium can occur like in other tissues, so that a part of the myocardial fibers become nonfunctional and frequent arrhythmias occur.
(5) Hypertension Hypertension is a common symptom of chronic glomerulonephritis, can be prevented and controlled by strict water and sodium control to prevent and control hypertension, but many patients can not control their blood pressure, need to use antihypertensive drugs, generally do not need double nephrectomy, the authors of a group of 98 cases of chronic hemodialysis patients, 31 cases of pre-dialysis blood pressure is normal, 67 cases of blood pressure is higher than 18.67/12kpa ( 140/90mmHg), by regular hemodialysis, combined with a small amount of antihypertensive drugs, 40 cases of blood pressure can be maintained in the normal range, 27 cases by using a variety of antihypertensive drugs, blood pressure is difficult to control, 17 of these patients received homologous cadaveric renal transplantation, in the functioning kidney in long-term survival (more than 4 years) of the 13 cases, 8 cases of blood pressure back to normal, 7 cases of patients taking a small amount of antihypertensive drugs, blood pressure can be maintained at 18.67/12kpa. can be maintained below 18.67/12kPa, suggesting that renal transplantation is an ideal treatment for uremic intractable hypertension.
Who is a candidate for uremia?
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Chronic glomerulonephritis is the leading cause of uremia. But most of them can't find the cause, generally suspected to be related to the body's immune deficiency, or due to repeated episodes of acute and chronic nephritis, lupus erythematosus, hepatitis or vasculitis infringement of kidney function, so that the renal function of the slow and progressive damage, hardening, must be done to determine the diagnosis of renal pathology section.
Diabetes, hypertension, people who often take herbal remedies and painkillers, and the elderly are candidates for uremia, in the statistics of dozens of countries that have participated in the comparison of data on end-stage renal disease in the U.S., Taiwan's uremia incidence rate of middle-aged and elderly people aged 45-75 years old and older is among the highest in the world, while diabetes, hypertension and the number of people complicating the uremic disease is rising year by year, and there are also good looking for remedies to eat herbs habit of living. of people, are likely to get a pass to enter the dialysis room earlier than the average person.
Uremia care
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According to the general nursing routine for internal medicine and diseases of this system.
[Observation of condition]
1. Closely observe the change of condition, measure body weight, blood pressure, and keep track of the amount of water in and out every day, and observe the stagnation or insufficiency of fluid in the body.
2. Regularly take the turbidity reduction pills, pay attention to the observation of hypertensive encephalopathy, heart failure and pericarditis and other signs of the disease, abnormalities in time to notify the physician.
Symptomatic care
1. Patients with frequent vomiting and diarrhea should pay attention to water and electrolyte disorders, and notify the physician when symptoms occur.
2. Patients should be protected from self-injury when convulsions and whoan occur due to abnormal brain manifestations or low calcium, and physicians should be notified immediately.
3. Breath with ammonia odor, easy to complicate stomatitis, should strengthen oral care.
[General nursing]
1. Give high calorie, high vitamin, high quality low protein diet, can be adjusted according to the renal function of the protein intake, hypertension
the person should limit the sodium intake, if dialysis treatment has been carried out, should be given to the high quality high protein diet.
2. For those who are resting in bed and are unconscious, agitated, convulsive, or comatose, bed rails should be placed and inspections should be strengthened to prevent falling out of bed.
3. Skin care due to metabolite retention caused by skin cancer itch, available hot water bath, do not scratch the skin to avoid
infection. The skin can be scrubbed with hot water to avoid infection, and the skin can be scratched to prevent bedsores.
[Health guidance]
1. Instruct patients to adopt a reasonable diet according to renal function.
2. Instruct patients to use medication correctly and observe side effects.
3. Pay attention to keep warm, prevent cold, and prevent secondary infection.
4. Pay attention to the combination of work and rest, increase the body's immunity.
5. Regular outpatient follow-up.
The causes of uremia in Chinese medicine
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Medical Zong Jinjian:
Equilibrium and edema belong to the spleen and lung meridians, all because of the water stop spleen and lung meridians, water stops in the chest is wheezing, the water stops in the diaphragm is distended, the swelling above the waist is the wind, the treatment should be sweating, the swelling in the waist is below the humidity (water), the method is suitable for diuresis, the swelling on and off the body is swollen, it is a wind and dampness injuries, method is suitable for sweat and benefit at the same time.
The swelling and asthma can not lie down, it is appropriate to chase the lung drink, swelling and fullness constipation is appropriate to attack the spleen water, swelling from the abdomen to the limbs can be cured, swelling from the limbs to the abdomen is difficult to cure, is solid method is appropriate to attack and drain, is weak method is appropriate to warm tonic, according to the evidence and the implementation of the, since there is no ineffective also.
The treatment of edema is not from the kidneys alone can be its success, from the text can be very clear that the treatment of edema has many different causes, different evidence, that is, to be cured, we must be from the cause of each disease to find the cause of certification and treatment, from many different treatment methods to achieve the purpose of medical restoration of health, healing.
Why are some people afraid of smelling oil and greasy food when they have a cold?
Why do older people prefer vegetarianism to fish, meat and grease? Why would many children today not eat meat and vomit when they do?
Many children with colds and fevers will urinate blood after being medicated, saying it is a streptococcal infection? Elderly people often have blood in the urine after surgery and killed countless people, this blood in the urine is streptococcal infection, or antibiotics anti-inflammatory heart and kidney caused by (see eating Western medicine will hurt the stomach, in fact, the five organs and six bowels are injured article)?
How is the formation of uremia and edema?
In fact, cold snot, phlegm, nasopharyngeal cancer, lymphadenocarcinoma, lung cancer, uremia? All of them are just one disease, due to anti-inflammatory (lowering fire qi) heartbreak, kidney, internal organs, causing colds wind evil was introduced into the body of different meridians produced by different evidence, and produce different meridian lesions only.
Colds and flu: snot and phlegm are watery, damp phlegm condensing in the nose and throat, for the solar meridian meridian lesions.
Nasopharyngeal cancer and lymphadenocarcinoma: water qi and wet phlegm are condensed under the ear, lymph and nasopharynx, which are the meridian lesions of Shaoyang meridian cold. (For details, see Nasopharyngeal Cancer and Lymphadenocarcinoma)
Lung Cancer: water qi, phlegm and dampness are condensed in the lungs and chest cavity, and are condensed by phlegm, dampness, water qi and blood stasis, which are the meridian lesions of cold and flu of Taiyin and Shaoyin meridians. (For details, see Lung Cancer chapter.) Lung stagnant water is phlegm, snot condensed in the chest cavity, lung.
Uremia: water, phlegm and dampness congealed under the heart (i.e., stomach) and vomiting or edema are meridian lesions of the Shaoyin and Taiyin meridians of colds.
Colds, nasopharyngeal cancer, lymphadenocarcinoma, lung cancer, uremia are cold water stored in different meridians into (
High blood pressure, diabetic patients water must be excreted from the sweat, such as exercise can be sweated to make the elevated blood pressure down, lower blood glucose, but today's medical treatment is to use diuretic in order to eliminate the body's water to lower the blood pressure, the use of blood pressure medication for a long period of time to diuretic, harming the heart and kidneys to heart (fire) is unable to evaporate water to drain the body. The long-term use of blood pressure medication for diuretics harms the heart and kidneys, causing the heart (fire) to be unable to evaporate water and perspire, while the yang in the kidneys fails, and yang qi is unable to rise, resulting in the storage of water under the heart (stomach), and the body vomits in order to get rid of the excess water that has been stored under the heart (stomach).
Diabetes is caused by the long-term use of insulin, resulting in insulin toxicity, all due to improper medical treatment, resulting in heart and kidney failure, resulting in systemic complications (see hypertension, diabetes), not hypertension, diabetes caused uremia.
The heart belongs to the fire, the lungs belong to the gold, the fire is the rise of the gas, today many uremia are due to colds are anti-inflammatory, resulting in the weakness of the heart and kidneys, so that the fire can not be gold (lungs) of the evaporation of water from the nostrils or the skin (sweat) out of the body, the heart (the king's fire) in the kidneys (the fire) in the weak Yang, phlegm, dampness, water accumulation in the diaphragm of the heart under the heart (the mouth of the stomach), the obstruction of lungs can not descend, gold can not produce water, the kidneys have no water, was examined for Kidney atrophy, urinary inaccessibility, in fact, is not a problem of the kidney, but the heart (fire) weakness, the inability to evaporate the water, the lungs of the Taiyin gas can not descend, when the complementary heart, lungs, so that the gas descending, like the earth is nourished by the rain and not drought, is the Jin Shengshui, the kidneys and kidney atrophy that is cured by the moist, urinary fluency and normal.
The yang in the kidney is weak (the lower cold), the body is unable to sweat, like winter, the ground is cold, no water vapor rise, the sky that is no rain can fall, there is rain can fall can not become the amount of water to moisturize the earth, so the earth is a piece of the withered as the renal atrophy.
Winter running outside, eat to the cold wind, that will vomit, vomit to a burst of sweat, the wind and cold excluded, vomiting that is cured, uremia patients due to be anti-inflammatory cold water accumulated in the heart of the lower (stomach) and vomiting, because the heart is anti-inflammatory weak, unable to sweat, so more than the vomiting, this vomiting can not be stopped, when to warm the heart yang treatment.
Drinking people sweat, if blowing cold wind, pores suddenly contracted, will vomit, because the pores by the wind and cold contraction of the blockage, so that the sweat, water and gas can not be discharged, the accumulation of water (wine) in the stomach will be vomited and discharged.
Many patients with esophageal cancer are not suffering from gastrointestinal and esophageal diseases and cannot swallow, but they are suffering from cold and wind-cold, which are introduced by anti-inflammation, and cannot be swallowed due to liver, gallbladder, or stomach, i.e., typhoid can be eaten and typhoid can not be eaten, but these patients are initially treated as gastrointestinal and gastrointestinal inflammatory vomiting and are anti-inflammatory to stop vomiting or are treated by surgery, or by electrotherapy, to the extent that the patients are unable to tolerate the pain of the situation. The author has treated several patients who were tested for esophageal cancer and were not treated with electrotherapy or surgery, and were cured by Xiaoqinglong Tang.
Running in winter and eating cold wind and vomiting, drunkenness and vomiting, and the vomiting of uremia, the same, for the pores can not sweat, the body from the vomiting of excess water caused by drunkenness, running for the body's pores for a short period of time to be blocked by the reaction of the phenomenon, the vomiting of uremia is due to the misuse of anti-inflammatory colds (for details, see colds and flu, why can not cure?) caused by fire (the heart is the ruler of the article), the body will not be able to cure. The first is that the body's pores are briefly blocked, and the body's pores are briefly blocked. The second is that the body's pores are briefly blocked, and the body's pores are briefly blocked, and the body's pores are briefly blocked. Research shows that 15% of hypertension will develop into uremia, and good or bad blood pressure control directly affects the occurrence, development, efficacy and prognosis of uremia. Therefore, hypertensive patients should be closely monitored to prevent uremia, and should pay attention to the following aspects:
First, the blood pressure will be controlled at the ideal level. China is a big country with hypertension, but there is a very dangerous three-low phenomenon of hypertension in China, i.e., low rate of knowledge, low rate of medication taking, and low rate of control. The census found that less than half of the patients know that they suffer from hypertension; less than 12.5% of them take medication for hypertension; and only 2.9% of them are able to take medication to control their blood pressure at an ideal level. Therefore, it is urgent to carry out the publicity of hypertension in the whole society and raise the awareness of the danger of hypertension.
Second, closely monitor kidney function. Controlling blood pressure at an ideal level is a prerequisite for preventing kidney function damage. At the same time, the kidney function of hypertensive patients should be closely monitored. Specific measures are:
1. Regularly check renal function, including endogenous creatinine clearance, blood creatinine, urea nitrogen, preferably every 2 months.
2. Closely observe whether there are early symptoms of uremia, such as weakness symptoms such as fatigue, back pain and leg weakness, digestive symptoms such as loss of appetite or nausea and vomiting, as well as anemia manifestations such as yellowish face, pale tongue, pale lips and eyelids. Once the related symptoms appear, kidney function should be checked in time to confirm any abnormalities.
3. All patients with decreased endogenous creatinine clearance and elevated blood creatinine and urea nitrogen should be treated promptly according to the early uremia treatment program.
Third, the rational choice of drugs and treatment programs. There are many varieties of antihypertensive drugs with different indications. The basic principle of choosing antihypertensive drugs is no nephrotoxicity, or there is a protective effect on the kidneys. Studies have shown that angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, calcium channel blockers and β-blockers have a protective effect on the kidneys while lowering blood pressure. As far as the treatment of hypertension is concerned, if we use western medicine to lower blood pressure, together with the Chinese medicine that regulates elevation and elevation and tonifies the liver and kidney, it has a good effect on keeping the stability of blood pressure and protecting the kidney function.
Kidney transplant can really make patients "get a new life"
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According to Guangzhou Daily, Qingdao, a machinery company, because of the employee Li × × kidney, in exchange for a series of trouble. Li × × suffered from uremia, in the maintenance hemodialysis (medically known as hemodialysis), has always been "the world is peaceful", a few months ago for the kidney, the huge medical expenses but the company and his own unbearable, just to prevent rejection to eat Santiamine solution 3 bottles per month, the price of each bottle is as high as more than 3,000 yuan, and there are many other Medical expenses. For this urgent need for funds to remodel production equipment, reversing the passive situation in the fierce competition in the market for the company, is really an unbearable drag. Originally, a hospital in Qingdao introduced kidney transplant (medically known as kidney transplant), claiming that: only a one-time cost of more than 60,000 yuan, the patient replaced the kidney will be able to solve the problem once and for all. Therefore, the company's leadership team took a look at the situation and thought that it would be better to let the patient have a kidney transplant to remove a long-term burden for the enterprise instead of spending money endlessly on hemodialysis (4,000-6,000 yuan per month). At that time, it was unexpected that the cost of kidney transplantation was even more than the previous cost of hemodialysis, and the medical expenses to keep the kidney alive would cost more than 10,000 yuan per month, and the burden would continue month after month, so how much would it cost to get rid of the problem? At present, the company has paid 170,000 yuan for this kidney, and Li x x's family for the payment of the huge 10% out-of-pocket medical expenses and poor to cope with, running around. Until now, they can only pay more than 10,000 yuan, and there are still nearly 20,000 yuan of unpaid bills.
It's a shame. In fact, on the issue of kidney transplantation, the people and the media still have some deficiencies in their understanding of the problem, and they think that after the transplantation of a kidney, everything will be fine, everything will be solved, and it will be OK forever. According to the report of Shanghai ** Hospital, which has more experience in kidney transplantation: in 800 cases, after kidney transplantation, those who can use it for 3 years without being obsolete are only about half of them, and those who can use it for 10 years are less than one in a hundred.
Maybe some people will say, the planted kidney is bad, you can change it again. The second time you get a new kidney, it will be more difficult, more expensive, and less effective. Of course, after kidney transplantation, if you can successfully keep the kidney, the quality of life is generally better than dialysis, but at present our country kidney transplantation, there are still cadaveric kidney and kidney planted into the patient in the process of all kinds of problems. In addition, there is the problem of tissue mating still to be further solved. Therefore, it is not as generally imagined, uremic patients kidney transplantation can be a permanent solution to solve the problem, a success. In fact, in just three years, 50% of the patients will no longer be able to enjoy the scenery and will have to go back to dialysis, not to mention the fact that after kidney transplant, they will have to take a large amount of expensive and harmful anti-rejection drugs for a long period of time. It is a heavy drag on the public and the family.
The uremic patients and their families are advised to consider the benefits and disadvantages of kidney transplantation and make a careful choice.
Holding urine can lead to uremia
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Holding urine can be very harmful.
Urine is a product of kidney metabolism, the kidneys regulate the excess water in the body by producing urine and excreting metabolic wastes and poisons produced by metabolism in the body. The water produced by daily diet and body metabolism in the body with the blood flow into the kidneys. Inside the kidneys, there are many "filters" called glomeruli. The glomeruli specialize in filtering water and metabolic wastes. When the blood flows into the "filter", the excess water in the blood along with the metabolic wastes in the body are filtered out to form urine. The urine passes through the ureter into the bladder and is stored there, and when it reaches a certain amount, it produces a sensation of urination, which is usually 1,000 to 2,000 milliliters of urine per 24 hours in an adult.
Urine is a metabolic product of the body, most of which is not needed by the body, and it is constantly being formed. If you hold your urine, the amount of urine retained in the bladder grows and the bladder enlarges, leading to damage to the bladder muscle due to dilation. Some people hold urine for a period of time, even if the discharge will be conscious of abdominal distension, which is the bladder expansion after the incomplete contraction of the cause. In addition, hold the urine too long, the pressure in the bladder increases, is bound to damage the metabolic function of the kidneys to excrete waste, so that the water and metabolic waste in the body to accumulate, resulting in uremia, causing renal failure, life-threatening.
Therefore, you should not hold your urine in any other situation except for a short period of time to do certain tests.
Beware of diabetes triggering uremia
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Latest statistics show that one out of three patients with uremia develops from diabetic nephropathy. Diabetes and end-stage renal disease (UTI), two seemingly unrelated diseases, are very closely linked. The latest statistics released at a symposium held in Shanghai on the latest progress in kidney protection research show that one in three uremic patients develops from diabetic nephropathy, and diabetic nephropathy has become the primary factor leading to end-stage renal disease.
According to the experts at the conference, China is one of the countries in Asia with a high prevalence of diabetes, and there are currently about 30 million diabetic patients, more than 90% of whom have type 2 diabetes. Because type 2 diabetes does not have the typical "three more and one less" (drink more, eat more, urinate more, weigh less) symptoms, as many as 67 percent of diabetics are undiagnosed. Even among diagnosed diabetics, less than a quarter are tested for microalbuminuria at the time of treatment for early detection of diabetic nephropathy, a fatal complication. At the same time, because more than half of diabetic patients have hypertension, the current selection of antihypertensive drugs is also very little attention to the protection of the kidneys, the heart and other target organs.
To this end, experts have called on doctors to update their knowledge as soon as possible, and to prefer treatment regimens that completely block angiotensin II, the main culprit of diabetic nephropathy, in diabetes treatment, in order to minimize and slow down the onset and progression of diabetic nephropathy.
What is the metabolic impact of the uremic state
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With renal failure, the accumulation of metabolic wastes in the body can involve many body systems. The decline in cell function, reduced enzyme activity, water and electricity balance disorder, renal failure on the metabolic impact is mainly manifested in: (1) sugar metabolism disorders Uremic patients with mild elevation of blood glucose, this elevation and diabetes pathogenesis is different, diabetes is the absolute or relative secretion of insulin is insufficient, and uremia patients with hyperglycemia is mainly the cells of insulin sensitivity is reduced. In normal people who take a certain amount of glucose orally, serum insulin increases accordingly; in the case of diabetic patients, this increase is more pronounced, which indicates that more insulin is needed than in normal people to make the cells utilize glucose. It has been reported that endogenous insulin secretion is normal in patients with uremia, and the level of ingested exogenous insulin maintained in the body is higher than that in normal people. Since insulin can be maintained in the blood of patients with uremia for a longer period of time, in patients with chronic diabetes mellitus, the dosage of insulin can be reduced once uremia occurs.
(2) protein metabolism disorders Protein metabolism produces nitrogenous wastes, due to the excretion of the body, accumulation in the body, blood urea nitrogen increases. Therefore, in the treatment of uremia, generally limit the intake of protein, patients with malnutrition, long-term hemodialysis patients, protein intake restrictions can be slightly relaxed, the serum amino acid content of patients with uremia is abnormal, some people's serum concentration of certain amino acids can be higher than that of a normal person 2 to 3 times. On the other hand, serum levels of essential amino acids may be lower than normal, and a deficiency of essential amino acids may have a significant impact on the reconstruction of autologous tissues.
(3) Abnormalities of fat metabolism The effect of uremia on fat metabolism has not been studied much, and it is known that most dialysis patients have increased levels of triglycerides and free fatty acids in the blood, and blood cholesterol and phospholipids are generally normal.
Hemodialysis
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Hemodialysis is a means of treating disorders such as uremia by utilizing a semipermeable membrane inside a hemodialyzer (artificial kidney) for the exchange of substances. The dialysis method is to connect the patient's artery to the artificial kidney, so that the blood flows along the tube made of fiber membrane to the venous end, the outside of the tube is dialysis fluid, and the flow