Saturday, August 4, 2012

Nocturia increased its causes


Nocturia, increased nighttime urination and urine output increased significantly, nocturia more than all day (24h) half of the total urine output by. Normal, nighttime urination 0-2, urine output was 300-400ml, about all day 24h urine output of 1/4 to 1/3. With increasing age, daytime urine and nocturia than the value gradually decreases to 1:1, the ratio of the age of 60. Less drinking water, usually after dinner, not eating, coupled with in vivo metabolic rate is low after sleep onset, slow blood flow, the original urine by tubular reabsorption, nocturia was significantly less than during the day urine. Clinical nocturia increased with kidney disease, drainage, and spiritual points. Nephropathy sexual nocturia increased, a variety of causes kidney damage, renal dysfunction, the kidneys can not during the day and in vivo metabolites completely discharged excretion resulting in increased nocturia, the need to continue in the night. Common in chronic tubulointerstitial nephropathy, chronic pyelonephritis, hypertensive renal arteriosclerosis, chronic renal insufficiency.

The diagnostic significance of urine general traits check nephropathy


The urine of the general traits inspection is part of the routine urine examination, the kidneys and urinary tract diseases have a certain diagnostic value. Including urine output, urine color, transparency, foam, odor, pH, specific gravity, infiltration volume (pressure), as described below.


(A) urine


(2) urine color is normal discharge of fresh urine, mostly pale yellow. The depth of the urine, in addition to the value of the level of enrichment depends on the urine and urine acidity (pH), is also affected by certain foods and drugs, so the larger changes. Occurrence of abnormal urine of kidney disease, caused by visible renal tuberculosis, kidney stones caused by a light red or reddish brown hematuria, tuberculosis oppression of the perirenal lymphatic white Chyluria, renal abscess caused by light green pyuria, etc..


(3) the transparency of normal urine is transparent, place may be a slight turbidity. Discharge of fresh urine was cloudy, mostly pathological, can be found in. Renal hematuria, pyuria, bacteriuria, fat, urine, chyluria.


(4) bubble normal urine shake of a small amount of white or light yellow foam. Severe nephrotic urine proteinuria, can produce a large number of white foam, which is due to protein changes the surface tension of the urine.


(5) normal smell of fresh urine, with special faint aroma. Place too long the urine, due to the contamination of bacterial decomposition of urea, ammonia odor; eating garlic or chili, urine with a garlic odor, and so on. The urine of the diabetic nephropathy ketoacidosis was apple-like odor, urine in the urinary system when the abscess and kidney abscess showing a corrupt and foul smell.


Under normal diet conditions (6) urine acidity (pH), urine pH of 4.6 to 8.0, an average of 6.0, normal urine showing a weak acid. Nephritis, renal tuberculosis common acidic urine, type I renal tubular alkalosis visible alkaline urine.


(7) the relative density of urine relative density of urine, the weight ratio of urine and pure water. Normal adults, in the ordinary diet, the relative density of urine more than fluctuations in the range of 1.015 ~ 1.025, the maximum fluctuation range of the 24h day of urine relative density of 1.003 ~ 1.035; relative density of the morning urine is often about 1.020. Urine relative density increased with acute nephritis, diabetes crazy Majesty kidney; urine relative density decreases, the common stage of chronic nephritis and diabetes insipidus.


(8) of urine 's penetration of the volume (pressure) urinary infiltration capacity of all means urine solute particles the total number. The amount of urine penetration only with the number of solute particles are less vulnerable to the impact of protein, glucose and other macromolecules, more realistic reflection of the renal concentration and dilution function. The normal adult urinary infiltration is generally 600 ~ 1000mmol / L, the average for the 800mmol / L, the maximum range of 40 of ~ 1400mmol / L. Reduce seen in obstructive nephropathy, uric acid nephropathy, increased seen in diabetic kidney disease.

The diagnostic significance of the chemical examination of urine for kidney disease

The chemical examination of urine, is an important item in the urine routine examination. It consists of a urine protein, urine glucose, urine ketone bodies, chyluria, as described below.


(1) normal urine within the urinary protein (Pro) contains only a small amount of protein a day 24h urine within 20 ~ 80mg conventional qualitative test was negative (a). When the urine protein content exceed 100mg/24h the conventional qualitative test is positive (+), known as proteinuria. Proteinuria, clinical common in acute and chronic nephritis, kidney disease, urinary tract infection and other diseases.


(2) urine (GLU), normal urine contains only trace of glucose, called physiological urine, the urine qualitative test is negative (a); urine quantitative test 0.56 ~~ 5.0mmol/24h. Renal glucosuria and diabetes, the urine increased.


(3) urine ketone (KET) ketone intermediate product of fat metabolism, including acetoacetate, beta-hydroxy butyric acid and acetone. Normal urine ketone content is minimal, qualitative test is negative (a); quantitative test: acetoacetate normal for 9mg/24h to the beta-hydroxybutyric acid 25mg/24h acetone 3mg/24h. Ketone body abnormalities seen in diabetic ketoacidosis, and diabetic nephropathy.


(4) chyluria extensive abdominal lymphatic duct obstruction and thoracic duct obstruction can occur chyluria, the vast majority of filariasis caused by the spot's. The chyluria occasionally in the pyelonephritis, renal tuberculosis, and other normal person does not appear chyluria.

The diagnostic significance of urinary sediment microscopic examination of kidney disease


Urine sediment microscopic examination of the abnormal results are often seen with the renal biopsy consistent with structural changes, in particular, abnormal results of urine protein analysis, the diagnosis of kidney disease have a greater practical value. Its contents, including red blood cells, white blood cells and pus cells, epithelial cells, tubular, salt crystallization, addition to the tube, its contents are as follows.


(1) red blood cell (RBC) in normal urine, usually red blood cells, or only individual red blood cells. After centrifugation, the urine, such as the microscope for each high power field, the average visible 1 to 2 red blood cells is abnormal; such as each high power field, erythrocyte, urine appearance pale skin, called microscopic hematuria in more than three; such as urinary appearance was to wash the meat in water samples or red ocher, compared with gross hematuria. Hematuria is common in acute nephritis, chronic nephritis, renal tuberculosis, kidney stones, kidney tumors.


(2) white blood cell (WBC) and pus cells in the normal urine can be a small amount of white blood cells, white blood cells per high-power field (HP) generally centrifuged urine for 1 to 2, it is still normal. Such as per high power field of more than 5 white blood cells, called microscopic pyuria. Microscope the pyuria prompt urinary tract suppurative inflammation, such as pyelonephritis, bladder, or urethritis, renal tuberculosis; glomerulonephritis, urine white blood cells can also be slightly increased.


(3) the epithelial cells of normal urine, showing that a small number of epithelial cells, centrifuged urine per high power field shows the epithelial cells remain normal. Epithelial cells have a flat, transitional, small round epithelial cells. Flat epithelial cells, generally little clinical significance. Transitional epithelial cells from different sources, surface, middle, and the underlying transitional epithelial cells, in which the middle transitional epithelial cells increased common in pyelonephritis. Small round epithelial cells from kidney, normal urine in rare, large numbers of tubular lesions, the diagnosis of renal parenchymal disease. When chronic renal congestion, renal infarction and hemoglobin calm, showing that the cytoplasm of round cells contain brown granules (hemosiderin).


(4) precipitation of salts Results goods urine salt crystals, mainly due to the influence of urine pH. Alkaline urine, a common trivalent phosphate crystals, the crystallization of urinary ammonium, non-product form of phosphate, calcium phosphate, calcium carbonate, calcium phosphate is more common in chronic pyelonephritis, the rest of little clinical significance. Acidic urine, common uric acid crystals, calcium oxalate Results goods, non-crystalline urate associated with hematuria appear, suggesting the possibility of uric acid stones. Cystine crystallization in normal urine is rare, the large number of cystinosis and the formation of stones. Normal urine, cholesterol is rare, but seen in renal amyloidosis or steatosis, pyelonephritis, cystitis, pyuria.


(5) other tangible components of lipid droplets appear separately in the urine is common in the nephrotic syndrome. Mucus filaments appeared in large numbers in the urine, can be found in the urinary tract irritation or mucosal inflammation. Microorganisms, such as urine, bacteria found in the fresh centrifuged urine, can be the initial diagnosis of urinary tract infection.


(6) two kinds of urinary sediment and quantitative examination 3h urinary cell excretion rate, normal male, red blood cells <3 x 104 / h, the white blood cells <7 × 104 / h; normal female, red blood cells <4 × 104 / h, white blood cells < 14 × 104 / h.

Glomerular functions check the significance of Nephropathy


Clinical clearance rate often through the determination of various substances to reflect glomerular function. Clear rate measurement, we can find the glomerular filtration rate, renal blood flow, tubular reabsorption and secretion of various substances in order to grasp the kidney function of the degree of impairment. Glomerular function tests include inulin clearance, myogenic hepatic clearance rate, serum creatinine, blood urea nitrogen, glomerular radionuclide clearance, etc..


(1) inulin clearance of inulin as a lower molecular weight polysaccharides composed of fructose-all by glomerular filtration, tubular its absorption, excretion, and therefore inulin clearance (Cin, ) can accurately reflect glomerular filtration rate. Acute glomerulonephritis, chronic renal insufficiency, Cin significantly reduced; chronic glomerulonephritis, renal arteriosclerosis, may have varying degrees of reduction; pyelonephritis, a little lower.


(2) endogenous creatinine clearance rate of endogenous creatinine is primarily through glomerular filtration, tubular almost its absorption and excretion. Therefore, within the creatinine clearance rate (Ccr) measurement, to more accurately reflect the glomerular filtration rate, is a commonly used method of kidney function is good or bad. Acute and chronic glomerulonephritis, Ccr can be reduced; late chronic glomerulonephritis, Ccr decreased significantly; chronic renal insufficiency, and poor prognosis.


(3) serum creatinine concentration of serum creatinine (Scr), depending on the body of nitrogen catabolism and renal excretion; In the case of relatively stable intake of food and in vivo catabolism, blood concentration depends on the ability of renal excretion. Therefore, Scr concentration, to some extent, can understand the degree of impairment of glomerular filtration, can more accurately reflect the kidney function. Renal failure, uremia, Scr increased.


(4) the concentration of blood urea nitrogen blood urea nitrogen (BUN), depends on the decomposition of the body nitrogen metabolism and renal excretion, to some extent, reflect the glomerular filtration rate is good or bad. Determination of serum BUN can be used as indicators of renal function of the extent of damage and therapeutic. Increased seen in acute glomerulonephritis, chronic glomerulonephritis.


(5) clear the rate of glomerular radionuclide glomerular radionuclide clearance with inulin clearance accurately reflect glomerular filtration rate, and has the advantage of no need to collect urine and continuous intravenous infusion of the drug; subject to radioactive substances into the body, so the pregnancy and lactating women should not be applied.

Diagnostic significance of the determination of renal tubular function in kidney disease


Determination of renal tubular function, including phenol red excretion test, kidney concentrated dilution test, urine osmotic pressure, urine concentration dilution test, free water clearance rate measurement, renal tubular glucose absorption determination of tubular Determination of ammonia hippuric acid excretion bicarbonate reabsorption excretion (alkali load) test, now commonly used tests are described below.


(1) of phenol red excretion test phenol red, also known as phenol sulfur peptide (PSP), is harmless to human body's pigment. Phenol red injected into the body, about 94% from the urine. Determination of phenol red excretion in the urine, can be used as a rough indicator to determine the excretion of proximal tubule function. 15min after the phenol red injection of the normal adult, the excretion of 28% to 51%, an average of 35%; the 2h excreted a total of 63% to 84%, an average of 70%. Low excretion of the elderly. Clinical practice, often for 15 min excretion <25%, the 2h excretion of <55%, row tubular secretion function to reduce the boundaries. Phenol red excretion rate, seen in glomerular, tubular or renal interstitial lesions.


(2) renal concentrated dilution test kidney (urine) enrichment experiments, the ability to observe the body's water shortage situation, the distal tubules to concentrate urine. 3 times normal urine specimens, at least a relative density of> 1.026 (the elderly in more than 1.020); urine relative density <1.020, indicating poor renal concentration. The extreme damage of the renal function, urinary maximum relative density of 1.010; uremia, urine relative density of 1.010 ~ 1.012; glomerulonephritis, pyelonephritis, hypokalemia and hyperkalemia, kidney disease, but also showed relative density of urine abnormalities .


(3) free water clearance rate of free water clearance (CH2O) per minute cleared from plasma to urine and pure water, to better reflect the kidney to regulate fluid balance in the body dry and too much water than urine osmolality the ability, it can more accurately determine the severity of the renal concentration and dilution function and renal disease. Normal CH2O 25 ~ 100ml / h. CH2O positive on behalf of the renal diluting capacity, a negative value on behalf of renal concentration capacity equal to or close to zero indicates that the kidney can not concentrate and dilute urine in the function of serious injury.


(4) determination of renal tubular glucose reabsorption With the constant increase in plasma glucose concentration, renal tubular reabsorption of glucose values ​​also increased when the blood glucose concentration exceeds a certain limit, renal tubular reabsorption capacity of saturated can not be too much sugar reabsorption to the urine. At this point, the amount of filtrate reabsorption of glucose, known as renal tubular glucose reabsorption (TMG). TMG significantly reduced, seen in severe acute glomerulonephritis and chronic glomerulonephritis; renal arteriosclerosis, chronic pyelonephritis, caused by the occlusion of part of the glomerular or tubular ischemia, TMG can be reduced.

The diagnostic significance of urine bacterial culture nephropathy


Urine bacterial culture, ordinary bacterial culture and a special bacterial culture of two kinds. Regardless of the bacterial culture before check-ups should be strict compliance with aseptic technique, proper collection of pollution-free urine specimens, available catheterization France, the middle of urination France, suprapubic bladder puncture.


Urine ordinary bacterial culture, clear urinary tract infection diagnosis and treatment of special significance, under normal circumstances, urine since the formation of the whole process of storage to the bladder, there should be no bacterial growth. Urinary tract infection pathogens in the urine to the large population growth, a common urinary tract pathogens E. coli, deformation, Pseudomonas aeruginosa, Aerobacter aerogenes, Staphylococcus aureus and other. By the common bacteria of the urine culture, what can be diagnosed bacterial infection, and susceptibility testing, the choice of antibiotics for clinicians to provide an objective basis.


Urine acid-fast bacilli (Mtb) to check is the key to the diagnosis of urinary structure. Urine acid-fast bacilli examination, direct smear method, urine Mycobacterium tuberculosis culture, fluorescence spectrometry and enzyme amplification method. Urinary sediment smear-positive detection rate of 50% to 70% detection rate is the highest positive first morning urine. The urine Mycobacterium tuberculosis culture positive detection rate of the method was higher, reaching 90%. Mycobacterium tuberculosis culture further confirmed the general sedimentation smear-positive, to be urine. Renal tuberculosis, Mycobacterium tuberculosis, often intermittent, a small amount of discharge, so check the continuous three times as well.

The diagnostic significance of the X-ray examination of kidney disease


X-ray examination nephropathy: KUB examination, excretory urography, retrograde pyelography, skin puncture, pyelography, renal angiography and other doctors to check the patient's condition. Now briefly introduce the commonly used X-ray examination of the first two methods.


(1) KUB examination is without any contrast agent contrast abdominal x-ray, which includes the kidneys, ureter, bladder, and part of the urethra. KUB, the diagnosis of renal and urinary tract diseases can not be omitted steps used to observe the location of the kidneys, contour, size and shape; observation of the urinary tract with or without stones, calcification shadows; around the renal or without abscess.


(2) excretory urography, also known as intravenous urography (IVU) or intravenous urography (IVP), is the most commonly used imaging methods in the diagnosis of kidney disease. Non-toxic organic iodine contrast agent (such as diatrizoate injection) by intravenous injection of the human body, and excreted by the kidneys to the calyx, renal pelvis, ureter and bladder, and on proper time, the X-ray urinary tract imaging. Clinical suspicion of renal tuberculosis, chronic pyelonephritis, renal tumors suitable for this check. Who are allergic to iodine, severe renal impairment, renal insufficiency, etc., generally are not suitable for this examination.

Friday, August 3, 2012

B-mode ultrasound for kidney disease


B ultrasound is mainly used for the diagnosis of parenchymal organs of the structural changes, and whether there is such as space-occupying lesions. Kidney solid organ, there are a large enough volume, the unique shape and good air permeability, and clear boundaries, good ultrasonic probe organ. Clinical, B-ultrasound for congenital anomalies, renal cystic disease, renal ptosis, kidney stones, kidney tumors, as well. Renal trauma, renal vein thrombosis, renal transplantation, and diffuse renal disease have better diagnostic value. In recent years, with the launching of the renal vascular color Doppler technology, can accurately determine the level of renal vascular injury and determination of renal blood flow, clinical diagnosis of renal artery stenosis, renal vein thrombosis and other vascular lesions caused by kidney damage higher the diagnostic value.

Treatment Principles for chronic nephritis


Chronic glomerulonephritis referred to as chronic nephritis is proteinuria, hematuria, hypertension, edema associated with slower progression of renal dysfunction for clinical characteristics of a group of glomerular diseases. Diversification of different pathological type, duration and onset of clinical manifestations, the symptoms may all have, or only a part of. Most persistent disease, the slow progress of the lesions of some patients with acute exacerbation and progress. Chronic nephritis can occur at any age, young or middle age males. Multi-onset slowly, the occult, history for years. Condition when the light weight, the progressive development of chronic renal failure.


Of patients with early weakness, fatigue, back pain, loss of appetite and other symptoms, edema dispensable, and usually not serious. Some patients may have no obvious clinical symptoms, which we call the "silent period". More than a urine test abnormalities in laboratory tests, proteinuria persists, usually less than 3.5g / d in the range of non-nephrotic syndrome, and there are varying degrees of glomerular hematuria and tube. Blood pressure may be normal or slightly elevated. With normal renal function or mild impairment (endogenous creatinine clearance rate or mild azotemia) for several years or decades, renal function gradually deteriorated and the corresponding clinical manifestations, such as: anemia, blood pressure increased, and eventually developed into uremia.


The treatment of chronic nephritis, in order to prevent or delay kidney function deterioration, improve and relieve symptoms and prevent complications as the main purpose. General comprehensive prevention and control measures and prevention principles are as follows:


(1) general principles of the measures of chronic nephritis, long duration, the condition is often repeated, to encourage patients to enhance the confidence to overcome the disease.


Should work and rest have degrees. Serious illness, bed rest should be obvious clinical manifestations. Stable condition, may be appropriate to get out of bed; mild, may be appropriate to do some light work or work, study, recovery of the disease.


Dietary salt restriction and control of protein intake. The diet should be given a high quality protein, according to the degree of renal dysfunction to control protein intake, and general control in the daily 30g ~ 40g, and appropriate to fill the shortage of kidney spirit (α-keto acids) or the kidney will be ammonia, to supplement the body of essential amino acids . Low-protein diet may be appropriate to increase the intake of carbohydrates (sugars) in order to prevent negative nitrogen balance. Massive proteinuria but normal renal function should be to relax the protein intake, but not more than the intake of daily 1g/kg.


(2) to prevent the occurrence of renal damage factors for upper respiratory tract infection, catching a cold, should be actively treated to prevent their entry into the renal toxicity of drugs or poisons, Hyperlipidemia, hyperglycemia, hyperuricemia and other symptomatic treatment to prevent the above factors further aggravate kidney damage.


(3) active control of hypertension, angiotensin-converting enzyme inhibitors (ACEI) and calcium channel blockers, to treat renal Pi hypertension and renal function deterioration. β-blockers, renin-dependent hypertension, there are good results. These drugs are fat-soluble, and from renal excretion, so Renal insufficiency, the dosage should be adjusted, and extend the treatment time.


(4) of anticoagulation and antiplatelet agents and the application of these drugs has a good stable renal function, reduce the role of the renal pathological damage. When the patient has a clear hypercoagulable state and certain pathological types could easily cause a hypercoagulable state, such as membranous nephropathy, mesangial capillary proliferative glomerulonephritis, and so on, can a long time.


(5) the application of hormones and cytotoxic drugs that generally do not advocate the application of these two types of drugs. But others believe that, with normal renal function, normal kidney size, such as mild mesangial proliferative nephritis and $ contraindications, you can use these two types of drugs, ineffective can be removed gradually.

The treatment principles of occult nephritis


Occult nephritis, physical examination or in the occasional case, urine routine examination revealed abnormal symptoms and signs, and renal function is normal. Occult nephritis, which include different causes, the different pathogenesis of glomerular disease. Clinically, occult nephritis can be divided into asymptomatic hematuria asymptomatic hematuria and proteinuria, asymptomatic proteinuria are three types. The following principles:


(1) asymptomatic hematuria is hematuria is common clinical presentation of primary glomerular disease, no special treatment. Usually should pay attention to rest, avoid over exertion; should be removed repeatedly infected lesions, acute infection, you should take timely measures to control inflammation, so as not to aggravate the hematuria condition.


(2) asymptomatic hematuria and proteinuria in asymptomatic hematuria and proteinuria, is a type of occult nephritis hematuria with proteinuria, their condition and prognosis compared with isolated hematuria was serious. Main such as hematuria, urinary protein <1g / d, generally do not need special treatment, but should be followed up closely observed; such as urine protein> 1g / d, renal biopsy to clarify the pathological diagnosis, such as pathological changes apparent by according to the treatment principles of primary glomerular diseases.


(3) asymptomatic proteinuria latent nephritis, occurs in young males, showed persistent proteinuria. Generally not clear before diagnosis, no special treatment. Patients should be taken to avoid fatigue and infection, do not use drugs, renal failure. Under the guidance of a doctor, you can use the Tripterygium wilfordii, but to prevent the occurrence of side effects.

Treatment principle for IgA nephropathy


IgA nephropathy, also known as IgA nephritis, Berger's disease, IgA mesangial glomerulonephritis, membrane deposition of IgA-IgG nephritis. IgA, immunoglobulin A, immunoglobulin is mainly present in the plasma with antibody activity, or the chemical structure and similar antibody globulin. IgA nephropathy is the most common form of primary glomerulonephritis, accounting for primary glomerulonephritis 1/3. IgA nephropathy is characterized by: recurrent gross hematuria or microscopic hematuria, glomerular mesangial District, there are structural abnormalities of the IgA1 wide range of deposition, while the increase in mesangial cells and matrix proliferation, mesangial electron dense deposits. about 15% to 20% of patients with lgA nephropathy can enter in the 10 years after the onset of end-stage renal failure. At present, the principle treatment of IgA nephropathy are as follows:


(1) general treatment for upper respiratory tract infection, gross hematuria, the application of effective antibiotic treatment; patients with hypertension should actively control blood pressure, in order to avoid hemodynamic abnormalities and vascular lesions aggravate nephritis disease; with recurrent gross hematuria attack patients can be considered for tonsillectomy. It is reported that the tonsils lesions, allows more than 40% of IgA nephropathy with hematuria patients have been alleviated.


(2) regulate the immune response of prednisone treatment of IgA nephropathy, about 40% response rate; combined use of dipyridamole, cyclophosphamide, phenytoin (daily 6mg/kg), serum IgA levels can decline; oral Cyclosporin A daily 5mg/kg, proteinuria can reduce.


(3) to remove immune complexes in the blood circulation to remove immune complexes in the blood circulation, giving IgA nephropathy in patients with gluten-free diet for 6 months to 4 years, blood IgA decreased proteinuria and hematuria were significantly improved. Application of cromolyn sodium daily 1.2g, can reduce proteinuria. IgA nephropathy in renal failure, plasma exchange, some treatment, proteinuria, hematuria disappeared and renal function returned to normal.


(4) decrease in glomerular mesangial IgA deposition can be used acetylene the hydroxyl Androstene isoxazole daily 200mg, four months after treatment, C3 increased, decreased urinary protein. Application of 20 peptide acid, fish oil (daily 1.6g), can delay the deterioration of renal function of patients with IgA nephropathy.


(5) application of traditional Chinese medicine of traditional Chinese medicine preparations madder diester, daily 0.3g hematuria patients with IgA nephropathy have a certain effect.

Treatment principle for diabetic nephropathy


Diabetic patients with proteinuria, 24h urinary albumin> 300mg, can be considered to exist diabetic nephropathy. Due to diabetic nephropathy insidious onset and progressive deterioration, kidney damage, the lesion is irreversible, until renal failure. Therefore, the prevention and treatment of diabetic nephropathy is particularly important, their treatment of the following principles:


(1) low-protein diet low protein diet can reduce glomerular perfusion, reduce proteinuria, lower diastolic blood pressure, and serum albumin concentration, creatinine clearance and stability. Currently recommended protein intake for a day 0.6g/kg daily protein intake of total calories, less than 20% is appropriate.


(2) early control of blood glucose of diabetic nephropathy, strict control of blood sugar, reduce proteinuria, improve glomerular filtration rate, thereby inhibiting renal hypertrophy. Insulin promotes the use of intensive therapy, enable the glomerular filtration rate and urinary microalbumin more than normal, improving renal function. Diabetic nephropathy in the late strict glycemic control, there are still certain benefits, help to reduce the incidence of urinary tract infections, and to prevent urinary tract infections further damage the kidneys.


(3) control of blood pressure and diabetic nephropathy with hypertension, multiple high-capacity, low renin, it will control the blood pressure at normal levels, is an important part of slow diabetic nephropathy deterioration of renal function. Clinical practice has proved effective to stabilize the blood pressure, can significantly reduce proteinuria, and renal function decline and deterioration of vision. That angiotensin-converting enzyme inhibitors such as captopril (captopril), benazepril (benazepril), suppression Ping Shu, diabetic nephropathy with hypertension is the most appropriate preparations. Such agents through the expansion of small arteries and reduce glomerular pressure, reduce proteinuria and stable renal function. Calcium antagonists such as nifedipine (nifedipine) and amlodipine (Norvasc), can also be used to control hypertension of diabetic nephropathy.


(4) application of anti-platelet and microcirculation drug compound aspirin, dipyridamole, tetramethylpyrazine, Salvia preparations with a stable renal function and reduce proteinuria role. Prostaglandin synthesis agent, B pentoxifylline, etc., reduce micro-albuminuria, increased the role of the creatinine clearance rate.


(5) should be used right kidney non-toxic or low toxic drugs in patients with diabetic nephropathy, the use of hypoglycemic agents, antihypertensive drugs and antibiotics, should select an effective and kidneys of non-toxic or low toxicity drugs. Appropriate level such as hypoglycemic New Drug sugar, only 5% by renal excretion, it is suitable for patients with diabetic nephropathy; antihypertensive drugs captopril, enalapril, etc., not only the systemic antihypertensive effect, but also reduce glomerular pressure, can reduce urinary protein excretion without compromising renal blood flow, is one of the current drug of choice in the treatment of diabetic nephropathy.


(6) late renal transplant patients with diabetic nephropathy should be preferred renal transplantation treatment. Cadaveric renal transplantation and living related kidney transplantation a high success rate, there are indications can choose the right time.

Treatment Principles for lupus nephritis measures



Systemic lupus erythematosus renal involvement, known as systemic lupus erythematosus nephritis, referred to as lupus nephritis. , About 1/4 to 2/3 of patients with systemic lupus erythematosus involving the kidney caused by lupus nephritis. After lesions of the degree of clinical renal involvement, direct impact on the prognosis of systemic lupus erythematosus, prevention and treatment of lupus nephritis is very important measures of treatment principles are as follows.
(1) general treatment to avoid light stimulation, wearing broad-brimmed straw hat in the summer when they go out, to avoid direct irradiation of ultraviolet light and welding arc. Fever, joint pain, and proteinuria, should rest in bed; edema, high blood pressure, low-salt diet; nephrotic syndrome should be a high-protein diet, and renal insufficiency should be a low protein diet.
(2) prednisone adrenal corticosteroids such as prednisone, treatment should be carried out as soon as possible and in sufficient quantities to use. Start can be daily 0.75 ~ lmg / kg administered three times daily, after symptoms changed to the morning fasting Dayton clothing 40mg or so. The condition is generally four to seven weeks of remission, proteinuria was negative. A week for 1 to 2 weeks decreasing 5mg, gradually replaced by the next day serving Dayton. The ideal treatment is changed every other day for 3 to 4 months after Dayton clothing, 20mg, to maintain more than 1 year.
(3) The steroid and immunosuppressive therapy commonly used prednisone plus cyclophosphamide, prednisone plus azathioprine, prednisone plus cyclosporine A treatment. Used in combination, can reduce the lupus nephritis, proteinuria, control of disease activity and reduce mortality.
(4) commonly used heparin anticoagulant therapy, Danshen preparations, low molecular weight dextran, venom antithrombotic enzymes. This treatment enables some patients with nephrotic syndrome, proteinuria decreased blood hypercoagulable state improves.
(5), Kunming Mountain Begonia and Tripterygium preparations for treatment of Tripterygium and Tripterygium Begonia preparation, Chinese traditional medicine "hormone", with the role of regulation of the immune, inflammatory, analgesic and reduce proteinuria, 50% to 70% of lupus nephritis. In combination with the hormone, can significantly improve efficacy.
(6) of critically ill and terminally ill treatment of severe lupus nephritis with rapidly progressive nephritis, can be used steroid pulse therapy and plasma exchange therapy. General immune complexes in the blood to prevent nephritis development and improving renal function. Advanced lupus nephritis into renal failure, should be based on the indications for dialysis replacement therapy; medications to control lupus activity may be considered to be in stable condition after the transplant.


Treatment Principles for allergic purpura nephritis


When allergic purpura kidney damage, known as Henoch-Schonlein purpura nephritis. Allergic purpura kidney damage rate of 30% to 50%. The disease occurs in children, domestic pediatric reports, allergic purpura nephritis accounted for 8% of the hospitalized pediatric urinary tract diseases, ranks third. The treatment of this disease the following principles:


(1) general treatment in patients with acute attention to rest, severe, should rest in bed. Found very important and remove allergens that can cause food allergies, drug should be used sparingly or avoid using, if necessary, desensitization therapy.


(2) symptomatic treatment of mild cases of the natural course of a well, the majority of cases after symptomatic treatment can be fully recovered. Available chlorphenamine (chlorpheniramine), diphenhydramine and other oral; or 0.25% procaine (Novocain) 100ml, plus a lot of vitamin C intravenous drip.


(3) corticosteroids and immunosuppressant treatment of nephrotic syndrome, corticosteroids plus immunosuppressive agents may be given comprehensive treatment. Such as prednisone daily 1 2mg/kg, cyclophosphamide daily 2 3mg/kg, depending on the condition of continuous rejection 6 to 12 months.


Crescent of more than 50%, showing a rapidly progressive glomerulonephritis who can use quadruple therapy (corticosteroids + immunosuppressant + dipyridamole + heparin, warfarin forest), methylprednisolone (methyl prednisolone) pulse therapy and plasma exchange therapy and other treatment. Generally believed that the good effect, but it should be an early application, post-drug effect is not ideal.


(4) end-stage renal failure treatment can be given dialysis or kidney transplantation in the treatment of kidney transplantation, about 1/3 recurrence.

Treatment principle for nephrotic syndrome


Nephrotic syndrome, referred to as "renal comprehensive" (the abbreviation NS), is a clinical syndrome caused by a variety of reasons. It is not an independent disease, but many risk factors, the permeability of the glomerular capillary filtration membrane by injury, massive proteinuria is one of the main features of a syndrome.


Nephrotic syndrome manifested as massive proteinuria (Adult: 3.5g / d; Children ≧ 50mg / (kg · d)), hypoalbuminemia (<30 g / L), varying degrees of edema, high blood lipids ( commonly known as the "three high and one low) and because of proteinuria caused by other metabolic abnormalities. Nephrotic syndrome secondary to many diseases. Although the cause of the cause of the nephrotic syndrome, but are caused by the loss of large amounts of protein in the urine of the mutual impact of clinical and laboratory abnormalities. Therefore, lost a lot of protein in the urine is the decisive factor leading to changes in the nephrotic syndrome series. Massive proteinuria and hypoalbuminemia is not only the main features of the nephrotic syndrome, the main basis of the clinical diagnosis of nephrotic syndrome.


Nephrotic syndrome of primary and secondary points, the former more than the incidence of upper respiratory tract infection, was divided into type I and type Ⅱ; the latter is seen in diabetic nephropathy, renal amyloidosis, lymphoma, lupus nephritis, allergic purpura kidney, hereditary nephritis. The principles of treatment measures are as follows:


(1) general measures in order to rest and avoid strenuous exercise. Edema of bed rest; edema, indoor activities; urine protein g / d, you can restore an appropriate outdoor activities. Should be given to low-fat and adequate protein and calorie diet, protein may be a day 1.5g / k the amount of supply of heat may be a day 125 ~ 167kJ/kg supply. Edema, salt intake should be limited to, day 2 ~~ 3g. Appropriate to add calcium, iron and vitamin B, and D and folic acid and so on.


(2) prednisone treatment programs adrenal cortical hormone, is still the main drug in the treatment of nephrotic syndrome, one of the most commonly used is prednisone. Conventional prednisone treatment program, the initial dose daily 1mg/kg, 6 to 8 weeks to obtain the efficacy to reduce, as ordered, sequential, in order to reduce the occurrence of side effects.


(3) the application of cyclophosphamide for hormone invalid and frequently relapsing children and adult patients with nephrotic syndrome, can be used cyclophosphamide treatment has some effect. Dose prescribed by a doctor, should pay attention to the prevention and treatment of side effects.


(4) diuretics and albumin, diuretics applications, visualization edema. Light, single-use restrictions to control the salt intake; severe edema, and a variety of diuretics available in recent years, commonly used furosemide (furosemide). Greater than conventional-dose intravenous or several diuretics can enhance the diuretic effect. Such as intravenous albumin given furosemide (furosemide), more can enhance the diuretic effect.

Treatment Principles for renal amyloidosis


That amyloid is not a starch substance insoluble fibrin. Amyloid deposition in the kidneys, cause kidney disease called renal amyloidosis. Disease treatment principles are as follows:


(1) the treatment of primary renal amyloidosis was advocated in combination with small doses of adrenal corticosteroids (such as prednisone), melphalan, and colchicine, relieve symptoms and prolong life role.


(2) the treatment of secondary renal amyloidosis secondary renal amyloid degeneration who should be on the basis of active control of the primary disease, the use of these drugs. Some cases in the control of chronic suppurative infection lesions, or resection, control of tuberculosis, often can stop the development or improvement of the disease, the precipitation of the starch-like substance can be absorbed, significant improvement in clinical symptoms, proteinuria disappeared.


(3) the development of uremia when the treatment of renal amyloidosis is an irreversible disease, when lesions later development of uremia stage dialysis replacement therapy, but poor long-term effects. Severe heart failure, viable kidney transplant.

The treatment principle for interstitial nephritis


Interstitial nephritis is the renal interstitial part of the inflammatory disease of the main lesion, lesions often involved the renal tubules, it is also known as interstitial nephropathy. Clinically can be divided into two kinds of acute and chronic interstitial nephritis, its treatment of the following principles:


(1) prevention interstitial nephritis to focus on prevention, after the removal of the general cause of the disease can stop the development of more than 90% of early cases can be fully restored. Caused by pyelonephritis, should be actively anti-infections; urinary tract obstruction caused by the obstruction should be lifted as soon as possible; caused by poison, drug, should immediately stop using these drugs or poisons, and for the appropriate treatment.


(2) The principle of treatment of acute interstitial nephritis acute interstitial nephritis, abrupt onset, as the main manifestation of renal interstitial inflammatory cell infiltration, often accompanied by impaired renal function. The main principle of treatment for the removal of the cause, such as nephrotoxic drugs is disabled from poisoning the environment, positive, infection control, treatment of immune disease, etc.; adrenal cortical hormone should be used for severe acute interstitial nephritis, and at the same time line antihypertensive diuretic, anti-allergy symptomatic treatment.


(3) the principles of treatment of chronic interstitial nephritis, chronic interstitial nephritis, insidious onset, slow progress, mainly as interstitial fibrosis and tubular atrophy. At present, no specific therapy in the western medicine treatment for different causes. Patients should pay attention to the rest, better nutrition to their own bodies; water, electrolyte and acid-base balance disorder, blood pressure control, improvement of anemia; such as the existence of urinary tract infection should actively control the infection, such as uremia dialysis treatment should be to correct.

treatment measures for Pyelonephritis principles


Pyelonephritis, also known as urinary tract infections, can be divided into acute pyelonephritis and chronic pyelonephritis in two principle treatment measures are as follows:
(1) the principle of treatment of acute pyelonephritis measures urinary tract irritation obvious, should rest, drink more water to increase urine output, promote bacterial discharge, thus reducing the urinary tract irritation. Oral medication: cotrimoxazole, 2 times a day, two each, while taking sodium bicarbonate tablets each lg, 2 times a day; or norfloxacin, 3 to 4 times a day, each 0.2g ; or nitrofurantoin, 3 to 4 times a day, each 0.1g. Severe symptoms accompanied by fever, can be added with ampicillin (ampicillin) 1g, or gentamicin 80 000 U, are intramuscular injection three times a day, 10 to 14 days for a course of treatment. As invalid, should be drug susceptibility test results, to replace other antibiotic therapy.
(2), pyelonephritis, urinary tract infection treatment principles of the recurrence of pyelonephritis, urinary tract infection by the symptoms disappeared after treatment, urine bacterial cultures were negative, but within six weeks of bacteriuria, and the same strains with the last is the recurrence. Recurrence, use of antibiotics should be based on urine culture susceptibility testing, the dose should be large, with a course of at least six weeks. Repeatedly made, should be given long-term low dose antibacterial therapy.
(3) pyelonephritis, urinary tract re-infection treatment principles pyelonephritis, urinary tract infection after treatment, the symptoms disappeared, and urine culture negative, but discontinued after 6 weeks bacteriuria, and strains with the last difference , that is, re-infection. Re-infection, treatment with the first infection the same. Frequent seizures, such as urinary tract infections, the onset of two or more times within six months can be used long-range low-dose antimicrobial therapy prevention. Specific method: every night before going to bed after voiding, orally once a single dose of antibiotics, the dose of the conventional dosage of 1/3 to 1/2 may make use of nitrofurantoin, amoxicillin (amoxycillin). One week after treatment, urine culture, review a month later, this method for a year or more.
(4) The principle of treatment of chronic pyelonephritis, urinary tract infections to chronic pyelonephritis and other urinary tract infection patients should go to the hospital for treatment, medication carefully under the guidance of a specialist, and in accordance with the urine culture susceptibility testing, timely, accurate and reasonable use of antibiotics, or with Chinese dialectical therapy. Patients should be sure that enhance physical exercise, and attention to the prevention, try to improve their resistance to disease.

Principle of treatment for renal tuberculosis measures


Renal tuberculosis, inflammation of the kidney infection caused by Mycobacterium tuberculosis. Renal tuberculosis is a chronic wasting disease, and has a slow onset, longer duration, it should adhere to treatment, and its principle measures are as follows:


(1) general measures should rest appropriately, pay more attention to rest, do not get too tired. Peace, high protein, high calorie, high vitamin diet, cut out fatty and spicy spicy food, should also avoid a partial eclipse, gluttony, and hot food; conditions, smaller meals system can be used to eat, and pay attention to food diversification and color, smell, taste, in order to promote appetite, continue to receive adequate nutrition to enhance physical fitness and disease resistance.


(2) drug treatment of renal tuberculosis medication, advocate the use of the "DOTS", that is, the oral administration of three drugs for six months therapy. Specific methods: rifampicin 0.6g, 0.3g of isoniazid daily oral dose; pyrazinamide 0.25 ~ 0.5g, 3 times a day orally. The first three kinds of medicinal four, and then using rifampicin, isoniazid 2 months.


(3) surgical treatment of renal tuberculosis, surgical treatment, even surgery to testify, must also be chemotherapy to stable disease or unilateral renal significantly improved after surgery should also be prescribed by a doctor to continue chemotherapy. Renal tuberculosis surgical indications are as follows: ① the side of nephropathy is very serious, it is estimated that chemotherapy does not cure and recovery of renal function, while the contralateral kidney function is not significantly impaired; ② ureteral stenosis, resulting in urinary tract obstruction; ③ kidney blood vessels subject to corrosion, lead to severe urinary tract bleeding; ④ tuberculous closed abscess, or intractable fistula by.

Thursday, August 2, 2012

Treatment Principles for hydronephrosis


Medicine, urine discharged from the urinary system obstruction, caused by intrapelvic pressure, renal pelvis expansion, renal atrophy, called hydronephrosis. Hydronephrosis is the most prominent manifestation of obstructive nephropathy, is a symptom of disease, stones from the urinary tract, inflammation, cicatricial stenosis, tumors and other renal causes can also be caused by disease of body sections, so the reason is extremely complex. Conservative treatment, can be used in Western medicine combined with dialectical therapy, the treatment principles are as follows:


(1) removal of the cause must first find out the cause of the water, the general removal of the cause, the water can be eliminated.


(2) Integrative treatment of hydronephrosis caused by systemic disease and nephritis, mostly mild to moderate hydrocephalus, and often bilateral, can be used in Western medicine and TCM differentiation. Spleen and kidney yang hydronephrosis available Zhen Wu Tang or Gui decoction treatment; silt water cross-resistance hydronephrosis available Tonga dextran, compound Salvia intravenous infusion therapy; liver and kidney type of renal immediately after the injection of water can be used Qijudihuang soup plus or minus diuretic Chinese medicine and Western medicine treatment; the Shilin Longbitong hydronephrosis, can be used traditional Chinese medicine Tonglin row of the mixture of stone "treatment at the same time intravenous infusion of balanced salt solution 1500 ~~ 2000ml furosemide 20 to 40mg, 5 to 7 days for a course of treatment, 3 weeks hydronephrosis cancellation rate was 93.4%.


(3) Surgical treatment of giant hydronephrosis, may be provided through the gastrostomy, further angioplasty treatment. Mechanical obstruction, hydronephrosis, should prompt surgical or interventional therapy treatment.

Treatment Principles for acute renal failure


Acute renal failure, is a clinical syndrome, which is caused by a variety of renal excretory function in a short period of time (hours or days) a sharp decline in glomerular filtration rate plunged to less than 5%, resulting in the rapid accumulation of metabolites of the quality of nitrogen and water, electrolytes in the body. Such as the timely diagnosis and treatment of acute renal failure is mostly reversible. The basic principles of the treatment of acute renal failure, treatment of the primary disease, and prevent the occurrence of complications following the principles of treatment measures.
(1) active treatment the incidence of a variety of acute renal failure caused by the primary disease, such as severe trauma, severe infections, should be positive and effective treatment, in particular, hypovolemia, shock, and removal of necrotic tissue.
(2) treatment of oliguria oliguria should be bed rest, treatment focuses on the regulation of water, electrolytes and acid-base balance, the supply of adequate nutrition, strictly limiting the protein intake, as far as possible to complement the high-quality animal protein of high biological value; early preventive hemodialysis or peritoneal dialysis, acute renal failure, infection, bleeding, coma and other complications, but should have a dialysis indications. Water and sodium restriction, should be strictly calculation 24h intake and output, according to daily to 12ml/kg standard supply, or the day urine output plus 500 ~ 600ml as standard supply. Hyperkalemia occurs, the most effective method is hemodialysis or peritoneal dialysis, should be promptly dealt with promptly. Metabolic acidosis, using 5% sodium bicarbonate solution 250ml infusion; 10% calcium gluconate 10ml plus 50% glucose 20ml, intravenous injection of potassium ions to antagonize the myocardial toxicity; 25% glucose solution 200ml plus insulin 16 ~ 20U , intravenous infusion. Fasting high potassium food is strictly prohibited lose banked blood. Strictly limited protein can daily 0.5g/kg supply, and should be appropriate to add the essential amino acids, while allowing heat to be maintained at between 6.6 to 8.7 MJ in order to reduce body protein breakdown.
(3) in urine of treated urine of beginning, the threat to the beginning of complications still exist, the treatment focus is still to maintain water, electrolyte acid-base balance, control azotemia, with particular attention to the dehydration and hypokalemia. Patients can not get up, it should be noted that the lungs and urinary tract infections, strict selection of the minimum renal toxicity of antibiotics. Control of water and diet can be gradually relaxed, the patient may gradually resume a normal diet.
(4) Recovery recovery period, generally no special treatment, mainly according to the different circumstances of the patient, strengthening nursed back to health and the gradual recovery of activity. It should also be regular follow-up of renal function, avoid the use of nephrotoxic drugs.

Treatment Principles for chronic renal failure


Chronic renal failure, also known as chronic renal insufficiency is a clinical syndrome that occurs in a variety of chronic kidney disease late, to stay its metabolites retention of water and electrolyte imbalance and acid-base balance disorders, severe renal damage mainly. By varying degrees of impaired renal function, renal function can be divided into decompensated renal insufficiency, azotemia (also known as renal failure early, the uremia early) and renal failure and end-stage (also known as uremia ) four, the principles of treatment are as follows:
(1) the general treatment of the general treatment including diet nursed back to health, nutrition therapy, stable environment for the body to maintain and symptomatic treatment. Low-protein diet and the diet to restore, is the most basic, the most effective measures, the application should be adjusted according to the situation. Rhubarb and its preparations, with a high metabolic state, to improve the healthy kidney tissue and reduce the residual nephron hypertrophy, and inhibit the mesangial cell proliferation, so the application can delay the process of chronic renal failure.
(2) angiotensin-converting enzyme inhibitors, such as angiotensin converting enzyme inhibitors such as captopril, according to the use of enalapril, etc., can reduce blood pressure, glomerulosclerosis and reduces proteinuria; long-term sodium bisulfate can correct acidosis, to reduce the formation of ammonia, to improve the protein and uric acid metabolism; application of phosphorus-binding agents and low-phosphorus diet, are conducive to slow down the development process of chronic renal failure.
(3) replacement therapy replacement therapy, including gastrointestinal dialysis, colorectal dialysis, peritoneal dialysis, hemodialysis, skin through near, according to disease and adapt to the indications selected. In recent years, advocates the early prevention of dialysis may be more favorable to the development of prevention and treatment of disease.
(4) kidney transplantation in the treatment of renal transplantation in the treatment of end-stage chronic renal failure, according to the indications application.

The treatment principles for renal anemia


Renal anemia, anemia due to impaired renal function. The reason, renal anemia of renal erythropoietin (EPO) to produce insufficient, or some toxic substances in the uremic plasma interfere with the red blood cell formation and metabolism caused by anemia caused by various factors. Renal anemia, as normal cells, normal pigment anemia, is one of the clinical manifestations of chronic renal failure. General began to emerge from the renal insufficiency, with the deterioration of renal function, the degree of anemia with the heavier. The treatment of renal anemia, has been a thorny issue in the clinical treatment principles are as follows:


(1) clinical applications to promote application of erythropoietin erythropoietin and renal anemia symptoms significantly improved, physical strength increased, increased appetite, hemoglobin and hematocrit increased. Erythropoietin (EPO) formulations, dose-dependent agents, the effective dose for the daily 50 ~ 150U/kg, intravenous or subcutaneous injection, can start small dose every 2 to 4 weeks of dose adjustment time; also start from the high-dose when the hemoglobin reach 100 ~ 120g / L, the tapering. Hemodialysis or peritoneal dialysis patients, the initial dose of weekly 100 ~ 150g/kg, can be subcutaneous or intravenous injection. Often in the two weeks after the injection began to appear efficacy, four weeks after a noticeable effect, can reach 8 to 12 weeks after the scheduled target of 100 to 120g / L


(2) the improvement of the dialysis blood or peritoneal dialysis treatment for renal anemia will certainly help, especially in peritoneal dialysis effect is better. Dialysis treatment, in addition to induced hemolytic uremic toxins inhibiting factor and erythropoietin relevant.


(3) intramuscular injection of male hormone intramuscular injection of male hormone, can promote the secretion of erythropoietin and erythroid stem cell proliferation, thereby improving anemia. Under normal circumstances, four weeks later, the male hormone, to a significant effect.


(4) severe anemia of chronic renal failure who lose new blood, particularly when myocardial ischemia or severe heart failure, should be given small doses several times lost the fresh blood in order to improve the symptoms of anemia.

Will you be addicted to Dialysis?


Typically, those suffering from renal failure, or has entered uremia period, with the gradual increase in serum creatinine, and the corresponding symptoms, enter uremia may people will mistakenly believe that dialysis is the final choice, but a lot of people will be consulted long dialysis addictive you?
Dialysis, the popular talk, is to use dialysis machines, instead of the human kidney produced by the body metabolic wastes are discharged, but this way is not fundamentally the treatment of kidney disease, that is not fundamentally block the abnormal increase in extracellular matrix against renal intrinsic cells, instead of the process is not blocked from the fundamental root cause of uremia: renal fibrosis progress, the dialysis process is based on a "temporary" means.
The reason why many patients on dialysis to live in fear, because real life does have a lot of patients with uremia, since the initiation of dialysis in other medical institutions, over time, the frequency of dialysis will be getting higher and higher, from the original once a week to twice a week, then three times a week, this frequency increases simply can not be reduced, seemingly addicted to the same, the essence of what is it? For most patients, the reason for the need for dialysis, the kidneys of patients with intrinsic cells are abnormal number of infringement of the extracellular matrix, instead, so that the kidney lost its original role in detoxification and maintain the body of water, electrolyte and acid-base balance, the loss of the important role he played in the human body. At this point, the use of dialysis patients will be the body of harmful toxins from your body is certainly very important, but more important is that, as far as possible to save the kidney remnants of the intrinsic cells to prevent the abnormal increase in extracellular matrix of residual cells of the kidney completely "swallowed" maximize the residual kidney inherent compensatory ability of the cells, this approach can be implemented on a large to kidney patients want. In reality the course of treatment only stopgap treatment for kidney disease, to take measures not fundamentally, that is not fundamentally prevent the abnormal increase in extracellular matrix inherent residual kidney cells to completely "swallowed", then the kidney remnants of the detoxification function will be lost, when the frequency of dialysis is certainly getting higher and higher, and fundamentally can not be reversed can not escape. In short, are more frequent dialysis seemingly addicted to the phenomenon, its essence is a temporary solution only in the choice of treatment, the root of the problem means to prevent the abnormal increase in extracellular matrix and residual renal intrinsic cells against alternative, that is, essentially blocking the continuous development of renal fibrosis, and damage inherent in cell repair. How to block the development of renal fibrosis fundamentally it? How can I do to solve the problem of it? Below will help you answer it.
Shijiazhuang kidney disease hospital after years of exploration and study the formation of a of with Shijiazhuang nephropathy hospital characteristics, treatment - micronized infiltration therapy of Chinese medicine, it is a combination of Li during the traditional recipe plus a combination of both of the modern treatment equipment to be shipped students. Its technology is the core of effective pharmaceutical treatment of kidney disease more Advanced Micro Devices of crushing the drug active ingredients fully release and mixed by the method of topical drug to penetrate into the lesion site.
Uremic patients in treatment at the same time accept the multi-target micro-based traditional Chinese medicine, but also the necessary dialysis treatment, the essence is an indicator and permanent effective combination of the two treatments, dialysis as a hospital, an important adjunctive treatment The ultimate purpose is to give the treatment of kidney disease fundamentally micro Chinese medicine multi-target therapy to gain time, in order to better preservation can reverse the damage inherent in kidney cells. Kidney treatment also maturity may be saved can reverse the damage inherent cells.
In summary, our dialysis would not be "addicted" to have a preliminary understanding and knowledge. So, whether dialysis, dialysis frequency is the number is not that you are not "fun", but whether you fundamentally the treatment of kidney disease, and whether blocking the root causes of kidney development of renal fibrosis, this is the key to the treatment of kidney disease .

Early signs of renal failure


The kidney is a huge "factory" of the human body, it can be excreted metabolites, toxins, and drugs; can maintain water and electrolyte balance; can also maintain the body's acid-base balance. A strong compensatory ability of the kidneys in the human body, under normal circumstances, only when the kidney damage in more than 50%, the human body have a discomfort feeling. Similarly, the symptoms of kidney failure is also very obvious in the early stages of renal failure, patients generally do not have any symptoms of discomfort. As the disease further deterioration of renal function gradual recession until late appear obvious pain. Therefore, for patients with kidney disease should always do urine and blood tests. Renal failure
First, patients with renal failure will be a mild form of edema
Some may suffer from edema. Decreased urine output, urinary frequency, nocturia increased foam in urine increased. Hand foot and ankle swelling. Accompanied by shortness of breath, swelling around the eyes.
Usually appear in patients with renal failure anemia
Suffered damage due to kidney function, the body can not produce enough hormones needed to manufacture red blood cells, resulting in anemia. Anemia often feel cold and tired.
Patients with renal failure also appear unwell
Produced in the body of toxins and waste accumulation in the body due to renal excretory function also suffered damage to the patient may feel myself discomfort. Symptoms include nausea, vomiting, trouble sleeping at night, loss of appetite, itching, and fatigue.
Other illness symptoms of renal failure
(1, urine was dark brown or blood red), high blood pressure, liquid bubble, a high degree of thirst, restless sleep, or sleepiness 6, loss of appetite etc.
For patients with kidney disease is concerned, we should always do blood, urine examination, in order to avoid renal failure, the emergence of these signals has shown that you may already be suffering from kidney failure, such as: edema, anemia, hematuria, nocturia increased some symptoms, in particular, should attract attention, we should be chased early detection, early treatment approach to treat our lives.

Can Cordyceps cure kidney disease.


Cordyceps sinensis can cure kidney disease? A lot of people are wondering, why is it called Cordyceps it? Insects summer, not winter grass it? Please Shijiazhuang kidney disease hospital experts to answer your questions What is Cordyceps? Cordyceps can cure kidney disease ?


Cordyceps is a precious traditional Chinese medicine in China, as China's three major tonic with ginseng, deer horn. As early as the Two years later the new Materia "in there" the Cordyceps gamping Baofei, kidney, complement the essence of phlegm to stop bleeding, has been labor, cough, governance phrenic patients are good "records. Chinese medicine believes that the two classics of Cordyceps into the lung, both lungs Yin, while kidney yang, attending the kidney, impotence, spermatorrhea, waist and knee pain, weakness after illness, weak cough, labor expectoration of blood, spontaneous sweating, is the only one able to simultaneously balance, regulating yin and yang of Chinese medicine.


Cordyceps is not winter as a "bug" as "grass" in the summer, and its essence is a fungus - Cordyceps fungus of ergot. Modern science discovered Cordyceps more and more magic. Overall, the caterpillar fungus not only has a regulatory role for the human function of various organs, there is some direct function of disease resistance.


Cordyceps sinensis is a rare Chinese herbal medicines, Chinese medicine stresses the two classics of Chinese caterpillar fungus into the lung, the Yin of both lungs, while kidney yang, the head kidney, etc., can simultaneously balance, regulating yin and yang.


Modern pathologic study found that Cordyceps immunomodulatory function, can regulate the immune system, reduce inflammation, and promotion of tubular epithelial cell proliferation, inhibition of glomerular mesangial cells, fibroblast cell proliferation and anti-oxidation effect, they are able to reduce the early renal ball high filtration, slow chronic kidney disease, disease and improve kidney function, reduce the toxicity of substances on kidney damage. Is currently the most commonly used drugs and kidneys, and can be appropriate to take.


Cordyceps have great efficacy in the field of kidney disease treatment, but its health effects is still dominant, rapidly progressive kidney disease, little effect, and may even aggravate renal dysfunction. Therefore, the Cordyceps varying degrees of kidney disease but also the difference between open


I do not know you now whether Cordyceps some basic understanding of expected more information please contact our experts or online customer service contact or send an email to our mailbox.

Can Chronic nephritis patients get married.


Modern society, with the quickening pace of life, the population suffers from kidney also more and more, especially for young people entering the marriage state is concerned, suffers from kidney can not get married to become the most talked about. This is also in order to have a healthy and happy family, to enjoy the fun and happy family life!


Chronic nephritis can get married? To the patient's own decision. Chronic nephritis, the disease is very complex, but the treatment is long. Its clinical proteinuria, hematuria, edema, high blood pressure. Chronic nephritis in tired of the cold easily be worse. The experts pointed out that patients with chronic nephritis the basis of marriage is in stable condition. In the case of serious illness is not suitable for marriage, then seize the time to treatment is the primary choice. Of course, in stable condition after married, but married couples living needs restraint. And pay attention to the prevention of colds, avoid exertion sports.


Chronic nephritis can get married? Shijiazhuang kidney disease hospital's experts pointed out that chronic nephritis in a certain degree will destroy the happiness of the patient's family, so I want to have a happy family, be sure to conduct a comprehensive treatment. The experts pointed out that the treatment of chronic kidney disease on the basis of selection of formal treatment. As we all know, Western medicine treatment of chronic nephritis is only symptomatic treatment, not fundamentally repair the damaged kidney cells. Chinese medicine treatment is a long process, but long-term use of other organs, the kidneys of Chinese medicine will cause some damage. Shijiazhuang kidney disease hospital of micro-penetration therapy of Chinese medicine, is to start from the fundamental to a valid prescription for the treatment of kidney disease, ultrafine grinding, drugs active ingredients fully release and mixed. And then with the effective penetrant and penetration, topical approach, the effective drug penetration to the site of renal lesions, to achieve the purpose of effective treatment of kidney disease. This innovative therapy, the elimination of the side effects of oral medication, but also to achieve the purpose of drug ingredients enter the effective lesions. Moreover, this innovative therapies, clinical practice has proved both effective and convenient. The therapy has become a major feature of the Shijiazhuang kidney disease hospital core support treatment technology, living in the core position of Shijiazhuang Kidney hospital for treatment. Its therapeutic mechanism is: vasodilators, anti-inflammatory, anticoagulant, anti-blood viscosity, degradation fibrosis substances blocking renal fibrosis progress, intrinsic cells to repair damaged and renal function and rebuild the proper structure of the kidney . Thereby eliminating the proteinuria and urinary occult blood.


Chronic nephritis Can you get married? This problem is not absolute, is determined on the basis of the patient's condition in order to understand clearly the problem of chronic nephritis Can married, experts recommend patients after cure after marriage, so that it can have a healthy and happy family.

Do not drink plenty of water will lead to kidney failure?


Chinese medicine is how to treat kidney disease causes it? Chinese medicine believes that: the incidence of kidney disease for two reasons: First, internal disorders, external intrusion.
Second, because of the lack of daily drinking water and lead to body water. So, often without water will lead to kidney failure you?
Cause of kidney. Everyday life, people always found to drink water, the only difference is that drink it, and then often do not drink plenty of water will lead to kidney failure? Often do not drink too much, nephropathy reluctance to see. So the truth is what is what?
After the observation of traditional Chinese medicine for many years and found that kidney disease and human water scarcity have a great relationship. And often normal in the life of continuous drinking water are related to insufficient because of the various systems of the body, various aspects of water shortage will cause a series of kidney disease. The medical profession believes that the human body is actually a body of water, but often the lack of drinking water shortage.
Therefore, the Chinese have "Yin Chang Yang often I" says, and often the early stages of kidney disease will appear because the body of water caused by the symptoms of Yin Yang Sheng. For this reason, when analyzing the causes of kidney disease, you should not ignore the drinking water to the kidneys induced.
Clinical, often without water often lead to kidney stones, pyelonephritis. Often do not drink, the body produces garbage, the impurities can not be immediately removed from the body with the urine, and easy formation of kidney stones, at the same time, because there is no water erosion, residual bacteria in the bladder, urethra, it is easy to reproduce , causing pyelonephritis.
And we all should be clear, either kidney stones or pyelonephritis, and its ultimate development may lead to kidney failure and even the occurrence of uremia, therefore, often without water is the cause of the kidney. Should the normal every day can not guarantee 2000cc's drinking water supply, then the occurrence of kidney disease is very likely.
The kidney is an organ to deal with water, often without water will lead to kidney failure. In fact, in addition to not drink lead to kidney failure, some of the details of the life habits can often lead to nephropathy, such as holding back urine, cold, rub mercury in cosmetics, excessive eating habits and so may people suffering from kidney disease .

Wednesday, August 1, 2012

Nephritis certain renal biopsy.


Nephritis must be carried out to biopsy it? Nephritis is not necessarily to renal biopsy? Nephritis is a kind of kidney disease, renal biopsy also known as renal biopsy, a pathological examination, experts to answer your questions.


Patients consulting nephritis must renal biopsy Well


The description of [the disease] experts Hello, I ask nephritis renal biopsy Well, you do not need biopsy using traditional Chinese medicine, now eat Chinese patent medicines, the effect is not very good, protein + +, occult blood + + + red blood cells, 30-year-old, over time do not renal biopsy can? nephritis can not root pruning it?


Experts answer] Hello "nephritis must biopsy Well" experts have been received, the following experts for a detailed explanation and specific guidance to patients on renal biopsy.


Nephritis must carry out a renal biopsy it? First, we have to understand what is renal biopsy. The renal biopsy also known as renal biopsy. Clear etiology and pathology of the disease, diagnosis of patients suffering from specific disease, a pathological examination of the means.


Nephritis must be carried out to biopsy it? But patients must be clear, renal biopsy is an invasive examination methods, is traumatic to the kidneys, followed by renal biopsy in the treatment of the significance of the treatment, and finally Renal biopsy is not every patient can do is its own for the crowd.


Nephritis must be carried out to biopsy it? Friends of patients, based on your description, the leakage of protein occult blood red blood cells are more and more, your mood, I can understand the extent of some non-invasive inspection can also clear the kidney damage and can guide use of drugs, such as renal loss of eight uremic seven. Patients may wish to directly click on the online consultation, exchange and experts.


Nephritis must be carried out to biopsy it? Nephritis do not necessarily biopsy, nephritis can do other non-invasive inspection, such as renal loss of eight uremic seven renal fibrosis in check and so on.


Nephritis must be carried out to biopsy it? Friends of patients, nephritis is a chronic, intractable disease, the nephritis your check, many patients do not adhere to treatment or improper treatment programs, often resulting in illness progress, which the patient must pay attention to. Clear pathological is also very important that patients be combined with and the specific circumstances, to do the the nephropathy professional check the course of treatment.


Nephritis must be carried out to biopsy it? Friends of patients, treatment for renal biopsy, you clearly do? If you have any ambiguities, you more than you can directly click on the online consultation and expert exchanges.

What is the performance of the symptoms of chronic nephritis


The symptoms of chronic nephritis, protein and occult blood what the plus sign is not it? Many of the pathological type of chronic nephritis, chronic nephritis early detection, early treatment, the prognosis is relatively good. Meanwhile, the understanding of the symptoms of chronic nephritis is very necessary.


Patients consulting the performance of the symptoms of chronic nephritis, protein and occult blood what a plus is it?


Description of [the disease] experts Hello, yet to be determined is not a chronic nephritis, is occult blood and protein, chronic nephritis, chronic nephritis plus, protein, occult blood is also


Experts on Experts answer] Hello "The symptoms of chronic nephritis, protein and occult blood what a plus is not it?" Has been received, the following experts on the related issues of chronic nephritis patients an answer .


The symptoms of chronic nephritis, protein and occult blood what a plus is not it? Many patients because of lack of understanding of the symptoms of chronic nephritis, not timely detect the disease, so missed the best time for treatment. Patients with a friend, your present situation, no longer rule out the possibility that chronic less nephritis, must be targeted treatment.


The symptoms of chronic nephritis, protein and occult blood what the plus sign is not it? Chronic nephritis What are the symptoms? The symptoms of chronic nephritis, mainly in the following areas:


The symptoms of chronic nephritis, protein and occult blood what, there is a plus sign are you? - Edema


The entire course of the disease, most patients with varying degrees of edema. Edema can be can be light weight, light in only the morning and found around the eyes, facial swelling, or in the afternoon of both lower extremities ankle edema. Patients with severe, generalized edema. However, there are a very small number of patients throughout the course of the disease do not always appear edema, is often easily overlooked.


The symptoms of chronic nephritis, protein and occult blood what a plus is it? - Hypertension


Some patients are hypertension symptoms to hospital for treatment, doctors want them to laboratory urine, chronic nephritis caused by high blood pressure. For patients with chronic nephritis, the incidence of hypertension is one sooner or later, their blood pressure can be continuous, intermittent, and diastolic blood pressure (higher than 12.7kPa) is characterized by high blood pressure level there are great individual differences, the light only 18.7-21.3/12.7-13.3kPa In severe cases, can even exceed 26.7/14.7kPa.


The symptoms of chronic nephritis, protein and occult blood what, there is a plus sign are you? - Urine abnormalities


Abnormal urine is almost a must in patients with chronic nephritis, including urine output changes and microscopic abnormalities. Edema in patients with decreased urine output, and the more severe edema, decreased urine output, the more obvious, and no edema in patients with normal urine majority. When patients with kidney serious damage, urine concentration - dilution of functional disorder, but also increased nocturia and urine specific gravity decreased.


The symptoms of chronic nephritis, protein and occult blood what a plus is not it? Friends of patients, symptoms of chronic nephritis did not know you not, you may wish to directly click on the online consultation and expert direct exchange.

Men with proteinuria, hematuria, nephritis?


Men with proteinuria, hematuria, nephritis? Contribute to the symptoms of male patients with chronic nephritis to help male patients with early detect the disease early to conduct a treatment, then what are the symptoms of male patients with chronic nephritis?
Patients consulting male with proteinuria, hematuria, nephritis?
[Description] expert condition Hello, I am a male, aged 36, proteinuria, as well as my blood in the urine, the doctor did not say not nephritis gave me anti-inflammatory drug, I nephritis do?
Experts answer] Hello "men with proteinuria, hematuria, nephritis?" Experts have received the following experts give you an answer in male patients with chronic nephritis symptoms.
Males with proteinuria, hematuria, nephritis? With the improvement of life now, more and more male patients with nephritis, the symptoms of male patients with chronic nephritis is mainly in the following areas:
Men with proteinuria, hematuria, nephritis? - Anemia
Often moderate to severe chronic renal insufficiency patients with anemia, fatigue, dizziness, pale and other symptoms. Except for patients with anemia, such as blood diseases, should be noted that the existence of chronic renal insufficiency.
Men with proteinuria, hematuria, nephritis? - Infection
The onset of male patients with chronic nephritis is often associated with pharyngitis, tonsillitis, upper respiratory tract and skin infections. Therefore, when suffering from infectious diseases, should check the urine, so as not to result in delays in treatment because there is no timely detection.
Men with proteinuria, hematuria, nephritis? - Changes in urine volume
Early in patients with chronic renal insufficiency may be just the night frequency of urination, and urine output increased. If healthy people before going to bed drink lots of water, sleep at night should not urinate or only urinating 1 If you urinate frequently at night more than 2 times, should go to hospital for examination of urine and kidney function, in order to confirm whether kidney problems.
Men with proteinuria, hematuria, nephritis? - Edema
Male patients with chronic nephritis Despite the lack of specific symptoms, but early often experience fatigue, weakness, back pain, eyelid, facial, ankle edema, increased urine bubble, urine abnormalities.
5 males had proteinuria, hematuria, nephritis? - Hypertension
About 1/3 of male patients with chronic nephritis increase in blood pressure, were headache, memory loss, poor sleep symptoms.
Males with proteinuria, hematuria, nephritis? For men, the symptoms of chronic nephritis in patients with issues related to clear it? If the patient symptoms are ambiguities of male patients with chronic nephritis, can directly click on the online consultation and expert direct exchange.

Symptoms of chronic glomerulonephritis


Symptoms of chronic glomerulonephritis, chronic glomerulonephritis symptoms of it? Chronic glomerulonephritis, chronic nephritis, the understanding of the symptoms of chronic glomerulonephritis is very necessary, the following experts on chronic glomerular nephritis-related issues to give you a detailed answer and targeted guidance.
Symptoms of chronic glomerulonephritis, chronic glomerulonephritis symptoms of it? Symptoms of chronic glomerulonephritis is often a place for patients relatively easy to overlook, so patients must pay attention to in their daily lives with chronic glomerulonephritis symptoms:
1, symptoms of chronic glomerulonephritis, chronic glomerulonephritis, symptoms, what does? - Prodromal symptoms
Patients with chronic glomerulonephritis respiratory tract or skin infection, such as acute pharyngitis, tonsillitis, gum abscess, scarlet fever, chicken pox, measles, skin, impetigo, etc., more than 1-3 weeks before the occurrence of chronic glomerulonephritis with chronic renal ball nephritis patients without prodromal symptoms.
2, symptoms of chronic glomerulonephritis, chronic glomerulonephritis, symptoms, what does? - Clinical symptoms
Friends of patients, clinical patients with chronic glomerulonephritis there will be some associated symptoms, such as high blood pressure, visual disturbances, headache, anemia. Hypertension of chronic glomerulonephritis, the patient's blood pressure can be from mild to moderate increase in the general adult 20 ~ 21.3/12 ~ 14.7kpa. With increased urine output, blood pressure in patients with chronic glomerulonephritis will gradually become normal, and usually lasts for 2-4 weeks. The small number of patients may be due to a sharp rise in blood pressure.
Symptoms of chronic glomerulonephritis, chronic glomerulonephritis symptoms of it? Symptoms of chronic glomerulonephritis, the patient must be clear, not every patient's symptoms in different patients showing different symptoms, these patients only the main, the typical symptoms of an explanation, which the patient must be clear. Exception when the discovery of his body, the patients must be timely to the hospital for treatment, identify the cause. Do not blind to treatment, do not ignore the condition.
Symptoms of chronic glomerulonephritis, chronic glomerulonephritis symptoms of it? Patient friends, your symptoms of kidney nephritis chronic very small ball clear? If you have symptoms of chronic glomerulonephritis there is not clear place, you can directly click on the online consultation and expert exchanges.

Nephritis eye bleeding


Nephritis, bleeding eyes is how is it? Nephritis eye bleeding why would it? Nephritis is a chronic disease, nephritis if the long-term not been brought under control, it will generate a lot of complications.
Patients consulting the nephritis eye bleeding is going on
[Condition] describe an expert Hello, I ask nephritis eye bleeding left eye lateral canthus, has chronic nephritis years, antihypertensive drugs, eating, high blood pressure, eating a new control of the screw top, not I, is family members, just checked, no, original eat traditional Chinese medicine, began to eat Niaoduqing, two years, indicators of high, creatinine 230, urea nitrogen, blood pressure control can, in recent years normal, that is just his eyes bleeding phenomenon.
Experts answer] Hello "nephritis eye bleeding is going on" experts have received the following experts nephritis-related issues to you a detailed answer and targeted guidance, patients can be help.
Nephritis eye bleeding? Patient's friends, you now consider the fundus lesions appear, let the drugs control indicators, lower creatinine index, we now need systems treatment, advise patients directly click on the online consultation, and expert exchange, experts give you a detailed answer and targeted guidance.
Nephritis, bleeding eyes how is it? We at the same time in the treatment of nephritis, must not be neglected care of the disease, to do the nephritis care is very important, on the nephritis of care primarily need to pay attention to the following questions:
Nephritis, bleeding eyes is how is it - the spirit of optimism
Nephritis patients must maintain a positive and optimistic mood, not in a pessimistic state, to eliminate the terror of the disease. Nephritis patients in addition to the usually increasing physical activity for patients with kidney yin deficiency friends can serve a number of drugs, lack of Wei, Qi, can be served Yupingfengsan kidney Peiyuan solid security table, prevent evils invaded table induced nephropathy, but to be taken under the guidance of a doctor.
Nephritis eye bleeding is going on - work and rest
For living patients with chronic nephritis must have a law of the law, but also to ensure adequate sleep, refused to eat too much, overwork, these will reduce the external resistance to the evil of the human body, increasing the chance of patients.
Patients with chronic nephritis in everyday life, be sure to pay attention to rest, had a time schedule in order to maintain the body balance of yin and yang and blood Regulating.
3, the the nephritis eye bleeding how is it - pay attention to health
For patients with chronic nephritis, it is necessary to keep the lower body clean, this can prevent patients with urinary tract infection; patency stool, which is conducive to the exclusion of metabolic waste.
Nephritis eye bleeding is how is it? Patients with a friend, you nephritis related issues you clearly do? Nephritis-related issues, ambiguities, you also do not worry, in order to condition the sake of, the expert advise patients directly click on the online consultation, and expert exchange.