June 26, 2022

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Kidney patients with declining kidney function need to control 4 indicators

Kidney patients with declining kidney function need to control 4 indicators

 

Kidney patients with declining kidney function need to control 4 indicators.  Kidney patients whose kidney function has begun to decline need to control these 4 indicators, otherwise they are more likely to get uremia.

 

Kidney patients with declining kidney function need to control 4 indicators

 


Even if the renal function of patients with chronic kidney disease has begun to decline, it does not mean that they will soon develop into uremia, or there is hope that they will not develop into uremia.


When the renal function of chronic kidney disease (CKD) begins to decline, it indicates that the patient’s viable nephrons have been significantly reduced, and most of the nephrons have lost their function, manifested as glomerular sclerosis and tubulointerstitial fibrosis. These sclerosis are related to The fibrotic kidney structure cannot be reversed and restored.

When serum creatinine slowly rises above the normal range, and there is no active disease, no acute exacerbation and reversible factors, generally speaking, only less than 25% of the kidneys on both sides of CKD patients have remaining functional nephrons, that is, more than 75 % Of nephrons have completely lost function.

If there is less than 25% of the residual nephrons, kidney patients need to be protected. Otherwise, the rate of renal function decline will increase, that is, chronic kidney disease (CKD) will progress faster and faster, until it becomes chronic Uremia stage in the late stage of renal failure.

However, even if the renal function of patients with chronic kidney disease has begun to decline, it does not mean that they will soon develop uremia, or there is hope that they will not develop uremia. How can it be done? This requires friends with kidney disease to control the following four indicators. To be precise, when kidney function has begun to decline, kidney patients need to control the following four indicators, otherwise they are more likely to develop uremia.

 

Kidney patients need to control the following four indicators:

Index 1. High pressure and low pressure: control blood pressure

The high pressure in blood pressure is systolic blood pressure (SBP), and the low pressure in blood pressure is diastolic blood pressure (DBP). They constitute two major indicators of high blood pressure. Chronic kidney disease is more likely to have high blood pressure when the renal function begins to decline. Both SBP and DBP will increase. The increased blood pressure will in turn promote the progressive development of chronic kidney disease, and the patient’s renal function will further decrease, that is, high. Blood pressure will accelerate the development of chronic kidney disease in the direction of uremia.

At this time, kidney patients need to control their blood pressure, not only to lower high blood pressure, but also to lower blood pressure. While eating a low-salt diet, choose antihypertensive drugs according to the condition to gradually lower high blood pressure. As long as there are no contraindications to the use of sartan/pril drugs, patients should be given these drugs as soon as possible, and other antihypertensive drugs (such as dipine, lohr, and oxazine) should be used in combination with antihypertensive therapy . It is not emphasized that the blood pressure must be reduced to normal in a short period of time, but the blood pressure must be controlled to reach the standard in the end.

 

Index 2. Urine protein quantification: reduce urine protein

The indicator of urine protein quantification refers to the 24-hour urine protein quantification, not a few plus signs of urine protein in urine routine. This index is significantly increased, and it is also a risk factor for the progressive progression of chronic kidney disease, which is beginning to decline in renal function.

Chronic glomerular disease will have a significant increase in urine protein. A 24-hour urine protein quantitative of more than 1.0 g is considered a moderate amount of proteinuria, and a 24-hour urine protein quantitative of more than 3.5 grams is a large amount of proteinuria. Such a high urine protein is in turn It can damage the kidneys and accelerate the development of kidney disease. For patients in the early stage of chronic renal insufficiency, treatment of reducing urine protein is still meaningful.

However, at this time, due to the high rate of glomerulosclerosis and tubulointerstitial fibrosis in patients, there are fewer protein-lowering drugs to choose from. Tripterygium wilfordii polyglycoside tablets, mycophenolate mofetil, and hydroxy Chloroquine, etc., can also choose protein-lowering treatment such as traditional Chinese medicine and Chinese patent medicine.

 

Index 3. Blood uric acid level: uric acid lowering treatment

Renal function begins to decline, that is, chronic kidney disease develops into chronic renal insufficiency. Chronic kidney disease is mostly in stage 2 or stage 3 and later. At this stage, patients are more likely to have hyperuricemia, which is manifested as an increase in the level of blood uric acid. Hyperuricemia can in turn damage the kidneys and affect renal function, which can cause chronic uric acid nephropathy and acute uric acid. Sexual nephropathy and uric acid nephrolithiasis, etc., lead to the accelerated development of chronic kidney disease. Uric acid-lowering therapy can use related drugs. When the patient’s glomerular filtration rate is less than 20ml/min, only drugs that inhibit uric acid production, such as febuxostat and allopurinol, can be selected as the patient’s glomerular filtration rate More than 20ml/min, you can also choose to promote uric acid excretion drugs, such as benzbromarone, but sodium bicarbonate tablets should be added at the same time.

 

Index 4. Immunity index: improve resistance

When the patient’s renal function has declined, the patient’s immune function is more likely to become worse, and there are abnormalities in immune indicators, such as decreased plasma albumin, decreased blood immune globulin IgG, decreased white blood cell count or function, and B Factor deficiency and so on.

After the immune function declines, patients with kidney disease are more likely to be infected, and the infection will aggravate the condition or promote the continued development of chronic kidney disease. Therefore, patients with kidney disease with low immune indicators need to improve their resistance and prevent infectious diseases.

The immune function of patients can be gradually improved through active protein-lowering treatment, avoiding long-term high-dose use of hormones and immunosuppressants, maintaining balanced nutrition, proper exercise, using cordyceps preparations and traditional Chinese medicine.

 

Has kidney function started to decline? If it is, patients with kidney disease can take the above measures to control these four indicators, and uremia will not occur so easily.

 

 

 

 

(source:internet, reference only)


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