June 26, 2022

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Will the patient not get uremia in the future after the urine protein drops?

Will the patient not get uremia in the future after the urine protein drops?

 

Will the patient not get uremia in the future after the urine protein drops?  A drop in urine protein is a good thing. If Kidney patents continues to do the above three things, it can make the good thing better and better to avoid the sudden onset of uremia.

Many Kidney patents have begun to understand the importance of urine protein, knowing that urine protein has been consistently higher than normal and is not conducive to protecting kidney function.

The higher the urine protein, the longer the duration, the easier it is for chronic kidney disease to progress to kidney failure and uremia.

Therefore, Kidney patents will pay attention to reducing urine protein, and one of the most important goals in the treatment of kidney disease is to reduce urine protein. Some people think that as long as the urine protein can be reduced, uremia will not occur in the future. However, this is not always the case.

For the following patient with kidney disease, although his urine protein decreased, he became uremia years later. what happened?

This is a 38-year-old male patient. He was diagnosed with nephrotic syndrome due to edema of both lower extremities 6 years ago. Renal puncture was not performed at that time, and it was not clear what pathological type it was. Hormone and traditional Chinese medicine were given to the nephrology department of the local city-level Chinese medicine hospital.

The patient’s edema subsided and the urine protein also decreased. After more than a month of treatment, This patient stopped the hormones himself, and only took Chinese medicine for about half a year. Later, I felt “nothing happened” and stopped all the drugs. However, until 2 months ago, the patient clearly felt fatigue, shortness of breath, and nocturia.

He went to the local municipal people’s hospital for further examination and was diagnosed with uremia. The blood creatinine value was as high as 1046.7μmol. /L and color Doppler ultrasound showed atrophy of the kidneys, and other abnormalities such as moderate anemia and elevated blood uric acid.

How can you get uremia if the urine protein drops? Urine protein began to drop. That was only the first step in treating kidney disease. After that, Kidney patents must do the following three things.

 

1. Continue treatment to achieve the best effect

Nephropathy with significantly elevated urine protein is more common in glomerulonephritis, primary nephrotic syndrome, IgA nephropathy, allergic purpura nephritis, and lupus nephritis, etc., all belong to glomerulonephritis. It does not mean that the patient’s urine protein is lowered. It’s over when you are done, and the key depends on how much protein in your urine drops.

If the urine protein is originally very high, if it only slightly drops, the 24-hour urine protein is still more than 1.0 grams, or even higher, it is not good. Such high urine protein will affect kidney function and promote the continued development of the disease in the long run.

Therefore, it is necessary to continue to standardize and combine medications to achieve the best curative effect, as far as possible to reduce the patient’s 24-hour urine protein quantitative to less than 1.0 g, preferably to less than 0.3-0.5 g.

In The Patient above, not only should the hormone be used in sufficient quantities, but also to ensure that the use time under the condition of sufficient use should not be less than 6 weeks, and then consider gradually reducing the dosage. At the same time, immunosuppressive agents and hormone combination therapy and other adjuvant therapies are also needed. Only in this way can the best effect be achieved.

 

2. Consolidate the curative effect and prevent repeated proteinuria

Even if the 24-hour urine protein quantitative of This patient is reduced to less than 0.3-0.5 grams, hormones, immunosuppressants and other drugs cannot be stopped immediately. Instead, the medication should be continued to consolidate the therapeutic effect and prevent repeated urine protein.

To consolidate the curative effect, about hormones: on the one hand, the hormones cannot be used in large doses for a long time, and on the other hand, they cannot be reduced too quickly.

To consolidate the efficacy, with regard to immunosuppressants: appropriate drugs should be selected according to different patients. Young and middle-aged nephrotic syndrome patients like This patient can choose cyclophosphamide or tacrolimus.

When using cyclophosphamide, the total dose for intravenous use should be no less than 6.0-8.0 grams; when using tacrolimus, the dose should be adjusted according to the blood concentration, and the blood concentration should be maintained between 5-10ng/L as much as possible, 2- Slowly reduce the dosage after 3 months.

To consolidate the curative effect, as for auxiliary drugs: you can choose to use sartan or pristine drug combination therapy, you can also use statin lipid-lowering drugs, as well as gastroprotective drugs and anti-osteoporosis drugs, and can also be combined with Chinese medicine treatment.

 

3. Also check regularly and irregularly

Not every time the kidney disease recurs, patients will have edema or other abnormalities, that is, some nephrotic syndromes or other glomerulonephritis can “quietly” relapse or progress.

When the kidney disease is relieved or the drug is completely stopped, Kidney patents will also perform laboratory tests on a regular and occasional basis to understand the changes in the condition.

Patients with no abnormal kidney disease should be checked regularly: at the beginning, they can be checked every month, and then every 2-3 months, or every six months; patients with kidney disease should be checked irregularly or at any time.

The inspection items cannot be less than these three items, that is, urine routine testing, blood pressure measurement, and kidney function tests. According to the condition, plasma protein, blood lipids, immune function, related antibodies, and kidney color Doppler ultrasound can also be checked.

Only in this way, it is possible to find the problem in the first time and take measures so as not to make uremia suddenly appear.

Kidney patents understand? A drop in urine protein is a good thing. If Kidney patents continues to do the above three things, it can make the good thing better and better to avoid the sudden onset of uremia.

 

(source:internet, reference only)


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