4 measures to treat early chronic renal failure

4 major measures to treat early chronic renal failure. Can “adsorbents” also lower creatinine? 　Different from other drugs used to treat chronic renal failure, “adsorbents” used to treat renal failure.　

Recently, a patient consulted and asked: “Can adsorbents lower blood creatinine?”. Regarding the “adsorbent” treatment of chronic renal failure and creatinine reduction, it is not clear in one sentence. Different from other drugs for the treatment of chronic renal failure, the “adsorbent” drugs used for the treatment of renal failure, such as medicinal charcoal, have a huge specific surface area and can effectively absorb creatinine from the gastrointestinal tract after being taken orally into the human body. Toxic substances such as uric acid, contained in its pores, can reduce the entry of such toxic substances into the body’s internal circulation. After the drug is absorbed and excreted from the intestines with toxic substances, it can replace a small part of the kidney’s detoxification function, and ultimately reduce the accumulation of toxic substances such as creatinine and uric acid in the body, thereby reducing the concentration of toxic substances including creatinine in the blood. Protect the viable nephron.

For the middle and late stages of chronic renal failure, in the case of high toxins in the patient’s body, taking medicinal charcoal “adsorbent” can have a certain effect on lowering creatinine, but it can only treat symptoms and relieve symptoms, and Can not solve the problem fundamentally. For such patients, treatment and correction of complications and complications are the most important, and the use of “adsorbents” can only be used as an auxiliary treatment.

For early chronic renal failure, the toxic substances including creatinine and uric acid in the patient’s body are not very high, whether it is the blood creatinine and uric acid value of the patient, or the toxic substances such as creatinine and uric acid in the interstitial space of the patient, both It is only at a high level, and the test results of some patients can even show that the blood creatinine and blood uric acid values ​​are in the normal range (only the glomerular filtration rate decreases).

At this time, if “adsorbent” drugs are used to lower creatinine, most of them cannot achieve the ideal creatinine lowering effect. Different from other drugs for the treatment of chronic renal failure, the “adsorbent” can only adsorb to the intestinal tract, and cannot repair and treat the glomerulus and tubule interstitium.

In fact, in the treatment of early chronic renal failure, the following four measures should be taken, and the effect is visible.

1. Must pay attention to and treat the primary disease

Nephropathy has been treated for a long time, and sometimes only knows the current situation, only pays attention to blood creatinine, and ignores what kind of kidney disease it is, that is, forgets what the primary disease is that causes renal failure. When a patient develops renal failure, the complete diagnosis of the disease includes at least two aspects:

One is the diagnosis of the primary disease, such as IgA nephropathy or lupus nephritis, etc. are the diagnosis of the primary disease;

The second is functional diagnosis or staging diagnosis. For example, chronic renal insufficiency or chronic kidney disease stage 3 is functional diagnosis and staging diagnosis. If it is only diagnosed as chronic renal insufficiency or chronic kidney disease stage 3, and the cause or primary disease is unclear,

Even if you don’t pay attention to and treat the primary disease, the effect can not be too good. If it is IgA nephropathy or lupus nephritis, a specific treatment plan should be worked out based on the test results. If you need to use hormones, you should use it early; if you need to use sartan drugs, you should use it as much as possible.

2. Remove the causes and incentives

Chronic tubulointerstitial nephritis caused by antipyretic analgesics, chronic pyelonephritis caused by repeated urinary tract infections, etc. Pain relievers and urinary tract infections are the causes of the disease; fever causes chronic renal insufficiency in patients with chronic renal insufficiency, and fatigue causes chronic kidney disease Elevated blood creatinine in patients with failure, fever and fatigue are the triggers of the disease.

Therefore, for early chronic renal failure, removing the above-mentioned causes and incentives can prevent or continue the further development of the disease. However, if the causes and incentives of the disease cannot be removed, the use of antipyretic analgesics, urinary tract infections have not been controlled, frequent fever, colds and fatigue, etc., chronic renal failure will continue to progress.

3. Actively treat the two major kidney injury indicators

Urine protein and high blood pressure are both the “effects” (results, manifestations and complications) of chronic renal failure and the “causes” (causes, that are causing or promoting the continued development of the disease). Therefore, it is particularly important to actively treat urine protein and hypertension. To control the condition of chronic renal failure, to a large extent is the treatment of proteinuria and hypertension.

Try to reduce the patient’s 24-hour urine protein quantification to less than 1.0 g (less than 0.5 g is better), and control the blood pressure at 100-120/60-80mmHg, which is very helpful to protect the residual renal function, prevent or continue Chronic renal failure continues to progress.

4. Avoid kidney damage

The renal function of patients with chronic renal failure is not only affected by uncontrolled primary disease, non-decreased urinary protein, substandard high blood pressure, infection and fatigue, but also other factors that damage the kidneys and cause kidney disease to accelerate. Before development.

Other factors include the use of nephrotoxic drugs (such as painkillers and tacrolimus, etc.), dehydration of the kidneys (high fever and excessive sweating, etc.), excessive use of drugs (repeated use of multiple drugs and over-dose use of certain Drugs) and kidney overload (too much infusion and too much meat and taste), etc., will cause the kidney to be injured again, and should be avoided as much as possible.

Therefore, patients with early chronic renal failure do not advocate taking “adsorbents” to lower creatinine. Taking the above four measures is both practical and reliable.

(source:internet, reference only)

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