Patients with renal cysts dietary considerations ?

When you are suffering from renal cysts are not careful , you know that in addition to injections and medicine with a doctor , the daily diet also allows patients with renal cysts achieve a multiplier effect , then what daily life should pay attention to?
First point: pay attention to diet , it is very detrimental to the treatment of renal cysts . Note that the class does not eat salty weekdays (including pickled ) , do not eat spicy category (including pepper , wine , shrimp , crab , etc. ) , contaminated eat ( including spoiled , leftovers , etc. ) , eat barbecue , and the occurrence of renal insufficiency or uremia should also pay attention to eat beans and their products , limiting animal protein foods , greasy foods and so on.
The second point : the water intake will be too large a burden on the kidneys certain extent . The incidence of kidney disease due to a variety of different , different course , treatment is not the same . In mild renal failure due to kidney function decline was concentrated , metabolites to need more moisture from the kidneys , therefore , no significant kidney disease such as edema , heart failure, high blood pressure , should not blindly water restrictions . Reminded that those patients with chronic renal failure , renal failure do not think you have to strictly limit the water , if too much water restrictions easy to increase the anti- deterioration of renal function .
The third point : salt intake is important to be regulated like doctor , otherwise the consequences could be disastrous. Control of salt , according to the patient's condition and the degree of renal function adjustment , not all patients with chronic renal insufficiency should strictly limit salt .
The fourth point : patients with renal cysts is important to pay attention to rest and avoid strenuous physical activity and abdominal trauma , kidney enlargement is more obvious when it is appropriate to replace the belt strap in order to avoid cyst rupture ; General to review the first six months (including blood , urine, renal function and B- ) ; avoid all nephrotoxic drugs .
Fifth : talk nutrition, renal cysts patients should eat foods containing high quality protein , note high fiber, high cellulose and low-fat food supplements , proper sugar diet.
The sixth point : not a partial eclipse , whole grains, fresh vegetables and fruits , cattle, sheep, pig meat , eggs , milk , fish etc. edible.

Daily life in patients with renal cysts you should refer to the above six requirements, maintain a good attitude and work schedules . Enhance their physical exercise , renal cysts will away from you .

Kidney patients can eat beans do ?

Toxic nephropathy toxic substances by the kidney caused kidney damage. Often named after renal toxic substances . What are the symptoms of toxic nephropathy performance ? With this question, we have to look at the introduction below .
Proximal tubular dysfunction manifested as Fanconi 's syndrome : Grapes diabetes, urinary amino acids , phosphate urine, sometimes with hypokalemia, toxic heavy metals found in some kidney disease , expired tetracycline toxic nephropathy ; distal renal tubular function diminish the performance of nephrogenic diabetes insipidus : polydipsia , polydipsia , polyuria , found lithium fluoride , demeclocycline caused toxic nephropathy ; renal tubular acidosis : high acidosis , water and electrolyte imbalance ( such as hypokalemia or hyperkalemia , hyponatremia , hypocalcemia , polyuria, polydipsia polydipsia , etc. ) ; renal osteodystrophy : renal rickets or osteomalacia , renal calcification or kidney stones , found in two amphotericin B induced toxic nephropathy .
Light only trace urine protein , red , white blood cells in urine and urinary tube , little or no urine azotemia . In severe cases , there may be a typical manifestation of acute renal failure syndrome , seen aminoglycoside antibiotics , inorganic mercury -induced toxic nephropathy . Fever, rash , swollen lymph nodes , joint pain, blood eosinophilia and other systemic allergic manifestations . Urinary eosinophilia . Also massive proteinuria was nephrotic syndrome , or hematuria . In severe cases of acute renal failure , found a variety of drugs , especially penicillin family , sulfa drugs , anti-tuberculosis drug poisoning .
Exogenous toxins such as penicillamine . Gold salts , venom , bee venom , pollen and other causes of immune glomerular disease, manifested as nephritic syndrome or nephrotic syndrome. The performance is difficult due to glomerular disease and other causes phase difference. Detailed inquiry should be whether the patient has kidney toxicant exposure history , provide the basis for the differential diagnosis , misdiagnosis and missed otherwise .
Toxic nephropathy treatment methods are described below:
1 stop exposure to toxic substances .
2, to promote excretion of toxic substances , the infusion can be applied antidotes be dialysis treatment when necessary. Where small molecular weight, and protein binding less evenly distributed in the body , could be discharged through the blood of dialysis . Where those with high protein binding effect of peritoneal dialysis is good . Plasma replacement therapy should be used with caution .
3 , symptomatic treatment.

4 , take measures according to the type of renal damage . Such as acute drug -induced allergic interstitial nephritis, nephrotic syndrome , the absence of contraindications, available adrenal corticosteroids, immunosuppressive drugs or shock therapy adrenocorticotropic hormone . Renal failure were available peritoneal dialysis or hemodialysis treatment.

Why mothers should be especially careful pyelonephritis ?

Pyelonephritis is how is it ? Why are women more prone to infection during pregnancy pyelonephritis it? Pyelonephritis refers to inflammation of the kidneys glenoid , mostly caused by a bacterial infection , usually associated with lower urinary tract inflammation , clinically difficult to strictly distinguish . According to the clinical course and disease , pyelonephritis can be divided into two phases of acute and chronic , chronic pyelonephritis is an important cause of chronic renal insufficiency.
Pyelonephritis is also common in pregnant women urinary tract diseases . This is because:
1 , ureter during pregnancy affected by estrogen and progesterone and expansion , resulting in tissue relaxation lumen expansion creeping slowly exclude urine retention, urinary retention often in the renal pelvis and ureter , which is bacteria in the renal pelvis and ureter create the conditions for growth and reproduction .
2 , female urethra is easy for the bacteria directly adjacent to the vagina and anus gathered , and the urethra and shorter , only 3 to 4 cm , such as poor hygiene , the bacteria invade the urethra and easily detected upstream of the renal pelvis , causing pyelonephritis.
3 , the couple before sexual intercourse without cleaning the external genitalia , male and female genitals during sexual intercourse tube in close contact and friction and collisions woman urethra, often easy to take advantage of the bacteria invade the urethra , causing bacterial pyelonephritis .
4 , the pregnant uterus can cause constipation bowel squeeze so easy to make colon bacteria invade the ureter , bladder, urethra and pelvis from the intestine through the lymphatic .
5, the body contact engaging force during pregnancy reduced susceptibility gingivitis , pharyngitis , tonsillitis , otitis media , rhinitis , bacterial infection of the lesion, can spread via the blood circulation to the urinary system , causing pyelonephritis.

In order to protect the health of pregnant women and fetuses , pregnant women should pay attention to hygiene , to maintain external genital hygiene , wash pants , bathe , when you wipe from front to back stool to prevent pollution of the urethra. The best woman after intercourse can answer a piss , so the bacteria may enter the urethra washed out . Pregnant women should strengthen moderate physical activity, enhance the body's resistance to diseases, to prevent the occurrence of disease , pregnant women should drink plenty of water , eat more fresh vegetables , fruits, to increase urine output , flushing the urethra to prevent the growth and reproduction of bacteria. If suffering from pyelonephritis , to timely treatment, and you want to disable the kidney damage drugs , such as gentamicin , kanamycin , iodine-containing contrast agents.

Nephrotic syndrome Diet Tips

Nephrotic syndrome diet is always plagued stumbling rehabilitation of patients, affecting patient recovery process, we will go to explain in detail below nephrotic syndrome ate.
Nephrotic syndrome ate? Nephrotic syndrome patients can legally effective if the diet to heal the consequences of progress, however, if it is improper diet will increase the patient's condition. So, nephrotic syndrome patients ate it?
First, the patients with nephrotic syndrome associated with severe edema should limit salt: edema in patients should be based on a high degree of edema avoid salt, reduce swelling and entirely by low-salt (3 g daily right-left), until the swelling subsided plasma When protein recovery on the verge of deformity, can give general diet.
Second, protection of nephrotic syndrome protein intake: how the amount in the nephrotic syndrome urinary protein excretion, hypoalbuminemia often makes colloid osmotic pressure drop, so stubborn Nanxiao edema, body resistance is also reduced, so in kidney disease Early syndrome, renal failure, under no circumstances shall be guaranteed at all times daily adult about 0.7 to 1.0 g / kg body weight of protein intake, helps relieve hypoalbuminemia and consequent complications .
Third, nephrotic syndrome fat intake requests: hyperlipidemia is often accompanied by a slight short-term patients with lesions can be improved, so the fat intake is not restricted; of membranous nephropathy and other refractory nephrotic syndrome. patient, long-term atherosclerosis can cause hyperlipidemia, therefore, should limit hoof Bang, fat and rich in animal fats.
Moreover, in patients with nephrotic syndrome due to increased permeability of the glomerular basement membrane, which in addition to the loss of protein in the urine, while missing some elements and combined hormones and proteins can cause indirect calcium, magnesium, zinc, etc. , which can be used drugs or food supplements.

In order to make possible the patient's condition nephrotic syndrome, early rehabilitation, we must understand the nephrotic syndrome ate.

How healthy diet nephrotic syndrome

Proper diet kidney disease patient rehabilitation plays a very important role. What kidney patients to eat ? How much to eat the right ? This is not a sentence to say where . According to the type of disease, the severity of each solution formulation .
We all know that diet for kidney patients to rationalize the rehabilitation of his illness plays a very important role. What exactly should that kidney patients eat ? Much to eat is most appropriate?
Nephrotic syndrome ate ? Nephrotic syndrome is a syndrome due to the increased permeability of the glomerular filtration membrane , a large number of plasma proteins are lost from the urine caused. Proteinuria , hypoalbuminemia , varying degrees of edema , high blood cholesterol are four clinical manifestations. Simple primary nephrotic syndrome occurs mainly in children and adolescents. Nephrotic syndrome symptoms exist Hypoproteinemia height edema , etc. Therefore, some patients on diet recuperating there are some wrong understanding .
Some patients believe that too much protein in the urine is lost , you must eat a lot of protein to supplement the loss in the body ; Some patients are afraid to eat protein with every meal eat some vegetables , thinking that it can reduce the amount of urinary protein leakage , in fact, both views are one-sided .
Excessive intake of protein will increase the burden on the kidneys , and inadequate intake of protein can not maintain normal physiological needs. Nephrotic syndrome , the daily intake of protein in urine protein loss should be determined based on how much the general body weight daily 1.5-2.0g/kg moderate to high-quality high-protein diet such as meat , eggs, milk , fish as well.
If patients had azotemia when protein intake should be limited , the daily protein intake in order to be able to maintain a minimum balance of nitrogen is appropriate supply of protein throughout the day should be limited to about 50g appropriate. As supplemental salt should also were given low-salt or salt-free , sodium -free diet according to the degree of edema .
Nephrotic syndrome, without severe edema ate , sodium daily supply about 2000mg, which should also include the sodium content in food , cooking and allows the addition of salt a day or 2-3g soy sauce 10-15ml?; edema were full-day limit for the amount of sodium in about 1000mg, when cooking with salt or soy sauce should not be added ; highly edema , full-day limit for the amount of sodium in less than 500mg.
Nephrotic syndrome ate ? Worth noting that , despite the salt is the main source of sodium , but a high sodium diet of some foods such as beef jerky , beef loose , shrimp , sea cucumber , egg, salted duck eggs , instant noodles, fried fritters , mustard , seaweed, pickled mustard greens , also should not eat .
Nephrotic syndrome ate ? Further , nephrotic syndrome also a timely supply of heat ( adult daily 126-147kJ/kg weight ) and a number of trace elements such as calcium, iron , and of vitamins A, D, B2, C, etc. Should limit intake of lipids , low-cholesterol diet with less oil as well, should also eat sea fishy , shrimp , crab , pickles, sweet sauce, fermented bean curd , bacon , sausage, bacon and other fat salty foods, tobacco, alcohol , vinegar stimulating food and garlic, leeks , onions and other spicy products , should not eat raw fruit . In light meals daily as well.

Nephrotic syndrome ate ? Nephrotic syndrome in addition to conduct regular treatment, diet therapy is also critical , scientific and rational diet helps patients undergoing regular treatment , on the contrary , it will hinder regular treatment .

Kidney disease can not eat foods

Nephropathy experts say: if not pay attention to diet often lead to kidney disease. Be sure to pay attention to hygiene to eat , try to eat the food stalls or street vendors , most of those places do not have a business license and health permit, health is a big issue , I believe most people have to get sick in that place experience , clinical experts pointed out that unhealthy diet , light easily lead to gastrointestinal diseases , severe food poisoning , even life-threatening, so we can not because of his momentary greedy or freeloaders , and give your body harm .
We need to note that , in order to protect our physical health , the diet should eat light food , especially too salty, pickled ( such as pickles , mustard , etc. ) , barbecue ( such as barbecue , chicken , etc. ) patients spicy ( including pepper , wine , shrimp, crab , etc. ) do not eat , in addition to rot , and do not eat leftovers , etc. , in patients suffering from uremia or renal insufficiency should also limit the greasy type of food and animal protein foods , while paying attention to diet beans and their products . So visible , only science and health reasonable diet, nutritional needs are met , and our bodies to be healthy .
Kidney patients can not touch food
Some foods on the rehabilitation of life in patients with kidney disease is very important , kidney patients often need to eat, but some food but then it is very detrimental to kidney health , kidney patients need to actively away . Here we give an introduction to the successful rehabilitation of patients with nephropathy which adverse food .
Beans:
Usually for patients with normal renal function , it is appropriate to eat some beans , but overall, soybeans, soy , beans, red bean , mung beans , and raw materials to be processed into tofu , tofu skin, vegetarian chicken , tofu, gluten , baked bran and other foods. These nutrient-rich , low in fat , cholesterol-free and because of protein contained in them is higher than the lamb , and vegetable protein , the elderly, hyperlipidemia, atherosclerosis ideal dishes. But for patients with renal dysfunction , the large number of protein- protein diet can increase the urinary excretion , increased renal dysfunction, it is best to eat.
Bamboo shoots :
Bamboo shoots health has certain adverse effects on the kidneys , it is because of panic shoots , sweet , and it has good heat water effect. But according to modern research , because bamboo shoots contain more insoluble calcium oxalate , which is chronic nephritis and renal dysfunction unfavorable , so should not eat .
Wild rice :

Wild rice is in life we are very favorite kind of food , commonly known as wild rice melon , but people with kidney disease should pay attention to eat. According to modern analysis , wild rice contains more oxalic acid and insoluble calcium oxalate , there is a certain negative impact on the rehabilitation of patients with kidney disease .

Bad habits easily lead to kidney failure

Bad habits easily hurt kidneys
It has long been believed that with age , there physiological kidney is normal. However , more and more people into the ranks of the kidney prematurely , the reason , experts believe that now , more and more kidney disease are caused by unhealthy habits , such as life without rhythm , unhealthy diet , excessive drinking, staying up late .
Late at night, is a modern urban people face intense competitive pressures forced a choice. Stay up all night long , not only affect a person's mental outlook, but also prone to dark circles , mental drowsiness , fatigue, loss of kidney essence , causing kidney .
Herbal tea because people can drink a drink occasionally , but not regularly drink herbal tea because of the bitter cold , spleen and kidney yang easily hurt , and the spleen and kidney yang is the root of human activities , especially for children and the elderly poor children is at in the development stage , often eating something bitter cold is not conducive to children Peibu spleen function .
TCM treatment advantage
Traditional Chinese medicine practitioners speak of " deficiency " in the concept of "kidney " refers not only to the kidney anatomical and physiological role is a fairly extensive , and human reproduction, growth, digestion, has directly or indirectly related to the endocrine and metabolic etc. vital organs , so the " symptoms of kidney deficiency " is a broad concept . Specifically, mental deficiency manifested as drowsiness , memory loss, pale mouth , chills , nocturnal enuresis , defecation , weakness, reduced male sexual function , poor woman uterus , etc., kidney manifested as dry mouth, dizziness , vertigo , insomnia and so on.
In the treatment of kidney or renal disease , Chinese medicine has a unique advantage . Western medicine is mainly used after the release of hormones and free drug treatment, drug side effects , and it is difficult to completely cure , and according to traditional Chinese medicine syndrome differentiation of different physical conditioning of yin and yang , some patients treated with Western medicine for a long time and still invalid , it turned to Chinese medicine, Chinese medicine for these patients also had a significant therapeutic effect.
Do not hold back workers doing routine urine problems found
If you get swollen eyelids , backache, fatigue , then you should raise the alarm , because it is likely that the initial signal kidney , although kidney disease early symptoms , but if the intention to "feel" , you can still find some , such as the red urine when urinating more foam and froth long duration ; limbs, face, body skin emit more red spots or redness ; limb joint pain ; fever. If you have these symptoms , then go to the hospital to be routine urine examination, only 10 yuan, if the abnormal urine should be done under the guidance of a doctor for further examination.
If there is systemic edema, decreased urine output, nocturia , blurred vision , pale skin, lips , etc. , then the disease has been more serious, but not to the most advanced , as soon as possible to the hospital for treatment too late.
Holding back urine can cause kidney
Some people are busy with work will be for a long time holding back urine , or simply do not drink all day , which can cause urinary tract infections and pyelonephritis , can lead to chronic recurrent infections also may develop uremia, and common clinical kidney stones, hydronephrosis , etc. , are also closely related , and for a long time without water .
It should be reminded that the kidney damage caused by drug abuse in recent years also showed a clear upward trend . About 25% of patients with renal failure and use of nephrotoxic drugs related to the anti-inflammatory medication as usual analgesics ( including some cold medicine, known as non- steroidal anti-inflammatory analgesic medicine ) , such as indomethacin , ibuprofen, Thailand Song, piroxicam , aspirin, paracetamol and other long-term or heavy use can lead to kidney dysfunction .
The above is about the relationship between kidney disease and some of our usual habits between , no matter how busy work and life , we must maintain a healthy and orderly habits to prevent disease in our body , affecting their health .ir health .

Why misdiagnosed kidney failure

There are many kidney disease , some symptoms are similar , it is easy to confuse patients , clinical findings indicate that the majority of patients with chronic renal failure symptoms are slow to happen, but a lot easier when we become the diagnosis of chronic renal failure in other diseases , such as : cancer, digestive diseases and other diseases , and thus delayed treatment , so that the patient's health is very bad . Here is a look at how kidney specialists say .
What is chronic renal failure ? How does it happen ? The occurrence of chronic renal failure secondary to come , for example, some of the more common kidney disease , the main manifestation is renal dysfunction , metabolic products of retention, water, electrolyte and acid-base balance , causing the kidneys can not maintain a stable internal environment . Etiologies of chronic renal failure is more complex, in primary renal disease , the most common chronic glomerulonephritis chronic renal failure more than half of the total incidence (about 50 - 70) , chronic pyelonephritis about accounting for a quarter , there are other causes of renal arteriosclerosis .
Experts pointed out : Chronic renal failure is a severe life-threatening disease , we must pay close attention ! Since early manifestation of the disease is not typical, but symptoms can occur in any one system , therefore, easily misdiagnosed as a disease of a system , especially in patients who had no significant chronic kidney disease , where there is weakness, fatigue , physical decline , abdominal pain, diarrhea, vomiting or gastrointestinal bleeding friend.

By introducing the above , we should be clear , easily misdiagnosed with chronic renal failure , Bukebufang , chronic renal failure is a severe life-threatening disease , neglect of prevention equals no responsibility for their own health . Chronic renal failure patients as long as the timely detection and timely treatment can generally get a better prognosis. I wish you a speedy recovery !

Need to guard against nephritis aggravated winter season

Respiratory diseases in winter and spring is a good season in coastal areas such as Shanghai , sooner or later, the temperature difference between night on highly prevalent respiratory infections in winter and spring , we look you will find now a fever , cough , sore throat on patient increased significantly over time autumn . Upper respiratory tract infections, including tonsillitis , otitis media , are likely to cause acute nephritis. This is mainly there is a hemolytic streptococcus , can cause acute glomerulonephritis by immune complexes appear edema, hematuria , proteinuria and hypertension . So if anyone , especially children, the emergence of sore throat, cough , fever, must be treated , do not because learning nervous, busy with work and delay the disease.
For chronic nephritis, infection also contributed to the cause of recurrent disease . Research data show that infection is the main cause of exacerbations of chronic nephritis . Even after timely treatment , most patients got better , but every time sicker would cause some damage to the kidneys , with the passage of time , the condition repeatedly, eventually leading to chronic renal failure .
Nephritis patients with hypertension , the cold weather, causing reflex vasoconstriction , more difficult to control blood pressure , and hypertension is to promote the deterioration of renal function until serious complications uremia. So nephritis patients with hypertension , be sure to follow the doctor's guidance, seriously good control of blood pressure, avoid rapid deterioration of renal function .
There are many kidney diseases, such as lupus nephritis , IgA nephropathy , etc., are cold-related . Therefore , be sure to be vigilant in the winter season and increased incidence of nephritis .
Thus , patients with a history of kidney disease , winter is coming, as do the following ::
① improve ventilation and prevent the flu. Time to open the doors and windows for natural ventilation can effectively reduce the number of microorganisms in indoor air , improve indoor air quality, indoor microclimate regulation is the most simple and effective method of disinfection of indoor air .
② attention to personal hygiene and protection. Develop good health habits is the key to prevention of infectious diseases in spring . Qinhuan , ground clothes, blankets when the weather is good exposure to sunlight. Respiratory diseases prevalent in the season should be reduced assembly, fewer trips to public places.
③ strengthening exercises to enhance immunity. Actively participate in physical exercise , and more fresh air to the outdoors , walking every day , jogging, exercise, blood flow to the body , such as boxing , stretch muscles , physical enhancement. To exercise reasonable arrangements to avoid the intense, a lot of movement .
④ law of life , maintaining adequate sleep . To arrange a good rest , so that the law of life , work and rest .
⑤ clothing, food and pay attention to detail . Climate variability, timely change clothes , must not cut too much at once ; attention sheltered cold sweat after exercise . Reasonable arrangements diet, do not smoke , do not drink , do not eat spicy food, reduce respiratory irritation. Do not drink unboiled water , do not eat unclean food , and refused to eat raw meat and eat a variety of seafood, fruit skin . To the water, adequate intake of vitamins, should eat more rich in quality protein , carbohydrates and trace elements in foods such as lean meat , eggs, dates, honey and fresh vegetables, fruits, etc. to enhance the body immunity .

⑥ timely medical treatment, periodic inspection . So the discovery of physical discomfort or timely medical treatment should be similar reactions , especially those with fever or abnormal urine routine should be early diagnosis and timely treatment.

Understand the basic features of hydronephrosis

First, the symptoms:
1 Low back pain is persistent dull or bulge discomfort.
2 waist abdominal mass initially started under the costal margin , and gradually extend laterally abdomen and waist , big may cross the midline of the cystic mass with smooth surface , the edge rule , there is a sense of volatility , tenderness obvious.
3 hematuria usually microscopic hematuria . Complicated by infection, hematuria aggravated after stones or trauma.
4 little or no urine , if both kidneys , solitary kidney or renal function only appears on one side the water , while patients with severe renal damage , and appears little or no urine .
5 oliguria and polyuria alternating part of patients seen in primary hydronephrosis . Available at a lot of times the mass suddenly shrink after urination , and pain relief , when the mass increases rapidly decreased urine output , increased pain .
6 hypertensive patients with severe hydronephrosis in about 1 /3 of hypertension , were mild or moderately elevated . May be due to the expansion of the renal pelvis caused by compression of the renal parenchyma interlobular artery ischemia due.
7 In the absence of spontaneous rupture of renal trauma cases, due to secondary infection caused by rupture of the renal pelvis , causing kidney and urinary extravasation around the hematoma . Manifested as sudden waist pain, generalized tenderness with muscle tension.
8 secondary infection fever elevated body temperature .
9 gastrointestinal symptoms may have abdominal pain , bloating , nausea , vomiting, drink lots of water after the above symptoms.
10. Bilateral obstructive chronic renal insufficiency, uremia.
11 , hydronephrosis often without typical clinical manifestations, mainly for primary disease signs and symptoms , diagnosis when hydronephrosis , presence of hydronephrosis should first clear , and then to identify the cause of hydronephrosis , lesion, degree of obstruction , with or without infection, and renal damage case . Through a comprehensive and detailed collection, analysis of symptoms and signs of history, as well as laboratory and comprehensive analysis of the various imaging tests , and more can confirm the diagnosis.
Second, the signs: signs of further examination may percussion pain from kidney area , mass, abdominal mass determine whether the presence of upper urinary tract obstruction .
Third, the diagnostic criteria :
1 back pain, lumbar cystic mass .
2.B super : kidney volume increases, cortical thinning, the essence of varying sizes liquid dark area .
3.X line intravenous urography display hydronephrosis .
4 isotope renogram , obstructive kidney diagram.

5 retrograde ureteral catheterization angiography by hydronephrosis .

Early symptoms of kidney failure five

Renal disease is a very serious disease, in patients with kidney disease can be reversed, so patients in the early stages of treatment is effective, it can effectively control the following to tell you about the early symptoms of kidney failure performance.
kidney-arabic@hotmail.com
Symptoms: Cardiovascular System
Patients usually have symptoms of heart failure or high blood pressure often feel palpitations or shortness of breath, often can not lie flat, it is easy rhythm disorders, patients with severe pericardial effusion and sometimes the phenomenon, sometimes will be blocked.
Symptom two: the nervous system
After the occurrence of the disease have lack of energy, headaches, dizziness phenomenon, some patients will suddenly drop memory, insomnia, difficulty urinating and other symptoms are also often seen, but also occur in patients with severe coma.
Symptom three: Digestive
After the occurrence of the disease patients often feel anorexia, nausea, vomiting, diarrhea, mouth often feel there is urine, or gastrointestinal bleeding.
Four symptoms: skin manifestations
The disease occurs when there will be a scaling phenomenon, the skin often feel no gloss, and sometimes there will be a melanin pigmentation, skin color will appear darker, adverse phenomenon edema or skin infections occur .
Symptoms five: Respiratory
When the disease occurs to us is going to affect the respiratory system, often feel that their mouths have Niaowei appear, but also gas metabolic acidosis breathing, have such a bad feeling.

In summary, we know that the early symptoms of kidney failure above the main five, so the disease occurs when people should pay special attention, pay attention to the various manifestations of the body, so that early in treatment, comprehensive treatment , as soon as the restore.

Daily care of patients with lupus nephritis specification

Lupus nephritis is not an incurable disease , not like some patients with lupus nephritis said as ferocious like a wolf . After investigation know that many patients only rule once, twice or more, and some even " cure " relapse again . Why would these lupus patients with recurrent and permanently it?
In daily life , lupus nephritis care do not get bit , not standardized, or lupus nephritis patients not at all clear how the daily care , resulting in recurrence of lupus nephritis . After recovering from lupus nephritis adhere attention care is very important, even essential.
Patients with lupus nephritis daily care specification :
1 , patients with lupus nephritis diet care:
Should be high-calorie , high vitamin , low-salt diet , in addition to renal insufficiency outside can give high-protein diet, the conditional long-term use of milk, especially colostrum , colostrum contains a lot because antibodies can increase the body's immunity.
2, the rehabilitation of patients with lupus nephritis exercise care:
Lupus nephritis patients have adequate sleep , to relieve fatigue , but may be appropriate to participate in various activities , housework and a wealth of recreational activities , farmers can light manual labor .
3 , patients with lupus nephritis psychological care:
Hormones can cause illness or taking posture , appearance change , not part of the patient's fertility and serious loss of function , so that the patient depressed, thinking overburdened lost confidence in life , to refuse treatment . Family should be more talk to patients , so that patients feel the warmth and love of people around the community, to increase confidence in the treatment and indicate drug reactions are reversible.
4 , lupus nephritis patients with relapsed to early treatment :
Patients with lupus nephritis remission alternating episodes , need early treatment if symptoms recur . Fatigue, infection, childbirth is often relapse incentives , attention should be avoided. Women of childbearing age should contraception, multiple organ damage should terminate the pregnancy. Of organ damage is not obvious , the disease still long , families who have an urgent desire fertility , also under the guidance of doctors have peace childbirth , mother safe precedent , but it must be under strict medical supervision .
5 , lupus nephritis patients with medication care :
Lupus nephritis patients proper treatment expert should guide the use of corticosteroids : The disease control can be taken daily or every other day 7:00-8:00 am on medication to reduce drug inhibition of adrenal cortex , and by taking the drug minus approach , in order to avoid "rebound " phenomenon.
6 , the families of patients with lupus nephritis should always observe the mental state of patients with lupus nephritis :
Disease activity may lead to abnormal mental state , mental anomaly appears : abnormal behavior , anxiety, apathy, and even stupor state , or the performance of over-excitement , hallucinations, paranoia or obsessions . While some patients are not psychiatric symptoms , their excitement or long-term use of hormone insomnia Department actions, in addition to use of sedatives or reduce the amount of hormones , the symptoms can be improved, but the combined mental disorders , often the disease is neurological, psychiatric system damage yet control performance , shall promptly notify the physician.
7 , lupus nephritis patients to combat colds and infections :
Once the infection should be promptly lot of antibiotics. When patients with lupus nephritis home care , prevention and treatment of colds should always pay attention warm warm ; If the cold , to follow the doctor's advice, taking small renal toxicity cold medicine , such as c -dimensional silver fins , SHL oral liquid, granules, etc. Radix .
8 patients with lupus nephritis General care:
Outdoor activities can be coated chloroquine facial cream , wear long-sleeved clothes, wearing a wide-brimmed hat to reduce sun exposure to avoid skin lesions . Interior should curtains. Good oral care , available 4% soda mouthwash to prevent fungal infections , fungal infections have been delicious with oral Nystatin 500,000 units three times a day , or 1 --- 4 % ​​of imazalil solution mouthwash daily 3-4 times. On the fingers, toes , nose, ear lobes and other parts of widespread arteritis merger Raynaud's phenomenon , should keep warm and avoid frostbite distal limb necrosis .

If proper treatment , coupled with lupus nephritis careful and reasonable care , it can control the treatment of lupus nephritis , but also can reduce the psychological fear of patients with lupus nephritis . Patients with lupus nephritis is best carried out under the guidance of a doctor or nurse specialists .

Children with acute nephritis how diet health approach

Acute nephritis is one of the common diseases in children , the whole subject to varying degrees of kidney damage , decreased urine output . Because of damage to the kidneys and systemic capillaries , the blood vessel wall permeability changes , resulting in systemic edema, high blood pressure , oliguria and other symptoms. At this point the patient's diet should avoid salt , water should not be overly restricted , in order to facilitate urination. When urine output to be increased , by no salt to salt , about 1.5 to 2 grams per day , that is, 50 grams of salt to eat 25 to 30 days . While limiting salt, alkali or salt who made ​​bread, pasta , crackers and a variety of pickles, pickles , etc. should be taboo , for human consumption, shall prepare himself alkali salt-free pasta.
When on protein intake in the early onset of significant oliguria and hypertension , should be properly controlled . Per kg body weight 0.5 grams ( or less than l gram per kilogram ) , such as a 7-8 year-old children , about a day to about 11 grams of protein , lean pork chop flesh equivalent to 50 grams, or 100 grams pomfret . However, dietary protein sources other day meat , there are cereals and other plant foods , the amount of the above example refers to the amount of day , the actual matching meals , animal food required to be considered , so that each day intake of protein ( see the following example ) within the limit . Because children are the growth stage, this low- protein diet food for too long , 2 to 3 days supply of protein that should be increased to about 30 grams per day .
General condition has alleviated sick children the freedom to choose the food , consider the beginning without salt , common salt diet after getting to and encourage sick children to eat more fruits and sugar foods. The amount of added Vit C and vitamin B complex tablets, according to doctor's orders according to the amount consumed.
The following example is a seven- day food intake of children aged when suffering from acute nephritis . Early protein restricted diet 11 g per day , disable salt.
Breakfast : a bowl of sugar porridge .
Snack ( 9:00 ) : Apple 1
Lunch: a bowl of porridge , egg yolk a yellow bean sprouts ( 100 g ) , 10 g of oil ( cooking with )
Snacks ( 14:00 ) : cook pears 1 ( 100 g ) , 20 g sugar
Dinner: a bowl of porridge , vegetables and 60 grams , 30 grams of potatoes , 10 g oil
Dim Sum ( 19:00 ) : Apple one ( 100 g )

As the amount of food consumed by the above , the day received 11 grams of protein , 917 kcal of heat . However, when the consumption of such food, mostly in the period of hospitalization , her condition improved at discharge , the original low-salt diet generally available , limit 1.5 grams of salt per day can be. Supply of protein without too restrictive , but to follow the doctor's advice to clinics regularly to discharge condition was observed after recovery .

Kidney patients eat foods which

First, high phosphorus foods :
1 , dairy products : milk , cheese , butter ;
2 , chicken , egg yolk ;
3 , meat : in particular, brain, kidney, liver, lean beef , lean pork broth ;
4 fish : sardines, fish, octopus , shrimp ;
5 , dried fruit , nuts , such as: walnuts , peanuts , etc.
Second, low phosphorus foods :
Soybean oil, jelly, melon, wheat starch, pork ribs , egg white, apple , tomato
Third, the high potassium foods :
1 fruit : bananas , grapes, watermelon, apricots , oranges, cantaloupe, melon , dried red dates ;
2 , vegetables: spinach, parsley , spinach , rape , cabbage , cucumber , leek, onion , leek , lettuce , potatoes , yams , fresh peas , soybeans , taro, potatoes, mushrooms , cedar, lily, mustard , lily , dried peanuts ;
3 , seafood : seaweed, kelp , shrimp , pomfret , catfish ;
4, the grain : buckwheat , corn, soybeans, black beans, green beans ;
5 , Other: tea ; vinegar ; malted milk ;
Fourth, with high uric acid foods:
Animal offal , Yuxia mussels , beer, mushrooms , beans, spinach
Five , including low- fat foods :
1 , meat : roast cooked beef, beef liver , lamb, chicken.
2 , fish and other seafood : carp , sturgeon , halibut, clams , crab , shrimp, oysters.
3 , vegetables: asparagus , eggplant , fresh beans, lettuce , peas ; potatoes, spinach, squash , tomatoes , cabbage, cauliflower , cucumbers , green peppers , carrots, white carrots .
4 Fruit: All fruits and fruit juices ( fresh , canned or frozen can ) .
5 , dairy products : skim milk ( milk or milk ) , artificial butter , home cheese.
6 , breads and grains : rice , bread , pasta, salty crackers, corn flour .
7 , condiments : honey , jam ; tomato sauce, ginger , mustard , coffee, tea
-
8 , limiting the intake of animal fat , diet rich supply of polyunsaturated fatty acids ( such as fish oil ) and vegetable oil ( soybean oil, rapeseed oil, sesame oil )
Six high-quality low-protein diet :

Should choose a high biological value protein , mainly animal protein, eggs ( yolks go ) , milk, lean meat , fish, etc.

Systemic complications after kidney transplantation

( A ) Infection
A bacterial infection
kidney-arabic@hotmail.com
Chest infections by common pathogens such as Streptococcus pneumoniae or Haemophilus influenzae, caused by a virus , the virus , such as Gram-negative Escherichia coli or Klebsiella caused extremely rare. Staphylococcal pneumonia can make the condition quickly deteriorated , chest X- ray shows a majority of small abscess formation, as the disease can not be controlled , can be fatal , though with the support of processing, such as intermittent positive pressure ventilation is also useless . TB is relatively rare, but if a patient previously infected with tuberculosis, because the immunosuppressive medications, can cause relapse, should pay particular attention be given preventive treatment if necessary. Kano is a star eosinophilic pathogenic bacteria that can cause pneumonia limitations , often prone to cause brain abscess bacteria reported . Sepsis is relatively rare, high fever , chills . It is often caused by gram -positive bacteria, such as no effective treatment, the disease developed rapidly, failure symptoms appear , often require enhanced care, ventilator and boost the application of measures , but it is difficult to recover. Another outbreak of infection often caused by refractory Clostridium (Clostridium difficile) due. The bacteria multiply in the colon , causing pseudomembranous colitis , for failure patients often have life-threatening , it seems prone to after treatment with broad-spectrum antibiotics , has been clear from the spread of the disease among patients but also with each other . If you live in the original transplant patients infected patients stayed in bed , can cause disease. Clostridium can also be disinfected bad sigmoidoscopy infection. Vancomycin is the cure for the treatment of pseudomembranous colitis . Patients with suspected bacterial infections such as suspected drug sensitivity test results without , can be the first choice of the second-generation cephalosporins ; as with aminoglycoside formulations , the choice of gentamicin, but to monitor drug blood concentration levels to adjust doses , prevention of renal toxicity damage.
2 fungal and protozoal infections
Oral Candida albicans infection is more common, effective Nystatin topical application . Pulmonary histoplasmosis Aspergillus and more severe infections caused by fungi , cryptococcal meningitis caused by these infections with 5 - fluorocytosine (5-FC) , or amphotericin B effective , but before treatment should first clear pathogens. Pneumocystis carinii pneumonia is more common in protozoan infections diagnosed biopsy needs to be done , can trimethoprim -sulfamethoxazole and methylisoxazole mixture (Co-trimoxazole) treatment. Toxoplasma protozoosis , Ramsey giardiasis caused by infection in transplant patients Pu reported.
3 virus infection
Due to the lack of effective anti-viral agents , so very difficult to deal with a virus infection. Virus rejection increase may be the result of increasing the antigenicity of transplanted organs .
( 1 ) CMV (cytomegalovirus, CMV): CMV infection is a common problem in transplant unit , the incidence varies greatly , many transplant centers consider allogeneic renal transplant recipients CMV infection rates over 70 %, although the majority of cases, no symptoms , CMV can be very serious, is a major cause of death. In CMV -negative by kidney donors , or if kidney donors are CMV negative blood transfusion before , its incidence can be reduced. Often a month of onset , clinical features are fever and lung infection symptoms , leukopenia after transplantation , decreased platelets , increased by a serum diagnostic test CMV titer , or isolate the virus and determined . CMV spread to the bladder as urine culture by the virus , can be found in the biopsy specimens of the virus , this infection is self- limiting, the need for adequate public support treatment, most patients can resume . However, increasing the chance of opportunistic infections in patients with a reduced white blood cells , may be secondary to bacterial , fungal infection. In severe cases, immunosuppressive therapy to disable or abandon the transplanted organ , so that patients have the opportunity to recover. Other lung infection caused by viruses , including influenza , parainfluenza virus and other respiratory sensitive .
( 2 ) skin herpes and papilloma virus infection : pathogenic people often great pain , herpes lesions also spread to a large area of ​​skin and nerve involvement , early application of iodine glycosides (Idoxuridine) is valid. Warts caused by HPV can be spread to the anus and genitalia , treatment is more difficult , and easy to relapse .
( 3 ) caused by the varicella-zoster Varicella : transplant patients can cause serious problems , extensive skin lesions can lead to meningitis or encephalitis , localized lesions of the blister with iodine glycosides effective , systemic reactions , if any , can be applied adenosine (Adenosine arabinosid).
In the early 1970s, due to the prevalence of viral hepatitis caused by the death of some of hemodialysis and transplant unit staff or patients, staff outbreaks of infection in the liver due to the formation of the antigen - antibody complex, resulting in progressive liver failure. To patients and staff of the routine examination of hepatitis B surface antigen (HBsAg), kidney and blood products and people were screened for hepatitis B to reduce the occurrence of great help . HBsAg positive patients should be given specialized machines hemodialysis , peritoneal dialysis , or switch to CAPD law . HBsAg positive patients for transplantation should be performed after systemic stable condition . Preoperative take certain measures to protect patients and surgery.
(B ) a lot of cardiovascular disease in patients with advanced renal failure have extensive atherosclerosis , while in case of hyperparathyroidism, may be associated with vascular calcification , surgery is more complicated. Smoking is detrimental disease , transplant patients should stop smoking.
1 hypertension in hypertensive patients with myocardial infarction risk of accidents and cerebral blood vessels, care should be strengthened after transplantation .
Kidney damage, especially renal ischemic changes , the activation of the renin - angiotensin system , so in many patients with chronic renal failure have a tendency to high blood pressure , and so far , although many effective drugs to control high blood pressure , but there are still some patients underwent bilateral nephrectomy need to be satisfied with blood pressure control . Kidney transplant has little effect on blood pressure , pre- transplant patients with normal blood pressure , hypertension may occur after surgery , which is due to the application of cortisol caused by immunosuppressive drugs . The sudden rise in blood pressure after transplantation may also be a sign of rejection , but need to be combined with other clinical manifestations of judgment . When high blood pressure can cause severe chronic renal allograft rejection or become small kidney fibrosis , this time should also consider whether the possibility of renal artery stenosis .
Postoperative hypertension can give to diuretics and β -blockers . If first-line drugs can not control blood pressure, should be added with vasodilator drugs such as hydralazine or prazosin (Prazosin). In seriously ill patients have to use angiotensin-converting enzyme inhibitors - sulfur methylmalonic proline (Captopril).
2 ischemic heart disease severe ischemic heart disease is a contraindication for transplantation , such as a recent heart attack patients should be appropriately delayed surgery. Myocardial infarction is one of the main causes of death after the transplant , but low dose steroid therapy for myocardial infarction with improvement.
3 arteriosclerotic peripheral vascular disease iliac vessels tend to cause difficulties on the surgical procedure , it is best for patients over the age of 50 in the preoperative angiogram . Side renal artery and external iliac artery anastomosis can cause external iliac artery stenosis , caused limb blood disorder, at the time of agreement , the external iliac artery only for simple cut , even Cprrel patch application method is also not the removal of part of the arterial wall . Pulse in the lower extremity transplant surgery should always check . Transplanted limb ischemia symptoms often indicate an impending blockage iliac vessels will lead to renal infarction. In this case , you should make an emergency angiography.
(C ) gastrointestinal complications
1 duodenal ulcer steroid immunosuppressive drugs often cause gastrointestinal ulcers applications . So two weeks after transplant patients should consider the application of antacid medications or applications H2 blockers . There is a history of duodenal ulcers and internal examination positive, while waiting for kidney transplants before , you should do first vagotomy and pyloroplasty , or highly selective line vagotomy . Ulcers occur when the patient after transplantation , clinical symptoms rarely , but can occur suddenly bleeding , black stools , or perforation. Postoperative patients complained of dyspepsia , endoscopy should be performed , if esophagitis, when gastric erosions, shallow ulcers and other manifestations, should give cimetidine or ranitidine (Ranitidine) and other drug treatment.
2 diverticulosis diverticulosis recipients are over 50 can become a serious problem. Acute diverticulitis can cause perforation or peritonitis. In the case of application of immunosuppressive drugs significantly increased its incidence . Peritonitis after surgery should be actively treated colon involvement loop to external fistula or be removed. Transverse colostomy simultaneously left iliac fossa drainage is an effective measure. To deal with this situation in a timely manner to avoid causing consequences.
(D ) endocrine abnormalities
1 hyperparathyroidism parathyroid hyperplasia produce too much parathyroid hormone, are common in patients with chronic renal failure in . After a successful transplant , tend to return to normal parathyroid function . But in some patients the need to continue dialysis hyperparathyroidism may still have symptoms. Also hyperparathyroidism lead to vascular calcification, which not only cause difficulties on the surgical procedure , but also affect the postoperative patency . If there are postoperative clinical hyperparathyroidism , could take Iα- hydroxy cholecalciferol ( vitamin D3). If the line is invalid parathyroidectomy .
2 diabetes treated with steroids to make abnormal glucose tolerance , although not overt diabetes patients urine and blood sugar, but the performance as a latent diabetes . Therefore, all patients should be checked urine and, if abnormal, showing mild compared . Control diet or oral hypoglycemic drugs can be controlled. Diabetes leads to severe renal failure kidney transplant feasible , but the patients after treatment is more complex, the unit should have experience in handling .
3 pancreatitis and recurrent pancreatitis related to hormone therapy , fortunately low incidence . When this happens when the hormone to cyclosporin A, and be symptomatic treatment.
( Five ) malignant lesions
Is now recognized as the immune system plays an important role in terms of prevention of tumorigenesis . But its detailed defense mechanism is not clear , it may be the early discovery of abnormal cells in the body , and in its proliferation and carcinogenesis before its destruction. When the immune system is suppressed , the occurrence of certain types of cancer the opportunity to increase , the incidence of lymphoma in allogeneic transplant patients than the control population of the same age incidence 100 times , more successful after more transplant rejection fewer responders , the occurrence of tumors the more common opportunities , may be caused by excessive immunosuppression . Various tumors can occur , but the skin cancer, the most common lymphoid tumors , cancer accounts for approximately 1/ 3 . In Australia , New Zealand, skin cancer is a particular problem , the high incidence of post-transplant , mainly basal cell carcinoma, squamous cell carcinoma, and melanoma , which have a strong tendency to metastasis and local recurrence is easy . Treatment should be considered based on the patient's condition , such as lesions confined , may continue to use immunosuppressive drugs, such as the transfer has been stopped immunosuppressive therapy should be considered .
Complications ( six ) application cortisol preparations
Cortisol immunosuppressive drugs after transplantation led to a series of complications in play an important role in the use of small doses of cortisol or every other day dosing can reduce the incidence of complications.
( Seven ) avascular necrosis of bone
In the early stages of kidney transplantation , because the long-term , high-dose application of cortisol immunosuppressive drugs , there are many long bone destruction . Wherein the femoral head is the most common lesions , showed ischemic necrosis of the femoral head , the patient difficulty walking, pain. Often need to be hip arthroplasty , femoral implant exchange to restore the patient's walking function . Knee and shoulder offenders are usually involved, but these artificial joint implant exchange ineffective . Cortisol preparations can cause osteoporosis, vertebral compression fractures.
( Eight ) cataract
According to statistics, about transplant patients generally 1/4 subcapsular cataracts occur , but not many serious visual impairment occurs . Minority who are causing serious consequences retinitis occurs, it can lead to blindness .
(Ix ) changes in the skin
Cushing faces class can appear , accompanied by acne, thinning of the skin loses its elasticity, the skin subjected to the creation of difficult to heal . In particular, the anterior tibial skin , post-traumatic necrosis and chronic ulcers can form a so-called transplant legs. This will not only extend the date of hospitalization , and severe cases require skin grafting treatment.
( Ten ) cortisol mental symptoms

Psychiatric symptoms after transplantation may have disorientation, hallucinations, paranoid delusions, but these symptoms may also , anesthesia , surgery, or patients with excessive stress and environmental factors are caused by metabolic factors . When the hormone reduced to a maintenance dose , the patient into a normal environment , psychiatric symptoms may subside .

Lupus nephritis serious?

Lupus nephritis serious? Lupus nephritis have a lot of harm to us. Lupus nephritis patients, 70% of the right and left kidney damage will occur, the time appears only different. Generally, lupus renal injury relatively late, mostly in lupus onset six months appear to 2 years. But there is also a lupus kidney disease begins as edema, proteinuria were. So we must be alert to the advent of lupus erythematosus nephropathy after diagnosis should be some strict attention to signs of kidney damage and performance.
Lupus patients with kidney disease about 1/6 when diagnosed with varying degrees of renal function decline. Lupus kidney damage is divided into:
① nephritic syndrome type, similar to acute nephritis
② nephrotic syndrome type, apparently swollen, large amounts of protein in the urine, hypoalbuminemia
③ chronic nephritis, renal dysfunction type, similar to chronic glomerulonephritis with edema, proteinuria, hematuria, hypertension, persistent, accompanied by anemia, impaired renal function, can occur in a relatively short period of uremia.
④ radical type, the patient's condition has developed rapidly, high fever, proteinuria, hematuria, increased red blood cell casts, sharp decline in renal function.
? Lupus nephritis serious yet, experts say, lupus nephritis is very serious, in everyday life we ​​must do the following care measures:
(1) whether acute, chronic active lupus nephritis, lupus kidney or renal insufficiency and failure stage, should stay in bed. When control of disease activity and remission, chronic lupus nephritis recovery, may be appropriate activities.
(2) to give low-salt, low-fat diet, limit protein intake, protein supplements should be given to the body lean meat, milk and other high-quality protein, eat beans and other vegetable proteins. Use of hormones elevated blood sugar, give sugar diet.
(3) severe edema and oliguria, pay attention to nutritional supplements and water, electrolyte, acid-base balance, accurate input required by your doctor or oral liquid medicine.
(4) recorded 24 hours of access to water, close observation of urine, edema, severe body weight twice a week, said, ascites volume once every three abdominal circumference.
(5) with hypertension, regular monitoring of blood pressure.
(6) to prevent infection, and oral and skin care, all disposal strict aseptic technique.
(7) renal failure, renal care by conventional treatment.

Lupus nephritis serious? Through some of the above brief introduction, I believe we have a certain understanding, then we must pay more attention in the usual time, prevent the occurrence of kidney disease, so that they have a healthy body!

What is the treatment of elderly people with diabetes should pay attention to

Note what diabetes treatment, many patients with diabetes, not just adults, the elderly, some young people suffering from diabetes because their body is weak, so it is more necessary in the treatment of attention, Xiao Bian explain to you what a treat older people with diabetes should pay attention to?
First, avoid strong choice for the role of antidiabetic drugs, mostly elderly diabetic patients with type 2 diabetes, the majority of mild, if diet and exercise alone who fail treatment, the choice of oral hypoglycemic agents, to avoid strong role and the role of choice long duration of hypoglycemic agents, in order to avoid low blood sugar.
Second, the low efficacy of oral hypoglycemic agents use insulin for treatment of elderly patients with diabetes long, if you already appear to reduce the efficacy of oral hypoglycemic agents or have significant complications of diabetes, insulin should switch as soon as possible.
Third, pay attention to check liver and kidney function, the choice of antidiabetic drugs, to consider whether the elderly suffering from liver and kidney related ailments, medication process, we should pay attention to check liver and kidney function.
Fourth, be careful of low blood sugar, low blood sugar tolerance for the elderly poor, the consequences are serious, blood sugar control standard than the average person loose some. Because hypoglycemia at night easier, so the elderly have to sleep at night before a test to measure blood sugar, if this blood glucose less than 6 mmol / l, it is necessary snacks, such drink milk and eat two or three cookies, prevent hypoglycemia. Usually, especially when a large amount of activity, the elderly have to carry a little biscuit, candy, snacks, etc. Once dizziness, palpitations, hunger, unresponsive and discomfort, to quickly eat candy, cookies, etc., while paying attention to sit rest, beware of hypoglycemia.
Fifth, under the guidance of antihypertensive and lipid lowering medical treatment to lower blood sugar before bedtime snacks to prevent hypoglycemia. Diabetes blood glucose lowering treatment not less, there will be more down the risk of hypoglycemia. A persistent low blood sugar also causes vasoconstriction, thereby causing serious damage to fall, trauma, fractures, severe and even be fatal. Especially for the elderly, low blood sugar will be greater harm, because their body functions degraded, do not feel sharp, often caused by low blood sugar coma until, when syncope was found, but this time has been very serious condition a.

Pay attention to what diabetes does, by explaining small series, we learn what it? Xiao Bian explained, are from the patient's point of view, in order to enable patients to treatment can be more confident, elderly diabetic patients can hope for better treatment of diabetes.

Chronic renal failure will lead to what disease ?

kidney-arabic@hotmail.com
Often complicated by high blood pressure , anemia , heart failure, pericarditis , cardiomyopathy , utilities and acid-base balance disorders , renal osteodystrophy , fractures, infections. In addition to the above complications , the long-term dialysis chronic renal failure who also have the following complications:
1 aluminum toxicity of conventional dialysis patients with ESRD complicated aluminum poisoning. Many causes of chronic renal failure in hemodialysis patients regularity aluminum poisoning , including: excessive dialysate aluminum content . When the aluminum content of the dialysate close to 50μg / L, a high incidence of aluminum-related bone disease . Therefore, the authors recommend at least dialysate aluminum content should be less than 10μg / L, preferably less than 5μg / L. The kidney is the only way to rows of aluminum , chronic renal failure, when the absorption of aluminum accumulation in the body caused the aluminum poisoning.
End-stage renal disease patients excretion of aluminum is blocked, more heavy accumulation of aluminum in the body , so that the aluminum content of the body can be 20 times higher than normal . Most organs of aluminum accumulation as bone, liver , and spleen . Increased bone content of aluminum and aluminum poisoning , can cause the aluminum -related bone disease.
Aluminum deposited mainly in calcified bone edges that are not mineralized bone and bone mineralization of young interface , causing osteomalacia . Osteomalacia histological changes in the severity and extent of deposition of aluminum edge -related bone calcification . And aplastic bone disease osteomalacia may be a prelude to aluminum caused . Aplastic bone disease was first reported in 1982, a renal osteodystrophy . Now that this is peritoneal dialysis patients with chronic renal failure , a major bone lesions. Some cases are caused by the excessive accumulation of aluminum , but the excessive suppression of parathyroid hormone may be a more important reason. PTH has an important role in maintaining normal bone metabolism . Parathyroid hormone may be transported by increasing bone mineralization and prevent the deposition of aluminum on the front edge , and parathyroidectomy on the occurrence of aluminum-related bone disease is a risk factor that can reduce bone formation rate and update rate so that the edge of the aluminum accumulation in bone calcification , thus interfering with the process of bone mineralization . Clinically, in patients with secondary hyperparathyroidism consider doing before parathyroidectomy aluminum-related bone disease should be excluded because of lower parathyroid hormone levels in patients with osteomalacia deposited aluminum can accelerate coexist in the bone and accelerates the aluminum -related bone disease occurs.
Last reported incidence of aluminum-related bone disease was as high as 15% to 25 %. In recent years , due to the restrictions on the use of aluminum-containing noticed phosphorus binders and improved dialysis treatment , the incidence rate has decreased significantly.
Clinical manifestations of aluminum-related bone disease is extensive bone and joint pain , can be positioned at the back, hips and ribs. Proximal muscle weakness , recurrent fracture is common in the ribs, neck , spine and femoral shaft , can be manifested as bone deformation . These symptoms reflect the content of aluminum in the synovial cavity .
Although aluminum-related bone disease in patients taking aluminum-containing formulations in patients with chronic renal failure , but the incidence of diabetes greater risk , which may be related to bone formation rate than normal about . Type 1 diabetes occurs before clinical diabetic nephropathy decreased bone formation rate that is , the reason is unclear, but the plasma parathyroid hormone levels in these patients is often low.
Aluminum-related encephalopathy early manifestation of intermittent language barriers , dyspraxia , late manifested as persistent language barriers , flapping wing tremor , myoclonus , seizures, personality changes, disordered thinking , disorientation, progressive dementia and aphasia . EEG dominant rhythm mild bradycardia .
Laboratory examination revealed anemia and other clinical manifestations of secondary aluminum poisoning caused by reversible small cell hypochromic anemia , iron supplementation does not improve , one of the reasons is too much aluminum can interfere with the absorption of iron . Treatment with recombinant human erythropoietin response has been poor , after correcting aluminum toxicity with deferoxamine can restore the efficacy of recombinant human erythropoietin for anemia .
Radiographic features of loose belt or pseudo fractures. True ribs and hip fractures and vertebral compression fracture is more common in patients on dialysis osteomalacia and less seen osteitis . There osteomalacia chronic uremic patients may also suffer from secondary hyperparathyroidism , therefore , may coexist with changes in bone erosion osteomalacia .
Bone histology osteomalacia is not excessive osteoid mineralization is characterized , this change is due to bone disorder caused by a protein matrix mineralization . The main change is not mineralized osteoid widened. Osteoid mineralization delay due to a certain extent, can also occur when the change osteitis . Therefore, the need to identify the damaged tetracycline mark mineralization rate. Maloney staining with aluminum can be found in most of osteomalacia in dialysis patients have a lot of aluminum deposition in bone . Most aplastic ( or lack of sexual power ) bone disease caused by aluminum poisoning, similar performance and osteomalacia , the main difference is that it does not have a big bone osteoid seam .
Bone biopsy is the gold standard for the diagnosis of aluminum poisoning , but not as a common means of diagnosis. By atomic absorption spectroscopy of plasma aluminum content can be accurately measured , but only the plasma levels reflect recent aluminum aluminum load , whether or not reflect toxicity of aluminum , because the aluminum concentration in plasma is not closely related to the storage tissue of aluminum. However , plasma levels of most aluminum aluminum-related bone disease patients was significantly higher ( i.e. > 75 ~ 100μg / L, normal <10μg / L). If the patient long-term contact with aluminum , aluminum levels in plasma and increased significantly (more than 150 ~ 200μg / L or more ) is very likely to occur aluminum-related bone disease , or encephalopathy.
Has been recognized , the test deferoxamine (DFO) is a diagnostic aluminum toxicity related diseases reliable indicator . Commonly used method is deferoxamine 40mg/kg, within half an hour after dialysis intravenous infusion, measured the pre-dialysis ( not given before deferoxamine ) and before the next dialysis ( 44h post- dose ) serum aluminum levels , difference between the two > 150μg / L or > 200μg / L as positive .
2 dialysis-related amyloidosis dialysis-related amyloidosis (DRA) is a long-term dialysis patients seen in bone and joint disease. The incidence of clinical symptoms and closely related to the length of time of dialysis . When dialysis is 0,12 5 years of 50% to 100% at 20 years . Amyloid deposition in the organization considerably earlier than clinical symptoms and radiological manifestations . It is reported that a group of prospective hemodialysis shorter than 2 years, the joint amyloid deposition rate of 21 %, 7 to 50 percent of those 13 years were 90% , more than 13 years by 100% .
( 1 ) in the pathogenesis :
① β2- globulin (β2-microglobulin, β2-M) deposition and other forms of amyloidosis as amyloid disease in bone cysts, and synovial tissue found in the Congo red staining , visible under a polarizing microscope apple green double refraction body . However, with primary amyloidosis , and fragments of immunoglobulin light chain amyloidosis secondary sediment serum A (amyloid A) is not the same , this disease amyloid protein mainly composed of β2-M , it is believed that β2 -M has a great affinity with collagen , is sufficient to explain the onset of the main sites of the joints and bones.
β2-M is a biocompatible type I antigen having a molecular weight of 11,800 . Available by glomerular filtration and is proximal tubular reabsorption and metabolism. Even at very low glomerular filtration rate of dialysis patients lacking this metabolic pathway by the very serious damage , resulting in a positive balance of β2-M while it increased plasma levels . β2-M 3mg/kg daily production was at or near 1500mg / week , standard fiber membrane can only remove a few β2-M, that the use of high permeability dialysis membrane can only be cleared <400 ~ 600mg / week β2-M. Peritoneal dialysis can remove 300mg / week β2-M.
Since DRA 8 rarely occurs before dialysis , dialysis and not all patients develop DRA, therefore , in addition to elevated plasma levels , there may be other factors involved in , for example, residual renal function , hemodialysis membranes , and the reaction inflammation , β2-M and other modified proteins while deposition.
② residual renal function : As long as there is a small amount of residual renal function , it is possible to maintain a certain amount of β2-M clearance and metabolism. Therefore , before the loss of renal function is not fully , it is possible to prevent the occurrence of DRA .
③ fiber membrane dialyzer properties : fiber membrane made ​​using standard hemodialysis porous fiber membrane than do dialysis plasma β2-M levels higher. Convection rate of high permeability membranes larger , and can be combined directly with β2-M, the lower the clinical use of high permeability dialysis membrane made ​​of bone disease and amyloidosis incidence of carpal tunnel syndrome . Type of dialysis membrane are also important factors . With cuprophane hemodialysis , in addition to low permeability , the patient 's peripheral blood mononuclear cells also increased β2-M . Poly (methyl methacrylate) film without activating complement not.
④ inflammatory response : studies show that with the expression of activated macrophages influx IL-I and TNF-β , along with severe amyloidosis lesions appear. These macrophage phagocytosis can not be sufficiently deposited in β2-M. Thus , the occurrence of destructive spondyloarthropathy may partly by the amyloid deposition and inflammation mediated reactions .
⑤ glycosylated β2-M: recently found that the presence of glycosylation β2-M in the wan amyloid deposits . This is a from 3 - deoxy- glucose (3-deoxyglucose) the modification of the activity of micro- globulin. By 3 - deoxy- glucose levels increased in serum of patients with uremia and dialysis , the patient may be more prone to renal failure β2-M modified . Amyloid deposits occur in the glycosylation by β2-M might stimulate the secretion of cytokines and as derived mononuclear cells was further promote these lesions. Pathogenic role of glycosylation β2-M can be prevented through the use of aminoguanidine , this preparation can inhibit advanced glycation end products .
While other proteins can promote the deposition of amyloid deposition material .
( 2 ) Clinical manifestations : The main clinical manifestations of DRA as carpal tunnel syndrome, bone cysts, spondyloarthropathy , pathologic fractures and joint swelling and pain , especially around the shoulder humeral joint inflammation seen . DRA is also a systemic disease , amyloid deposits are also found in skin, subcutaneous tissue , rectal mucosa , liver , spleen, and blood vessels.
① carpal tunnel syndrome (CTS): the most common symptoms. Common in hemodialysis after 8 to 10 years, more than nine years of dialysis by about 30% have this symptom .
② humeral joint inflammation around the shoulder : the shoulder is a common site to produce symptoms , leading to chronic back pain . DRA amyloid deposits seen in the subacromial bursa and synovial tissue.
③ exudative joint disease : more than 8 years of dialysis patients often exudative joint disease , which can occur with carpal tunnel syndrome. Exudate bilateral, especially seen in the knee and shoulder .
④ spondyloarthropathy : 10% to 20% of dialysis patients first symptom is pain in the neck . Damage seen in the cervical area, leading to the radial bone disease ; disc and spinal stenosis edge corrosion common ; may also occur under the notochord sclerosis , severe cases can lead to paralysis or infiltration through the epidural space leading to cauda equina compression. MRI can accurately find the extent of lesions.
⑤ bone disease : Typical performance for the end of a long bone bone cyst formation . Cystic lesions containing amyloid , which increases with time , may be associated with carpal , pathologic fractures of fingers , femoral and humeral head and acetabulum , tibial plateau and distal radius .
3 changes of trace elements renal failure and dialysis great impact on trace element metabolism , they accumulate in various parts of the body can cause toxicity.
( 1 ) Aluminum : See aluminum poisoning.
( 2 ) Copper: dialysis patients with chronic renal failure without making plasma copper levels are often normal , but can also be slightly lower. With cuprophane hemodialysis patients might accumulate copper , it is not observed the accumulation of any clinical impact . Copper may cause acute poisoning with a high copper content dialysate do hemodialysis . Clinical manifestations of high fever and severe hemolytic anemia. An increase in neutrophils may also occur , metabolic acidosis , pancreatitis , diarrhea and vomiting. In vitro , the red blood cells can lead to loss of contact with copper reduction glutamine , Heinz body formation increased their increased hemolysis , inhibition of glutathione reductase and glucose-6 - phosphate dehydrogenase reduce . Copper can also directly damage red blood cell membrane. When the pH of water is less than 6.5 , brass and copper parts inside can be filtered out , and therefore not suitable for use as dialysis water .
( 3 ) Zinc: eating a low -protein diet in chronic renal failure, nephrotic syndrome and massive loss of protein in urine is often very low plasma zinc content . It was reported that the zinc content of plasma and red blood cell levels in hemodialysis patients with certain zinc significantly increased , this may be because the zinc content in the dialysate than in plasma levels due to the filtrate . Now dialysate are used deionized water or reverse osmosis water content of plasma and tissue of patients with normal or low in zinc . Many patients taking ferrous sulfate can lead to poor absorption of zinc . Together with zinc in the dialysate may cause loss of zinc deficiency . If oral zinc supplements , preferably ferrous sulfate suspended in order to promote the absorption of zinc .

Zinc deficiency in hemodialysis patients can cause taste and smell diminish or disappear . Impotence and low plasma testosterone levels associated with high plasma levels of gonadotropins and progesterone have been attributed to the emergence of zinc deficiency, but the lack of definitive evidence. Preferably every six months on dialysis patients by atomic absorption spectroscopy of a plasma zinc levels . However , determination of plasma levels of zinc is just a rough indicator of zinc deficiency judgment , granulocytes and platelets in the determination of zinc is more sensitive than the plasma content. Children receiving regular hemodialysis growth retardation occurs should consider whether caused by zinc deficiency.

What do you know of diabetic nephropathy

Diabetic nephropathy (diabetic nephropathy, DN) is a serious and chronic complications of the biggest dangers caused by diabetes , glomerular sclerosis microvascular disease caused by diabetes caused , is characteristic of this disease . Is also a major cause of death in patients with IDDM . Diabetic patients with infectious diseases such as pyelonephritis, renal papillary necrosis, renal vascular disease such as atherosclerosis, is not a category of diabetic nephropathy. With the progress of diabetes treatment and technology, died of diabetes complications such as fewer patients with acute ketoacidosis , diabetes mellitus and cardiovascular disease and kidney disease has become the main cause of death in diabetic patients in recent years , resulting in residual reasons. Diabetic nephropathy occurs not only in type 1 diabetes. In recent years, found that Type 2 diabetes can also develop into diabetic nephropathy .
Signs and symptoms Edit this paragraph
Diabetic nephropathy insidious onset , slowly progressive , not much about the early symptoms of kidney disease . Early nephropathy and renal enlargement , glomerular filtration hyperthyroidism and microalbuminuria sustainable for many years , is not easy to be noticed , so most patients with diabetic nephropathy is significant proteinuria or party is aware of significant edema . The main clinical manifestations of this disease are as follows :
1 proteinuria of diabetic nephropathy is the first clinical manifestation , first as intermittent , after conversion to sustainability. By radioimmunoassay or micro albumin in urine albumin , earlier diagnosis can proteinuria , beneficial to control the disease.
2 diabetic nephropathy edema occurred more due to massive proteinuria and edema caused by this late stage has been developed to show that diabetic nephropathy . More associated with decreased GFR and other clinical manifestations of renal dysfunction , suggesting a poor prognosis.
3 hypertension appeared later . Multi- stage diabetic nephropathy when elevated blood pressure, diabetes may be associated with renal vascular resistance changes in the structure and function are closely related , in addition, sodium retention is one of the factors for hypertension . Hypertension can increase the development of worsening kidney disease and renal function , and therefore control of hypertension is essential.
4 anemia in patients with diabetic nephropathy significant azotemia , may have mild to moderate anemia. Anemia is a disorder of erythropoiesis , ineffective treatment with iron .
5 abnormal renal dysfunction intervals vary greatly from proteinuria appears to renal function, if diabetes is well controlled, multi proteinuria without renal dysfunction. If the control is not good , there will be azotemia , renal insufficiency. In addition , diabetic nephropathy is often accompanied by diabetic retinopathy.
From diabetic nephropathy progression to , and can be divided into five stages , diabetic nephropathy Danish scholar Mogensen will be divided into the following five :
A ( functional changes of ) : also known as the glomerular filtration rate or hyperthyroidism increased period of . Early diabetic glomerular filtration rate both increased , at this stage for several years . Gradually increased renal blood flow , increased glomerular filtration rate , serum creatinine and urea nitrogen is lower than normal . This period , kidney volume increased approximately 20% increase in renal plasma flow , creatinine clearance rate increased by about 40%, kidneys no histological changes . Glomerular filtration rate and renal volume , weight increase , increased glomerular and tubular volume related. Observation confirmed early diabetic glomerular filtration rate and renal plasma flow increased correlation . Diabetes, high filtration and afferent and efferent arteries artery contraction .
2 ( early glomerular lesions period ) : also known as resting phase , or normal albuminuria period . Often appear in insulin-dependent diabetes duration of 18 to 24 months. Period is characterized by glomerular structural damage occurs , the first is a mild thickening of the basement membrane , 2 to 3 years after the start of mesangial matrix expansion , 3.5 to 5 years of basement membrane thickening . This ultrafiltration still exists. Urine albumin excretion rate increases after exercise , is the only current clinical evidence.
3 ( recessive kidney period ) : or early diabetic nephropathy , often appear in the insulin- dependent diabetes mellitus 5 to 15 years. Current major damage to the glomerular basement membrane charge barrier . So that heparan sulfate and sialic acid constitutes the glomerular basement membrane components is reduced, then the corresponding decrease in negative charge , the charge barrier damage , albumin excretion . Urine protein was intermittent , somewhat heavier proteinuria and kidney function began to subside . This poorly controlled diabetes , tissue hypoxia, increased renal microcirculation filtration pressure related to or induced by the constant promotion of high blood pressure, high blood sugar , exercise, urinary tract infection and protein load. This period of glomerular filtration rate is still higher than normal , with the progression of the disease , urinary albumin excretion rate (UAER) and gradually increased fixed at 20 ~ 200μg/min, after the current phase of high blood pressure can occur .
4 ( diabetic nephropathy period ) : also known as persistent proteinuria or clinical stage diabetic nephropathy . Peak prevalence in the course of 15 to 20 years , 20 % to 40% of insulin- dependent diabetes to enter the , 24h urine protein > 0.5g, such measures are not taken , the glomerular filtration rate decreased rapidly.
This may have a lot of proteinuria , accompanied hypoalbuminemia, edema and hyperlipoproteinemia . Low albumin urinary protein loss in addition to outside hyperlipidemia , and diabetes itself insufficient protein and protein intake related metabolic disorders . Clinical plasma protein levels may also see the edema than the other causes kidney , which is due to changes in people with diabetes is albumin glycated albumin , which passes through the capillary membrane easier than normal albumin . Nephrotic syndrome caused by diabetes prognosis is more sinister , and rapid access to azotemia . Once azotemia , glomerular filtration rate , proteinuria often quickly reduced.
5 ( uremia ) : namely, end stage renal disease ( referred to as ESRD). Insulin- dependent diabetes mellitus in 30% to 40% develop in 20 to 30 years after the prevalence of end-stage renal disease, uremia appears manifestations and histological changes accordingly . Creatinine clearance rate is slightly higher than non- diabetics . According to statistics from insulin-dependent diabetes to enter clinical diagnosis of diabetic nephropathy an average of about 19 ​​years , persistent proteinuria to death an average of six years , with a total duration of about 25 years. In the United States and Europe has become the most important reason of diabetic nephropathy with end-stage renal failure requiring dialysis or a kidney transplant individual .
These diabetic nephropathy staging , three former patients no obvious clinical manifestations of kidney damage , kidney pathology can still be reversed , should be timely and effective treatment can prevent further development of diabetic nephropathy. So three formerly known as diabetic nephropathy and non- clinical stage . And upon entering 4 after kidney damage occurs not only in patients with clinical manifestations, pathological changes have been difficult to reverse , the progressive development of the disease , eventually entering uremia . Non- insulin-dependent diabetes know very little about the natural history of nephropathy due insidious onset , as well as the inclusion of factors such as hypertension and arteriosclerosis , half of the patients do not know that he is sick . Often due to occasionally check blood sugar or suffering from other diseases were found. This type of diabetes is estimated lower clinical nephropathy was 2.5 % to 10% , progression to end-stage renal failure five to 10 years, elderly patients compared to younger patients progress rapidly. Glomerular filtration often unsure of , an increase in non -insulin-dependent diabetic patients diagnosed in 20% to 37% has been fixed urine albumin excretion rate , such a high excretion rate of microalbuminuria and long-term misdiagnosis may related. Proteinuria and glomerular filtration rate may be normal during the years .
In addition , with regard to hypertension is more common in diffuse glomerulosclerosis , renal arteriosclerosis and renal failure . Part of tuberous sclerosis with mild diastolic blood pressure , early large fluctuations in blood pressure , increase was sustained after . Recent studies have found that diabetic kidney disease, with the increase in urinary protein excretion rate , increased kidney dysfunction , diabetes, blood pressure rhythm abnormalities are more obvious. Diabetic kidney disease resulting in nighttime blood pressure . Possible reasons are:
( 1 ) Shuinazhuliu : diabetic nephropathy patients with decreased renal blood flow , glomerular filtration rate , proximal tubular reabsorption of sodium and water increased, leading to sodium retention .
( 2 ) the relative nocturnal polyuria : increased pressure within the glomeruli nocturnal patients with diabetic nephropathy , renal hemodynamic abnormalities associated with circadian tube and balance disorders , manifested as nocturnal polyuria .
( 3 ) patients with diabetic nephropathy kidney autonomic dysfunction : autonomic nervous system dysfunction may aggravate renal blood flow abnormalities on the one hand by increasing glomerular transmembrane hydrostatic pressure , on the other hand is also involved in the occurrence of sodium and water balance disorders , thus affecting the circadian rhythm of blood pressure .
2 drug treatment edit this section
Treatment of diabetic nephropathy treatment should be comprehensive , emphasizing prevention and early treatment. Should have such a concept that when patients with diabetes , in the treatment of diabetes , we must consider the prevention of diabetic nephropathy. Positive control of blood glucose , urinary albumin excretion rate checked regularly to control blood pressure, reduce urinary protein excretion .
1 . The control of blood glucose in diabetic nephropathy occurs affected by many factors , including high blood sugar is extremely important factors . The relationship between hyperglycemia and diabetic nephropathy is self-evident , experimental and clinical studies have confirmed good blood glucose control can significantly reduce the incidence of diabetic nephropathy. Therefore , control of blood glucose is essential. Numerous clinical and animal experiments show that in diabetic renal hypertrophy and hyperfiltration state , the timely control of blood glucose , corrected metabolic disorders, renal hypertrophy and hyperfiltration state can be partially restored. Diabetic nephropathy increased glomerular filtration rate and elevated glycated hemoglobin is consistent . Therefore, controlling blood sugar is the basic treatment for diabetic nephropathy . Treatment should take diabetes education, diet , adequate exercise , medication and blood glucose monitoring and other means , as much as possible so that near-normal blood glucose control . If strive to make glycosylated hemoglobin < 7% , fasting plasma glucose <6.0mmol / L, 2h postprandial blood glucose <8.0mmol / L, taking care to avoid hypoglycemia . The main measures include diet therapy and medication.
( 1 ) dietary treatment of diabetic nephropathy : Diabetic nephropathy diet therapy has its particularity, the total calorie intake should be determined according to the patient height, weight and activity level . Nutritional composition , and pay special attention to protein intake. Diabetic nephropathy , glomerular filtration in the high state , high -protein diet will make this high filtration state continues , aggravating change glomerular hemodynamics. Therefore, it is advocated in the early stage of diabetic nephropathy to limit the intake of protein. Hoping to lighten the load of glomerular filtration . General 0.8g / (kg · d) of the protein is more appropriate. To have entered clinical stage , patients with edema, proteinuria , renal damage , shall in accordance with endogenous creatinine clearance rate to arrange protein intake . Patients must be of high quality protein intake of protein , essential amino acids that high levels of animal protein -based.
( 2 ) Select diabetic nephropathy oral hypoglycemic drugs should consider their metabolic pathways : glibenclamide ( glyburide ) , gliclazide ( gliclazide ) of the active metabolite is mainly excreted by the kidneys. Renal dysfunction, easily lead to low blood sugar, unfit for use. Gliquidone ( Gliquidon ) is mainly metabolized in the liver , only approximately 5% excreted by the kidney, renal insufficiency , the use of more secure , and high-dose range used as the drug of choice in patients with diabetic nephropathy . Glipizide ( glipizide ) part metabolites excreted by the kidneys , but the activity is weak, are unlikely to cause low blood sugar reactions , safer. Biguanide oral hypoglycemic drugs already in clinical proteinuria of diabetic nephropathy should not be used because it is excreted unchanged in the urine , could easily lead to the accumulation of lactic acid caused lactic acidosis. For with diet and oral hypoglycemic agents in diabetic nephropathy patients with poorly controlled , insulin as soon as possible to postpone , delay the onset of diabetic nephropathy and development. It should be emphasized that, for patients with significant renal impairment , taking into account the extension of the half-life in blood insulin , followed by patients with anorexia, eating less , these need to be refined to insulin dosage adjustments, frequent monitoring of blood glucose, avoid low glucose occurred.
Note also improve insulin resistance, reduce hyperinsulinemia. Diabetic patients often due to the presence of insulin resistance and hyperinsulinemia improper treatment caused lasting hyperinsulinemia can stimulate the arterial wall smooth muscle and endothelial cell proliferation ; increased hepatic LDL produce , promote arterial wall lipid calm ; damage endogenous fibrinolytic system such as stimulation of the endothelial cells produce inhibitors of plasminogen , and promote thrombosis ; term hyperinsulinemia can increase blood pressure and the onset and progression of weight gain can be accelerated atherosclerosis. In addition to reducing hyperinsulinemia appropriate use of oral hypoglycemic drugs, trace elements such as vanadium and chromium supplements may also increase insulin sensitivity.
In recent years, found that drug rosiglitazone thiazide TZDs as antidiabetic drugs . Its hypoglycemic effects include decreased plasma glucose and insulin levels , improve glucose tolerance ; decreased plasma triglycerides and free fatty acid levels ; reduce the role of hepatic gluconeogenesis and stimulate adipose tissue and skeletal muscle glucose uptake . Insulin resistance is better drugs .
Moreover, according to recent findings in diabetic non-enzymatic glycation end products (AGE) has an important role in the development of diabetic nephropathy , diabetic nephropathy using AGE inhibitor therapy .
① aminoguanidine : an AGE inhibitor, which under high glucose conditions can also be effective in preventing or inhibiting AGE AGE generating activity . Aminoguanidine competition through a combination of glucose and protein macromolecules , selective inhibition of non-enzymatic glycation of proteins formed early products. According to the research , but also to prevent NO activation aminoguanidine adjust early diabetic vascular dysfunction.
② aldose reductase (spirohydantoin): clinical observations preventing diabetic retinopathy , peripheral neuropathy, and nephropathy mild and slow onset . Due to the use of a short time, do not use a wide range of objective assessment to be made ​​.
2 Control Hypertension Hypertension is the occurrence of kidney patients with impaired renal function , the main factor in development, but is controllable factor. The same is true for diabetic nephropathy . Hypertension in the development of diabetic nephropathy play a very important role , therefore , control of hypertension , is the key to delaying the development of diabetic nephropathy . To limit the control of hypertension in patients with first intake of sodium , while smoking , drinking, weight loss, proper exercise , which is the basis of treatment.
Now generally believed that patients with diabetic nephropathy blood pressure should be controlled at 17.5/11kPa less. Relevant data show that blood pressure dropped from when 21.3/12.7kPa 18.0/11.3kPa, urinary protein excretion was significantly reduced, the rate of decline in glomerular filtration rate dropped from a monthly 1ml/min monthly 0.35ml/min, in patients with diabetic nephropathy survival was significantly prolonged antihypertensive treatment before l0 -year cumulative mortality rate was 50% to 70 % and 18% after treatment . Clinical studies have confirmed an effective antihypertensive treatment can prevent or significantly delay the onset of many chronic diseases and the development of diabetes . Studies have shown that active antihypertensive treatment can slow the progression rate of clinical diabetic nephropathy , especially in the blood pressure began to rise yet reached clinical hypertension is more obvious when , antihypertensive therapy should be to reduce mean arterial pressure , restore circadian blood pressure and reduce glomerular internal pressure .
Choice of antihypertensive drugs , angiotensin converting enzyme inhibitors currently preferred , it can reduce urinary excretion of protein , slowing the rate of decline in kidney function . The mechanism is :
( 1 ) reduced glomerular capillary pressure, thus correcting high filtration state also reduced proteinuria, ACEI can also believes that the recent improvement in the selectivity of the glomerular capillary filtration effect .
( 2 ) inhibition of cell growth factors such as transforming growth factor- β like activity, and improve glycemic control and may increase insulin sensitivity in skeletal muscle .
( 3 ) reduced mesangial cell phagocytosis of macromolecules , thus reducing the inter mesangial cell proliferation caused by proteinuria and tubulointerstitial fibrosis.

( 4 ) promote the degradation of matrix metalloproteinases that part of the extracellular matrix degradation has been formed . ACEI role not only for the buck , but not in patients with diabetic nephropathy with hypertension should also apply , and easy to medication, its main side effect is cough. Currently, the popular use of angiotensin -converting enzyme inhibitors (ACEI) long-acting formulations .

Medical polycystic kidney stones how dirty the contralateral abdominal pain

Patients who were suffering from kidney resection and bladder tuberculosis after anti-TB treatment may gradually improved, but because these patients compared with severe bladder tuberculosis, often easily lead to bladder contracture. Shall be used to expand the capacity of the bladder approach to governance. Common ways to expand the capacity of the bladder or kidney back sigmoid junction kidney bladder augmentation, bladder augmentation due back renal hematuria and more mixed with postoperative urine.
(1) dirty polycystic kidney stones treatment: usually required in the implementation of the kidney with glucocorticoid matter resection. Polycystic kidney stones dirty contralateral pain Description: contralateral kidney polycystic kidney pain is dirty stones late complications caused by a bladder tuberculosis. According to statistical data of the country in 1959, 1,334 cases of polycystic kidney stones dirty cases of secondary contralateral abdominal pain (16%) in 1962, 4,748 cases of polycystic kidney stones dirty cases accounted for 13.4 abdominal pain secondary to contralateral %.
(2) bladder tuberculosis treatment: patients who were suffering from kidney resection and bladder tuberculosis after anti-TB treatment may gradually improved, but because these patients compared with severe bladder tuberculosis, often easily lead to bladder contracture. Shall be used to expand the capacity of the bladder approach to governance. Common ways to expand the capacity of the bladder or kidney back sigmoid junction kidney bladder augmentation, bladder augmentation due back renal hematuria and more mixed with postoperative urine. Complicated urinary tract kidney cysts, and in the long-term follow-up in the back of renal dilatation affect emptying, so are currently using sigmoid junction kidney bladder augmentation. If you need to perform concurrent bladder contracture urethral stricture urinary diversion, such as ostomy ureter, bladder straight kidney surgery, back surgery, such as kidney bladder.
(3) dirty polycystic kidney stones and abdominal pain governance has problems: dirty polycystic kidney stones and abdominal pain governance has decided to abdominal pain and impaired renal function procedures and must remove the obstruction of urgency. In general cases, such as renal function better, should be in coordination with the glucocorticoid substance suffering first nephrectomy, the patient improved further after the treatment of abdominal pain. Such as severe abdominal pain, poor kidney function, or secondary to inflammation, should be in coordination with the glucocorticoid substance nephrostomy first water side, the situation improved after the line to be patient suffering from kidney resection.

(4) kidney and ureter water governance: kidney and ureter water governance depends on the disease caused by the water. When governance is the most critical issue whether the bladder contracture. Such as bladder contracture, a disease caused by obstruction of the urethra lose lower ureteral stenosis or stenosis, the rule is simple, the effect is better. Who may be mild ureteral dilatation cystoscopy. When severe stenosis may be cut or ureter ureteral orifice surgery replanting. If you adapt for bladder contracture sigmoid junction kidney bladder augmentation, while the ureter to the renal tubular graft.