First, the etiology and pathogenesis
( - ) Pre-renal azotemia
1 , decreased intravascular volume causes bleeding , gastrointestinal loss, dehydration , excessive diuresis .
2 , in the case of systemic vascular resistance sepsis , allergic reactions , anesthesia , reduce cardiac afterload drug use . Angiotensin- converting enzyme inhibitors, non-steroidal anti-inflammatory drugs , epinephrine , norepinephrine , narcotics and cyclosporine can cause , such as glomerular filtration rate decline.
3 , inadequate cardiac output resulting in lack of effective circulating volume cardiogenic shock , congestive heart failure , pulmonary embolism , cardiac tamponade caused by decreased renal perfusion .
(B ) post-renal azotemia
Include urethral obstruction , bladder dysfunction or obstruction, ureter or renal pelvis obstruction. An enlarged prostate , bladder , prostate or cervical cancer , retroperitoneal fibrosis or neurogenic bladder can lead to urinary tract obstruction .
Less common causes include bilateral ureteral calculi , urinary stones and renal papillary necrosis. In isolated human kidney , urinary tract obstruction can cause unilateral renal azotemia .
(C ) Renal ARF
1 , glomerular disease rapidly progressive glomerulonephritis , glomerulonephritis and severe infection after nephrotic syndrome with ARF.
2 , the pathological manifestations of acute interstitial nephritis interstitial inflammation with edema and renal tubular damage.
Mainly caused by drugs, and other causes include infectious diseases, autoimmune diseases or idiopathic .
3 , ischemic etiology of acute tubular necrosis and poisoning.
4 , renal vascular disease is rare
(D ) the occurrence of chronic renal insufficiency on the basis of ARF
Chronic renal disease with acute interstitial nephritis , diabetic nephropathy with contrast-induced nephropathy , glomerular disease after application of various ACE cause prerenal ARF
Second, the clinical manifestations
Were divided into oliguric and non- oliguric .
High resolution type ARF: tissue catabolism fast , blood urea nitrogen and serum creatinine were daily > 14.3mmol / L (40mg/dl) and > 170umol / L (2mg/dl) annually.
1 , prerenal azotemia , oliguria , elevated blood urea nitrogen
2 , post-renal azotemia suddenly interrupted urine or no urine without
3 , renal parenchymal involvement may be due to different parts were mixed .
(1) RPCN with rapidly progressive glomerulonephritis syndrome.
( 2 ) oliguric ATN typical oliguria , polyuria and recovery .
(3) AIN drug-induced more than a medication history, minorities have a history of allergies . Performance with interstitial tubular dysfunction , such as the decline in renal function is not parallel with anemia , low blood potassium , blood sugar normal and positive urine and acidosis .
( 4 ) ARF malignant renal vascular hypertension, one or both macrovascular (
Third, diagnosis and differential diagnosis of acute and chronic renal failure
1, ARF is composed of a variety of reasons so that the two rapid decline in renal excretory function in the short term , increasing the average daily serum creatinine ≥ 44.2umol / L.
2 , and further identified as oliguria , non- oliguric or high resolution type ?
3 , note the following points : ① the use of diuretics can increase urinary sodium excretion , so at this time can not rely on urinary sodium excretion and fractional excretion of sodium as a diagnosis ; ② who have diabetes and proteinuria or mannitol , dextran or contrast after the agent can make the urine specific gravity and urine osmolality , and should not be used as a diagnostic basis.
4 , should also be excluded chronic renal failure. Application B- measure kidney size and nail creatinine measurements help identify acute and chronic renal failure. B- kidneys is not small , thin renal parenchyma thickness not support acute renal failure. Nails represent the patient's serum creatinine serum creatinine level three months ago , so if the normal creatinine nails also supports the diagnosis of acute renal failure .
5 , renal biopsy is the gold standard for the diagnosis of early implementation of emergency biopsy to confirm the diagnosis .
Fourth, the rule boils and prognosis
1 , treatment of pre-renal azotemia should first find the cause .
2 suspected ARF caused by renal obstruction, the catheter should be placed in the bladder . Increase the capacity of the bladder residual urine , or export a lot due to obstruction of urine retention .
3 , renal parenchymal ARF
RPCN immunosuppressive therapy ; after severe acute streptococcal glomerulonephritis should be supported mainly symptomatic , if necessary, can be applied to dialysis ; nephrotic syndrome with ARF should actively steroid treatment of nephrotic syndrome , dialysis may be supplemented , if necessary therapy.
ATN treatment is the key to disable the allergenic drugs , corticosteroids required when necessary.
ATN light treatment to support , symptomatic conservative therapy.
Malignant hypertension should be gradually actively buck . Early renal artery or renal vein thrombosis or embolism kidney disease correspondingly large thrombolysis and anticoagulation therapy.
2014年6月4日星期三
Forward after renal transplantation due to elevated serum creatinine What are the reasons ?
Chronic renal allograft dysfunction is most prelude graft dysfunction , although new immunosuppressive agents and infection control measures applied , making the loss of acute graft decreased significantly , but the loss did not improve long-term kidney transplant , kidney transplant patients currently face the main risk factors for : cardiovascular disease , cancer, infection leads to death and chronic allograft dysfunction leading to graft loss.
Chronic renal allograft dysfunction caused by many factors , common are the following:
1 , donor type ( live or dead body ) ,
2 , hot and cold ischemic time is too long
3 , there have been previous acute rejection ,
4 , advanced chronic rejection
5 , primary glomerular disease recurrence ,
6 , delayed graft function after recovery
7, BK virus-associated nephropathy
8, the transplanted kidney Doppler ultrasound , vascular resistance index (RI)> 0.80
9 , diabetes, hypertension,
10 histocompatibility antigen pair does not meet the elevated levels of reactive antibody
11 , subclinical rejection,
12 , poor patient compliance , treatment does not conform
13 transplant renal artery stenosis
14 renal transplant urinary tract obstruction
15 recipients of lower urinary tract obstruction
16 , nephrotoxic immunosuppressive
The above situation can cause chronic renal allograft dysfunction , so the above reasons for the identification of renal transplant protection is very important. Many reasons clearly need a transplant biopsy , so transplant biopsy is very important. Only by examining and even transplant biopsy to confirm the diagnosis and for treatment in order to achieve therapeutic effect, prolonging graft survival time.
Chronic renal allograft dysfunction caused by many factors , common are the following:
1 , donor type ( live or dead body ) ,
2 , hot and cold ischemic time is too long
3 , there have been previous acute rejection ,
4 , advanced chronic rejection
5 , primary glomerular disease recurrence ,
6 , delayed graft function after recovery
7, BK virus-associated nephropathy
8, the transplanted kidney Doppler ultrasound , vascular resistance index (RI)> 0.80
9 , diabetes, hypertension,
10 histocompatibility antigen pair does not meet the elevated levels of reactive antibody
11 , subclinical rejection,
12 , poor patient compliance , treatment does not conform
13 transplant renal artery stenosis
14 renal transplant urinary tract obstruction
15 recipients of lower urinary tract obstruction
16 , nephrotoxic immunosuppressive
The above situation can cause chronic renal allograft dysfunction , so the above reasons for the identification of renal transplant protection is very important. Many reasons clearly need a transplant biopsy , so transplant biopsy is very important. Only by examining and even transplant biopsy to confirm the diagnosis and for treatment in order to achieve therapeutic effect, prolonging graft survival time.
2014年6月3日星期二
What are the performance of renal failure ?
Renal failure is a variety of diseases leading to kidney dysfunction in general. It renal dysfunction , metabolic products retention, water, electrolyte and acid-base balance as the main performance . In the early renal failure , the patient may be no obvious discomfort, just check can be seen in creatinine clearance decreased urine concentration is poor, and so reduce the excretion of phenol red . Obvious clinical symptoms appear only when the development of severe renal insufficiency stage . Mainly in the following areas:
( 1 ) Gastrointestinal manifestations: when is the development of renal failure and uremia earliest and most obvious symptom , seen anorexia, nausea, vomiting, diarrhea or constipation , may also be gastrointestinal bleeding.
( 2 ) mental , neurological manifestations: listlessness, fatigue, weakness, dizziness, headache , memory loss, insomnia, irritability , foot burning, itchy skin , can occur late to lethargy, delirium , convulsions, coma.
( 3 ) the performance of the cardiovascular system : renal failure, often accompanied by high blood pressure , and myocardial damage , heart failure and uremia pericarditis , pericardial effusion.
( 4 ) the performance of the hematopoietic system : patients with difficult to correct anemia and easy bleeding, such as subcutaneous bruising, nosebleed , bleeding gums, gastrointestinal bleeding, or intracranial hemorrhage.
( 5 ) Other: Due to renal failure caused by acidosis, the patient may appear deep breath , dry skin, dull, nocturia , polyuria caused dehydration, electrolyte imbalance, acid-base balance disorders , infection , and even oliguria , edema , no urine and other serious conditions .
( 1 ) Gastrointestinal manifestations: when is the development of renal failure and uremia earliest and most obvious symptom , seen anorexia, nausea, vomiting, diarrhea or constipation , may also be gastrointestinal bleeding.
( 2 ) mental , neurological manifestations: listlessness, fatigue, weakness, dizziness, headache , memory loss, insomnia, irritability , foot burning, itchy skin , can occur late to lethargy, delirium , convulsions, coma.
( 3 ) the performance of the cardiovascular system : renal failure, often accompanied by high blood pressure , and myocardial damage , heart failure and uremia pericarditis , pericardial effusion.
( 4 ) the performance of the hematopoietic system : patients with difficult to correct anemia and easy bleeding, such as subcutaneous bruising, nosebleed , bleeding gums, gastrointestinal bleeding, or intracranial hemorrhage.
( 5 ) Other: Due to renal failure caused by acidosis, the patient may appear deep breath , dry skin, dull, nocturia , polyuria caused dehydration, electrolyte imbalance, acid-base balance disorders , infection , and even oliguria , edema , no urine and other serious conditions .
2014年6月1日星期日
Renal atrophy patients can recover if it can recover renal atrophy
Once the immediate onset of renal atrophy is a more serious illness , to people's lives has brought great impact study , many patients suffering from renal atrophy want to know whether to restore health , you know, a lot of patients for their disease often have a negative attitude. So small to give us a clear explanation , so we all know there is a bottom.
Long-term kidney disease , delayed healing , will lead to the occurrence of renal insufficiency . If renal atrophy renal insufficiency has entered the first two , azotemia . This period is reversible stage kidney disease . If you give a positive patients with early and effective treatment , the disease can be controlled. Symptomatic treatment and anemia , hypertension, fatigue and illness prompted progress , look great attention ! Should repair the damaged kidney tissue therapy treatment in the first place . to stop the progress of the disease , making the disease regression steady state . For patients with renal atrophy , this is a very important issue, I hope to give you a help in detoxification while symptomatic , should be used for their own treatment, the use of traditional Chinese medicine active substances, effective renal artery expansion at all levels , remove diseased tissue , repair damaged glomerular filtration barrier , increased glomerular filtration area, so that the lower serum creatinine and other toxins naturally , with the gradual recovery of renal function , a variety of symptoms have been alleviated , the condition can be recovery.
With the above understanding , the patient must have some understanding of renal atrophy common sense. As renal atrophy can restore health , it is necessary that we do early treatment, proper care, in order to have the possibility to restore health .
Long-term kidney disease , delayed healing , will lead to the occurrence of renal insufficiency . If renal atrophy renal insufficiency has entered the first two , azotemia . This period is reversible stage kidney disease . If you give a positive patients with early and effective treatment , the disease can be controlled. Symptomatic treatment and anemia , hypertension, fatigue and illness prompted progress , look great attention ! Should repair the damaged kidney tissue therapy treatment in the first place . to stop the progress of the disease , making the disease regression steady state . For patients with renal atrophy , this is a very important issue, I hope to give you a help in detoxification while symptomatic , should be used for their own treatment, the use of traditional Chinese medicine active substances, effective renal artery expansion at all levels , remove diseased tissue , repair damaged glomerular filtration barrier , increased glomerular filtration area, so that the lower serum creatinine and other toxins naturally , with the gradual recovery of renal function , a variety of symptoms have been alleviated , the condition can be recovery.
With the above understanding , the patient must have some understanding of renal atrophy common sense. As renal atrophy can restore health , it is necessary that we do early treatment, proper care, in order to have the possibility to restore health .
Introduction renal atrophy patient health knowledge
It should be noted in patients with renal atrophy daily life emphasizes attention to health care, but still have a lot of friends do not really recognize the problem , even a serious injury himself of the disease , and there is no life of their own unhealthy diet adjustments . In order to be able to let everyone truly recognize the problem , we look to experts about the health knowledge of renal atrophy .
Renal atrophy patients can eat green beans . This special effect related with green beans . First, the role of green beans detoxification pure heart . Second, green beans cool, sweet , refreshing and thirst can usually drink ; Third, because of its diuretic efficacy under the gas , thus poisoning the food or drink , acute nephritis , hot swollen, hot and thirsty, heat dysentery , ulcer, pox virus , rash , etc. have a certain effect . These effects are believed everyone understand in everyday life.
You might be familiar with the effectiveness of green beans , green beans , but the specific cooking method is a luxurious : the power of heat green beans in the skin, detoxification of reactive account. I did not need to drink to eat beans together , we can achieve a good refreshing effect. If it is for detoxification , the best beans boiled . Such bean soup muddy color , poor summer heat effect, but detoxification stronger. This is not even understand, cook green beans next time , you had better remember that science Beans .
Nor how tasty eating green beans seems , is not what other foods can be cooked together with other foods cooked with green beans , better efficacy, such as heatstroke can drink green bean soup Silver Flower : ? Lily Wash the rice washing clean , into the pot, add water, set Wuhuoshaofei , simmer Aozhi can be cooked into porridge ; mung bean soup melon : melon peeled and cut into small pieces wash , wash well with green beans into the pot , add water cook over low heat for about 1.5 hours , add sugar and mix thoroughly pan.
Green beans calories , protein , dietary fiber , calcium, iron , carbohydrates , phosphorus, potassium, magnesium , manganese, zinc , niacin, copper , vitamin E compared with similar food above average . So, green beans kidney disease diet is the best ingredients , the home must have. There are a lot of people also have a diet of mung bean , of course, of which there are some patients with kidney disease .
Renal atrophy of health care among the must adhere to their own lives, although experts point just above brief introduction , but if we can gain a better understanding of the words , to everyone 's health is of great significance .
Renal atrophy patients can eat green beans . This special effect related with green beans . First, the role of green beans detoxification pure heart . Second, green beans cool, sweet , refreshing and thirst can usually drink ; Third, because of its diuretic efficacy under the gas , thus poisoning the food or drink , acute nephritis , hot swollen, hot and thirsty, heat dysentery , ulcer, pox virus , rash , etc. have a certain effect . These effects are believed everyone understand in everyday life.
You might be familiar with the effectiveness of green beans , green beans , but the specific cooking method is a luxurious : the power of heat green beans in the skin, detoxification of reactive account. I did not need to drink to eat beans together , we can achieve a good refreshing effect. If it is for detoxification , the best beans boiled . Such bean soup muddy color , poor summer heat effect, but detoxification stronger. This is not even understand, cook green beans next time , you had better remember that science Beans .
Nor how tasty eating green beans seems , is not what other foods can be cooked together with other foods cooked with green beans , better efficacy, such as heatstroke can drink green bean soup Silver Flower : ? Lily Wash the rice washing clean , into the pot, add water, set Wuhuoshaofei , simmer Aozhi can be cooked into porridge ; mung bean soup melon : melon peeled and cut into small pieces wash , wash well with green beans into the pot , add water cook over low heat for about 1.5 hours , add sugar and mix thoroughly pan.
Green beans calories , protein , dietary fiber , calcium, iron , carbohydrates , phosphorus, potassium, magnesium , manganese, zinc , niacin, copper , vitamin E compared with similar food above average . So, green beans kidney disease diet is the best ingredients , the home must have. There are a lot of people also have a diet of mung bean , of course, of which there are some patients with kidney disease .
Renal atrophy of health care among the must adhere to their own lives, although experts point just above brief introduction , but if we can gain a better understanding of the words , to everyone 's health is of great significance .
Renal atrophy early or mid- how to care
Care for renal atrophy , experts also discussed more than once . Renal atrophy of the best care in the early or mid- on in a timely manner , this time the condition is not very serious , if taken appropriate means , there are still likely to ease . We all know that the early or mid- renal atrophy how to care it? With the view below it.
1 , limiting protein intake may be appropriate consumption of milk, meat , they contain many essential amino acids to supply the body needs .
2 , should be considered edible fats monounsaturated fatty acid foods, such as vegetable oil. Restrict water, salt intake should not increase the burden on the kidneys causing edema.
3 , avoid eating too much potassium foods such as bananas, dried fruit , beef , pork, sardines, soy sauce , lettuce and wheat .
4 , eat more dark green vegetables.
Strictly speaking, renal atrophy is difficult to cure diseases , if due to other diseases caused by impaired renal function in a very small case, a thorough treatment of the primary disease , can be controlled and mitigated . Patients had a history of kidney disease , or other diseases can cause kidney damage , and the family has a history of hereditary kidney disease , infectious diseases can cause renal atrophy in active prevention also should be reasonable diagnosis , once diagnosed as renal atrophy , control and treatment should be carried out immediately .
At the same time do not forget to treatment of renal atrophy care, assist in the treatment of the patient's condition while remission , allowing patients to maintain a good mood , to cure renal atrophy confidence.
1 , limiting protein intake may be appropriate consumption of milk, meat , they contain many essential amino acids to supply the body needs .
2 , should be considered edible fats monounsaturated fatty acid foods, such as vegetable oil. Restrict water, salt intake should not increase the burden on the kidneys causing edema.
3 , avoid eating too much potassium foods such as bananas, dried fruit , beef , pork, sardines, soy sauce , lettuce and wheat .
4 , eat more dark green vegetables.
Strictly speaking, renal atrophy is difficult to cure diseases , if due to other diseases caused by impaired renal function in a very small case, a thorough treatment of the primary disease , can be controlled and mitigated . Patients had a history of kidney disease , or other diseases can cause kidney damage , and the family has a history of hereditary kidney disease , infectious diseases can cause renal atrophy in active prevention also should be reasonable diagnosis , once diagnosed as renal atrophy , control and treatment should be carried out immediately .
At the same time do not forget to treatment of renal atrophy care, assist in the treatment of the patient's condition while remission , allowing patients to maintain a good mood , to cure renal atrophy confidence.
What are the symptoms of renal atrophy ?
In recent renal atrophy is also one of the high incidence species, and renal atrophy generally left renal atrophy, atrophy of the right kidney and renal atrophy symptoms, illness distinction, the symptoms are not the same , there is the kidney and renal atrophy function transformation is complementary, when patients with renal atrophy appeared to last will certainly appear to fit the symptoms of renal function with missing kidney failure. So the main manifestations of renal atrophy , what does ? Here's to specifically explain :
Like nausea , vomiting , heart failure, high blood pressure , anemia , renal atrophy patients will show face, legs swollen , itchy skin symptoms , some patients with low back pain will be severe . Renal atrophy is due to a problem with the kidneys , due to inflammation , injury, poisoning and drug side effects caused by kidney patients is a symbol of renal function decline , so patients should take the initiative after renal atrophy find healing , to avoid deterioration of the development of renal failure and uremia. Focal or full anatomy of the renal parenchyma destruction seen in any mass lesions , focal pyelonephritis , the real scar , infantile polycystic kidney disease , chronic pyelonephritis or injury and other diseases. Renal vascular disease caused by renal atrophy artery intima disease , trauma, malignancy or heart disease caused by several diseases caused by embolism .
The above content is about the symptoms of renal atrophy introduction, I hope for everyone's understanding help. There is also hope that we can focus on their own health. Once a disease , we must promptly to the hospital for treatment.
Like nausea , vomiting , heart failure, high blood pressure , anemia , renal atrophy patients will show face, legs swollen , itchy skin symptoms , some patients with low back pain will be severe . Renal atrophy is due to a problem with the kidneys , due to inflammation , injury, poisoning and drug side effects caused by kidney patients is a symbol of renal function decline , so patients should take the initiative after renal atrophy find healing , to avoid deterioration of the development of renal failure and uremia. Focal or full anatomy of the renal parenchyma destruction seen in any mass lesions , focal pyelonephritis , the real scar , infantile polycystic kidney disease , chronic pyelonephritis or injury and other diseases. Renal vascular disease caused by renal atrophy artery intima disease , trauma, malignancy or heart disease caused by several diseases caused by embolism .
The above content is about the symptoms of renal atrophy introduction, I hope for everyone's understanding help. There is also hope that we can focus on their own health. Once a disease , we must promptly to the hospital for treatment.
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