Hemodialysis is one of the methods in treating Acute or Chronic Renal
Failure, which aims at replacing parts functions of Renal Failure, such as
eliminating supersession, adjusting water, electrolyte and acid-base balance,
etc. Dispersion, convection, ultrafiltration, adsorption and so on are the
fundamental theory of hemodialysis. So far, the basic indications of
hemodialysis in China are that:
1. Acute Renal Failure
(1) Acute pulmonary edema;
(2) Potassium in blood is above or equal to 6.5 mmol/L;
(3) High-catabolism;
(4) Oliguria or anuria lasts for over 2 days. Serum creatinine is above or
equal to 442μmol/L(5mg/dl); blood urea nitrogen is no less than 21.4
mmol/L(60mg/dl);
(5)Obvious symptoms of Uremia.
2. Chronic Renal Failure
(1) Ccr ( Creatinine clearance rate) is less than 10ml/min;
(2) Scr (Serum creatinine) is no less than 707μmol/L(8mg/dL);
(3) Blood urea nitrogen is no more than 28.6 mmol/L(8Omg/dL)
(4) Hyperkalemia;
(5) Metabolic acidosis;
(6) Obvious water retention;
(7) Obvious Uremic symptoms;
(8) Serious complications, such as anemia, pericarditis, gastrointestinal
hemorrhage and so on.
After having known the indications of hemodialysis, patients can take
dialysis according to their condition.
If you have any questions about kidney disease , you can sent your cases ,
Our kidney expert will reply as soon as possible . I hope you'll get well soon
!
2015年9月9日星期三
Disequilibrium and Renal Failure - Shijiazhuang Kidney Disease Hospital
In the period of Renal Failure, disequilibrium may occur to all system with
the disequilibrium of water, electrolyte and acid-base occur firstly. These
disequilibrium can be summarized as “three-high, three-low and three-poisoning".
"Three-high" refers to hyperkalemia, hypermagnesemia and hyperphosphatemia.
“Three-low" refers to hyponatremia, hypokalemia, hypochloremia.
“three-poisoning" refers to water intoxication, acidosis and Uremia. 1.
Hypermagnesemia When GFR is less than 20 ml/min, hypermagnesemia usually occurs
for the reducing of magnesium from kidneys. 2. Disequilibrium of potassium To
patients of Renal Failure, all remaining renal units as well as intestinal tract
eliminate much more potassium, thus leading to increasing of potassium in blood.
3. Sodium and water disequilibrium Mild retention of sodium and water may occur
to Renal Failure patients. If patients of Renal Failure intake overmuch sodium
and water, edema, Hypertension and Cardiac Failure is easy to occur. Edema
usually accompanies with hyponatremia, which is called diluted low-sodium. 4.
Metabolic acidosis To patients of Renal Failure, the metabolin such as
phosphoric acid, vitriol and other acidic materials may be retention in kidneys.
Kidney tubules have the functional deficiency of secreting hydrogen ion as well
as making NH4+, thus leading to the increasing intervals of blood anion. After
the concentration of HCO3 reduces, metabolic acidosis occurs. 5. Balance of
metabolic calcium and phosphorus The concentration of phosphorus is adjusted by
the absorption of intestinal tract and excretion of kidneys. With the reducing
of remaining renal units, less phosphorus is eliminated, thus increasing the
concentration of phosphorus. At that time, phosphorus will combine with calcium
and pile up the tissue. Renal Failure patients must test it carefully. Besides,
high-concentration of phosphorus may restrain the producing of calcitriol, thus
aggravating Renal Failure. Calcitriol is the main factor in maintaining blood
calcium. The insufficiency will reduce the concentration of blood calcium, thus
affecting the concentration of blood phosphorus. Knowing more about Renal
Failure can help patients of Renal Failure treat it timely. As for the specific
number of dysequilibrium, patients of Renal Failure can go to hospital to get
the result.
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
Self-nursing of Dialysis Patients - Shijiazhuang Kidney Disease Hospital
There are lots of things the patients who are taking dialysis can do. To some
degree, self-nursing by the patients of dialysis is more important than that
done by others. Patients of dialysis is more clear about their conditions than
others. Daily matters need attention:
1. Receive dialysis at a certain time;
2. Proper exercises and enough sleep;
3. Prevent infections and develop a good habit of defecating in a certain time;
4. Take the blood pressure and make records about it;
5. Pay attention to the intake of water and diet;
6. Observe the color of urine and defecation, skin and the situation of bleeding; 7. Contact with the hospital immediately when any discomfort occurs.
Ways of measuring weight at home:
1. Measure weight by using the same scale at the same time;
2. Be no more than 2 to 3 kg between two times of dialysis;
3. Upper limit number of weight-gaining Times of Dialysis Weight-gaining 1 times/week 0.5 kg/day 2 times/week 1 kg/day 3 times/week 1.5 kg/day
Ways of controlling the intake of water:
1. Measure urine volume everyday;
2. The daily water intake is 500 ml more than the urine volume;
3. Do not eat salty food, otherwise the patient will drink much water;
5. Do not eat too much noodles which contain much water.
Ways of adjusting mentality: When the dialysis patient feels depression, they can express their feeling to their friends and family members. Dialysis patients can do some exercises properly at the same time. Patients can talk all their feelings to their doctor, for example, sexual disorder. In a word, keeping a good mood is important for patients' recovery. Ways of taking medicine: Different dialysis medicines have different functions, so patients should take medicine according to doctors' advices. For the calcium tablet, patients should take it with their meal. Only in this way can the tablet reduce phosphorus ion.
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
1. Receive dialysis at a certain time;
2. Proper exercises and enough sleep;
3. Prevent infections and develop a good habit of defecating in a certain time;
4. Take the blood pressure and make records about it;
5. Pay attention to the intake of water and diet;
6. Observe the color of urine and defecation, skin and the situation of bleeding; 7. Contact with the hospital immediately when any discomfort occurs.
Ways of measuring weight at home:
1. Measure weight by using the same scale at the same time;
2. Be no more than 2 to 3 kg between two times of dialysis;
3. Upper limit number of weight-gaining Times of Dialysis Weight-gaining 1 times/week 0.5 kg/day 2 times/week 1 kg/day 3 times/week 1.5 kg/day
Ways of controlling the intake of water:
1. Measure urine volume everyday;
2. The daily water intake is 500 ml more than the urine volume;
3. Do not eat salty food, otherwise the patient will drink much water;
5. Do not eat too much noodles which contain much water.
Ways of adjusting mentality: When the dialysis patient feels depression, they can express their feeling to their friends and family members. Dialysis patients can do some exercises properly at the same time. Patients can talk all their feelings to their doctor, for example, sexual disorder. In a word, keeping a good mood is important for patients' recovery. Ways of taking medicine: Different dialysis medicines have different functions, so patients should take medicine according to doctors' advices. For the calcium tablet, patients should take it with their meal. Only in this way can the tablet reduce phosphorus ion.
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
Relationship Between Renal Failure and Creatinine
Recently, I have received a letter from a American woman who was diagnosed with Renal Failure three days ago. Her doctor tells her that her creatinine is high. She does not understand the relationship between Renal Failure and creatinine. Therefore , I write this article to introduce the relationship between Renal Failure and creatinine.
High creatinine occurs after the kidneys have been invaded by various diseases. The damaged renal inherent cells have phenotype transformation with forming the pathological changes. It stimulates the kidney endothelial fiber cells and makes them changed into myofibroblast.
Then we talk about mechanism, the transformed myofibroblast cells will invade and stimulate the normal kidney tissue at the same time, having the same pathological changes and then expanding the whole kidneys, thus leading to Renal Failure. At this time, because the kidneys are constantly damaged, function of discharging waste will decrease, which result in the gathering of the creatinine and other toxin. Therefore, there is creatinine in blood and urea nitrogen increased the creatinine in urine decreased and the two kidneys’ filterability decreased and so on. In addition, patients also have symptoms of hypertension, highly dropsy and so on. The reason for the high creatinine still has relationship with four kidney damaging periods:
1. Compensatory Stage of Renal Failure
The GFR (glomerular filtration rate) is 50 ml to 80 ml/min. At the moment the endogeny also refers to the Ccr decreased, but when it is above 50 ml/min, Scr is below 178 μmol/l, Blood Urea Nitrogen is below 9 mmol/l, there is no clinical symptom. It is also called Renal Reserving Function Declined stage.
2. Discompensation Stage of Renal Failure
Ccr, 25—50 ml per minute; Scr increased to more than 178 μmol/l (2 mg/dl); blood urea nitrogen, over 9 mmol/l (25 mg/dl). There is no uncomfortable feeling except mild anemia, symptoms of digestion and the nocturnal enuresis increased. However, after tiring work, infection, fluctuation of blood pressure or having over much protein, the clinical symptoms will become serious. It is also called the Azotemia Stage.
3. Stage of Renal Failure
Ccr, 10—25 ml/min; Scr, 221—442 μmol/l; blood urea nitrogen, 17.9—21.4 mmol/l. Most of patients with Renal Failure suffer from symptoms of digesting tract and Anemia, and mild metabolic acidosis and calcium and phosphate metabolize abnormally without obvious disordering metabolism of salt and water. At this moment, kidneys still have certain function, so it is regarded as the early stage of Uremia.
4. Uremia stage
Scr is over 442 μmol/l and blood urea nitrogen is more than 21.4 mmol/l, various Uremia symptoms like obvious anemia, serious nausea, vomiting and all kinds of nervous system complication, even coma will occur. Besides, symptoms such as no salt and water metabolism and acid- base disturbance, little urine or no urine will happen to patients of Renal Failure. When the Ccr is less than 10 ml per minute and Scr is over 707 μmol/l, it is called terminal period, or the late period of Uremia.
In a word, the creatinine is various with the development of Renal Failure.
Patients of Renal Failure should pay attention to the changes of their
creatinine which can reflects their condition of the disease. If you still can
not understand it, you can contact us by email, message or telephone.
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
2015年9月8日星期二
Symptoms in Early Stage of Renal Failure
1. Sleepiness and lack of strength
These may be the earliest manifestations, but they can be easily ignored, because there are many factors causing sleepiness and lack of strength. Especially for these people who work very hard, most of them will think these discomforts are caused by pressure and overwork. If these symptoms recover soon after a good rest, they are much easier to be ignored.
2. Pale yellow facial complexion
It is caused by anemia. Because this symptom progresses very slowly, you won’t find obvious contrast in a short time.
3. Edema
This symptom is easy to be detected. The kidneys can not excrete the redundant water, which lead to the retention of water in the tissue space. There appear edema on the ankles and eyelids at the very beginning and it will disappear after a good rest. If this symptom progresses to continuous edema or systemic edema, it indicates the patient is very sick.
4. Change of urine volume
Due to the decline of filtration function of kidneys, the urine volume of patients will decrease as the disease progresses. Although the urine volume may be normal, if toxin or waste released in the urine reduce, it also manifests the kidneys are damaged.
5. High blood pressure
When the kidneys are damaged, renal excretion function of sodium and water will be influenced, leading the retention of sodium and water. At the same time, kidneys will secrete some substances which can raise the blood pressure. Therefore, there may appear various degrees of high blood pressure to the Renal Failure patients in the early stage. When there is high blood pressure together with bad blood clotting mechanism, it may easily cause nasal or gum bleeding.
6. High creatine level
Due to the high creatine level, toxin accumulated in the body can not be excreted, which will lead to dysfunction of digestive tract and loss of appetite. As the disease progresses, there will appear abdominal discomfort, nausea, vomiting, or even diarrhea. At that time the disease has been more serious and the patients have to go to see a doctor.
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
These may be the earliest manifestations, but they can be easily ignored, because there are many factors causing sleepiness and lack of strength. Especially for these people who work very hard, most of them will think these discomforts are caused by pressure and overwork. If these symptoms recover soon after a good rest, they are much easier to be ignored.
2. Pale yellow facial complexion
It is caused by anemia. Because this symptom progresses very slowly, you won’t find obvious contrast in a short time.
3. Edema
This symptom is easy to be detected. The kidneys can not excrete the redundant water, which lead to the retention of water in the tissue space. There appear edema on the ankles and eyelids at the very beginning and it will disappear after a good rest. If this symptom progresses to continuous edema or systemic edema, it indicates the patient is very sick.
4. Change of urine volume
Due to the decline of filtration function of kidneys, the urine volume of patients will decrease as the disease progresses. Although the urine volume may be normal, if toxin or waste released in the urine reduce, it also manifests the kidneys are damaged.
5. High blood pressure
When the kidneys are damaged, renal excretion function of sodium and water will be influenced, leading the retention of sodium and water. At the same time, kidneys will secrete some substances which can raise the blood pressure. Therefore, there may appear various degrees of high blood pressure to the Renal Failure patients in the early stage. When there is high blood pressure together with bad blood clotting mechanism, it may easily cause nasal or gum bleeding.
6. High creatine level
Due to the high creatine level, toxin accumulated in the body can not be excreted, which will lead to dysfunction of digestive tract and loss of appetite. As the disease progresses, there will appear abdominal discomfort, nausea, vomiting, or even diarrhea. At that time the disease has been more serious and the patients have to go to see a doctor.
If you have any questions about kidney disease , you can sent your cases , Our kidney expert will reply as soon as possible . I hope you'll get well soon !
How Can I Lower Creatinine 4.1 After Kidney Transplant
The Function of Kidneys
Kidneys are one organ of the urinary system and the main excretory organ of
human body. They can sustain the stability of the inner environment through
regulating water, osmotic pressure and acid-base balance by discharging waste
products and toxic substances and reabsorbing useful substances in the process
of generating and discharging urine. The substances secreted by kidneys are
related to kinds of human metabolism. Therefore, kidneys are important organ
which keep the normal activities. The following are the main functions of the
kidneys:
1. Maintain water balance. Generating urine is the primary function of kidneys, through which kidneys can maintain water balance. The generation of urine comes from blood plasma. The completion of generating urine is composed of three processes: glomerular filtration, glomerular reabsorption and renal tubular drainage remit and secretion. In the three processes, except generating urine, kidneys will also regulate the urine volume according to the volume of water in the body so as to keep water balance and sustain normal life.
2. Release metabolites and harmful substances such as toxicant, drugs etc. kidneys filtrate blood plasma through generating urine, which can filter out the product of metabolism in the body and some other toxicant and chemical drugs entered into human body and reserve water and nutritional substances. These waste and harmful substances are discharged through urine, thus guaranteeing the stability of human inner environment.
3. Keep acid-base balance. Kidneys regulate acid-base balance in human body through releasing acidic materials, reabsorbing alkaline and alkaline substances or keep acid-base balance through controlling the discharge volume ratio of acidic and alkaline substances.
4. Maintain the composition of body fluid and keep a balance of fluid electrolyte. Kidneys can regulate the substances in human body, such as plasma, hemalbumin, glucose, amino acid, hormone vitamin, potassium, sodium, chloride etc and make them exist in human body according to a certain proportion and density so as to sustain normal activities of human body.
5. Regulate incretion. Kidneys can secrete and synthesize some substances, which can play a role in regulating human physiological function. Renin and prostaglandin secreted by kidneys regulate blood pressure and electrolyte metabolism by influencing the product of ANGII and they can also involve in hematopoiesis by producing erythropoietic factor and secreting erythrogenin, stimulate bone marrow erythroid proliferate and differentiate and speed up the synthesis of hemoglobin. 1, 25 - double hydroxyl vitamin D secreted by kidneys participates in regulating calcium and phosphate metabolism to sustain the normal structure and function of the bones.
We could see from the above, kidneys are not only a simple excretory organ, but also an important organ influencing the inner environment and normal physiological activities of human. Therefore, kidneys have a significant meaning for maintaining human life.
1. Maintain water balance. Generating urine is the primary function of kidneys, through which kidneys can maintain water balance. The generation of urine comes from blood plasma. The completion of generating urine is composed of three processes: glomerular filtration, glomerular reabsorption and renal tubular drainage remit and secretion. In the three processes, except generating urine, kidneys will also regulate the urine volume according to the volume of water in the body so as to keep water balance and sustain normal life.
2. Release metabolites and harmful substances such as toxicant, drugs etc. kidneys filtrate blood plasma through generating urine, which can filter out the product of metabolism in the body and some other toxicant and chemical drugs entered into human body and reserve water and nutritional substances. These waste and harmful substances are discharged through urine, thus guaranteeing the stability of human inner environment.
3. Keep acid-base balance. Kidneys regulate acid-base balance in human body through releasing acidic materials, reabsorbing alkaline and alkaline substances or keep acid-base balance through controlling the discharge volume ratio of acidic and alkaline substances.
4. Maintain the composition of body fluid and keep a balance of fluid electrolyte. Kidneys can regulate the substances in human body, such as plasma, hemalbumin, glucose, amino acid, hormone vitamin, potassium, sodium, chloride etc and make them exist in human body according to a certain proportion and density so as to sustain normal activities of human body.
5. Regulate incretion. Kidneys can secrete and synthesize some substances, which can play a role in regulating human physiological function. Renin and prostaglandin secreted by kidneys regulate blood pressure and electrolyte metabolism by influencing the product of ANGII and they can also involve in hematopoiesis by producing erythropoietic factor and secreting erythrogenin, stimulate bone marrow erythroid proliferate and differentiate and speed up the synthesis of hemoglobin. 1, 25 - double hydroxyl vitamin D secreted by kidneys participates in regulating calcium and phosphate metabolism to sustain the normal structure and function of the bones.
We could see from the above, kidneys are not only a simple excretory organ, but also an important organ influencing the inner environment and normal physiological activities of human. Therefore, kidneys have a significant meaning for maintaining human life.
Symptoms of Renal Failure in Different Stages
In clinical, Renal Failure can be divided into three stages, in which the
symptoms are completely different. Because of the special structure of the
kidneys, Renal Failure patients won’t feel any apparent physical changes and
symptoms until the renal function is close to complete loss.
There are different symptoms in different stages.
⑴ In Starting Stage: In this stage, patients often suffer from some known causes of ATN, such as hypotension, ischemia, sepsis, nephrotoxin etc, but there is no apparent damage of renal parenchyma. Acute Renal Failure can be prevented in this stage. As there is obvious injury to the renal tubular epithelium, GFR suddenly declines and symptoms of Renal failure become apparent in clinical, it enters maintenance stage. In the beginning, Renal Failure is usually asymptomatic and there is no alarming symptom for us to know how our kidneys are functioning, so we should take urine test and blood test regularly to follow up the disease condition. Sometimes, though Renal Failure patients feel good, some indications of kidney disease can be found through medical tests.
⑵ In Maintenance Stage or Oliguric Stage: The period is usually 7 to 14 days, and the shortest can be several days while the longest can be 4 to 6 weeks. GFR (glomerular filtration rate) of the patients is always low. Many patients may have oliguria symptom (urine volume <40Oml/d). However, some patients may not appear oliguria symptom. Their urine volume may be more than 400ml/d, and this is called Non-oliguric Acute Renal Failure. For this kind of disease, the patient’s disease condition is usually milder and the prognosis is good. Whether urine volume lessens or not, as the renal function declines, there will appear a series of symptoms of Renal Failure. Infection is another common and serious complication of Acute Renal Failure. Some other organs may also fail to work accompanying with Acute Renal Failure or in the progression of the disease.
⑶ In Recovery Stage: In this stage, the renewed renal tubule cells will repair the renal tubule to complete recovery. Glomerular filtration rate can gradually restore to normal or close to normal range. Patients with oliguria symptom become diuresis, and the daily urine volume can reach 3000-5000ml or more. The phenomenon may last 1 to 3 weeks and then glomerular filtration rate will recover to normal. Comparing with the recovery of glomerular filtration rate, the restoration of glomerular epithelial cells function (the reabsorption of solute and water) usually needs several months. A small number of patients will eventually suffer different degrees of renal structure and function deficiency.
The Systemic Symptoms of Renal Failure
Discomfort
The continuous accumulation of toxin and waste in the body may cause discomfort to Renal Failure patients. The Symptoms include nausea, vomiting, poor sleep in the night, no appetite, pruritus (skin itch) and fatigue.
Edema
Some Renal Failure patients will appear edema, decrease of urine volume, frequent urination (especially at night), swelling in wrist and ankles, breath hard and eyelid edema.
Anemia
Kidneys can not secret enough hormone for producing blood cells because of the damage to renal function. People with anemia often feel cold and tired.
Other symptoms of Renal Failure
Blood urine (with brown or blood red color)
Hypertension
Foam in urine
Diarrhea
Extreme thirst
Disturbed sleep or somnolence
Decline of sexual desire
There are different symptoms in different stages.
⑴ In Starting Stage: In this stage, patients often suffer from some known causes of ATN, such as hypotension, ischemia, sepsis, nephrotoxin etc, but there is no apparent damage of renal parenchyma. Acute Renal Failure can be prevented in this stage. As there is obvious injury to the renal tubular epithelium, GFR suddenly declines and symptoms of Renal failure become apparent in clinical, it enters maintenance stage. In the beginning, Renal Failure is usually asymptomatic and there is no alarming symptom for us to know how our kidneys are functioning, so we should take urine test and blood test regularly to follow up the disease condition. Sometimes, though Renal Failure patients feel good, some indications of kidney disease can be found through medical tests.
⑵ In Maintenance Stage or Oliguric Stage: The period is usually 7 to 14 days, and the shortest can be several days while the longest can be 4 to 6 weeks. GFR (glomerular filtration rate) of the patients is always low. Many patients may have oliguria symptom (urine volume <40Oml/d). However, some patients may not appear oliguria symptom. Their urine volume may be more than 400ml/d, and this is called Non-oliguric Acute Renal Failure. For this kind of disease, the patient’s disease condition is usually milder and the prognosis is good. Whether urine volume lessens or not, as the renal function declines, there will appear a series of symptoms of Renal Failure. Infection is another common and serious complication of Acute Renal Failure. Some other organs may also fail to work accompanying with Acute Renal Failure or in the progression of the disease.
⑶ In Recovery Stage: In this stage, the renewed renal tubule cells will repair the renal tubule to complete recovery. Glomerular filtration rate can gradually restore to normal or close to normal range. Patients with oliguria symptom become diuresis, and the daily urine volume can reach 3000-5000ml or more. The phenomenon may last 1 to 3 weeks and then glomerular filtration rate will recover to normal. Comparing with the recovery of glomerular filtration rate, the restoration of glomerular epithelial cells function (the reabsorption of solute and water) usually needs several months. A small number of patients will eventually suffer different degrees of renal structure and function deficiency.
The Systemic Symptoms of Renal Failure
Discomfort
The continuous accumulation of toxin and waste in the body may cause discomfort to Renal Failure patients. The Symptoms include nausea, vomiting, poor sleep in the night, no appetite, pruritus (skin itch) and fatigue.
Edema
Some Renal Failure patients will appear edema, decrease of urine volume, frequent urination (especially at night), swelling in wrist and ankles, breath hard and eyelid edema.
Anemia
Kidneys can not secret enough hormone for producing blood cells because of the damage to renal function. People with anemia often feel cold and tired.
Other symptoms of Renal Failure
Blood urine (with brown or blood red color)
Hypertension
Foam in urine
Diarrhea
Extreme thirst
Disturbed sleep or somnolence
Decline of sexual desire
订阅：
博文 (Atom)