Clinical manifestations of kidney disease

The most basic feature is a large number of proteinuria, hypoproteinemia, (height) edema and hyperlipidemia, the so-called "three high and one low", and other metabolic disorders characterized by a group of clinical syndrome.

1、A large number of proteinuria
A large number of proteinuria is the most important clinical manifestations of NS patients, but also the most basic pathophysiology of nephrotic syndrome. A large number of proteinuria refers to adult urine protein excretion> 3.5g / d. In normal physiological conditions, glomerular filtration membrane with molecular barrier and charge barrier, resulting in increased protein content in the original urine, when far more than the proximal tubule back to the amount of absorption, the formation of a large number of proteinuria. On this basis, where the increase in glomerular pressure and lead to high perfusion, high filtration factors (such as high blood pressure, high protein diet or a large number of infusion of plasma protein) can increase the discharge of urine protein.

2、Hypoproteinemia
Plasma albumin down to <30g / L. NS is a large number of albumin lost from the urine, promote albumin liver compensatory synthesis and increased renal tubular decomposition. Low albuminemia occurs when liver albumin synthesis is not sufficient to overcome loss and breakdown. In addition, NS patients due to gastrointestinal mucosal edema caused by eating loss, lack of protein intake, poor absorption or loss, but also increase the causes of hypoalbuminemia.
In addition to plasma albumin reduction, some plasma immunoglobulin (such as IgG) and complement components, anticoagulant and fibrinolytic factors, metal binding protein and endocrine binding protein can also be reduced, especially a large number of proteinuria, glomerular Pathological damage is more severe and non-selective proteinuria is more significant. Patients prone to infection, hypercoagulable, lack of trace elements, endocrine disorders and immune dysfunction and other complications.

3. edema
NS hypoalbuminemia, plasma colloid osmotic pressure de
creased, so that water from the vascular cavity into the tissue gap, is the basic cause of NS edema. Recent studies have shown that about 50% of patients with normal or increased blood volume, plasma renin levels normal or decreased, suggesting that some of the primary renal sodium, water retention factors in the NS edema mechanism play a role.

4. Hyperlipidemia
The reason why NS is associated with hyperlipidemia is not yet fully elucidated. High cholesterol and / or hypertriglyceridemia, serum LDL, VLDL and lipoprotein (α) concentration increased, often associated with hypoproteinemia. Hypercholesterolemia is mainly due to increased liver lipoprotein production, but in the surrounding cycle to reduce the decomposition also play a part of the role. Hypertriglyceridemia is mainly due to catabolic disorders caused by increased liver synthesis as a secondary factor.

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Chronic nephritis patients with health care methods

Chronic glomerulonephritis (chronic nephritis) is an immune injury disease, until now there is no special effect to cure it, protect the kidneys, reduce the kidney further damage, slow down or inhibit the decline in renal function, still Is the purpose of the treatment of the disease requirements. In addition to the prescription drugs of the doctors, the patient's life management and the prevention of certain factors that damage the kidneys are an extremely important measure and must be done by the patient or his family. Only doctors and patients with close cooperation in order to get good results.

1, diet:
There are three major nutrients in food - protein, fat and carbohydrates. Which is associated with kidney disease is mainly protein. In the kidney disease, high protein load will increase glomerular sclerosis, accelerate renal function decline. Inadequate intake of malnutrition, reduce the body's resistance to disease, the human body is also unfavorable. This is a pair of contradictions: too much protein, the kidney adverse; lack of protein, the overall disadvantage. This requires patients to adjust their own "both sides can accept the midline" in order to avoid biased. In theory, the daily protein intake of about 60 grams is appropriate, but accurately count the number of food, not impossible, but cumbersome difficult to implement. Generally asked to do: the number of general family meals, not overeating, stable and relatively constant, regular review of blood albumin content and physical condition and make the appropriate adjustments. In addition, salt is closely related to high blood pressure, but excessive restrictions can cause decreased serum sodium concentration, long-term hyponatremia can cause harm to the body, including the nervous system, kidney, heart and muscle, which is another group of contradictions, More salt is not, less salt is not OK. In theory, the daily salt to 6 grams or so is appropriate, generally asked to do: food flavor is light, try not to eat salted food.

2, self-protection anti-infection:
Patients with nephritis, when the body resistance to disease decline, the occurrence of various infections, nephritis will increase or acute activity. Infected parts of the most common is the throat and respiratory tract, followed by skin and other parts. Therefore, the anti-cold, by wet, eat dry, irritating food, pay attention to oral clean, keep the skin clean, occasional damage and timely protection, to prevent bacterial invasion.

3, to deal with the appropriate activities and the relationship between fatigue:
With nephritis, excessive activity will aggravate the condition, such as changes in urine test will increase, increased urinary protein or hematuria increased, after the break is improved or restored to the original level. In principle, normal renal function, should participate in some gentle recreational activities, but the confrontation of the movement, or consume more physical exercise, is not so appropriate.


4, do not abuse drugs:
All kinds of drugs, many excreted from the kidneys, so the kidney is the most vulnerable to drug damage organs. A little carelessness will increase kidney damage. Before applying the drug, in addition to knowing whether the drug is effective for a disease, it must also be known whether the drug is toxic to the kidneys.

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kidney insufficiency

kidney insufficiency is a common kidney disease, is the health of patients caused great harm to the disease. If not timely treatment of kidney insufficiency or improper treatment, at any time to threaten the lives of patients. However, many people in life do not know the consequences of kidney insufficiency, often resulting in delayed treatment of patients, eventually leading to uremia, a threat to life and health.

One: hematopoietic system kidney symptoms. Severe anemia as an important symptom, early patients with bleeding tendency, often accompanied by subcutaneous ecchymosis, epistaxis, bleeding gums, or even hematemesis, blood in the stool, hematuria, intracranial hemorrhage, menorrhagia, most may have pericardial bleeding.

Two: skin symptoms. Boring, desquamating, dull.

Local patients with darker skin, caused by slow melanin calm. Urea from the sweat glands after the discharge will be white crystal called "urea cream" to comfort the skin and cause uremic dermatitis and skin itching (skin itching and secondary parathyroid hormone is also related).
   
Three: cardiovascular system symptoms. Often high blood pressure, myocardial damage, arrhythmia, and may have small arteries, retinal arteriosclerosis can affect vision and retinal hemorrhage. Severe cases can show pericardial friction sound (cellulosic pericarditis), the majority may have pericardial effusion, and even the emergence of pericardial tamponade. To the end of renal dysfunction will be more serious harm, easily lead to the emergence of heart failure.

Four: respiratory system performance. Exhaled gas with urine, susceptible to bronchitis, pneumonia, pleurisy. Severe metabolic acidosis can be shown when Kusima breathes. Understand the harm of kidney insufficiency, to early control of kidney disease.

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kidney disease

Kidney disease is a serious disease, the kidney is the origin of our body, but also the body of the engine, after suffering from kidney disease, the human body will have a serious impact and injury, so that after the kidney must be a high degree of attention, Especially for timely inspection and treatment, treatment should also go to the regular hospital, a lot of kidney disease friends do not attach importance to life, leading to serious illness, kidney disease on the impact of the body what?

 Hazard 1, proteinuria: In the early stage of IGA nephropathy, the microvascular damage in the kidney, the most important protein in the blood will penetrate the urine, the urine will be excessive protein.

 Harm two, kidney failure: with IGA nephropathy increased kidney disease, kidney microvascular injury is growing, the loss of protein will be more and more.

 Harm three, uremia: renal dysfunction, the metabolic waste will accumulate in the kidney, which will seriously damage the kidneys, resulting in the kidney can not effectively produce red blood cell vitamins, severe cases can occur kidney failure, uremia.

Harm four, the patient will be varying degrees of hematuria, which is mainly due to acute gastroenteritis or urinary tract infection after the attack. Hematuria will generally continue for several days, and then to the ongoing microscopic hematuria, hematuria in some patients can disappear, hematuria is an important manifestation of renal decline, random patients should be a special care.
 Harm five other parts. The disease may occur in patients with nephrotic syndrome, rapid nephritis syndrome, renal failure, a few can appear abdominal pain with hematuria.

 The above description is about the impact of kidney disease on the body what has been the treatment of kidney disease is particularly critical in the treatment of life and diet on the conditioning is more important, not only pay attention to the daily diet, the patient in life also To have a good living habits, but also to adjust their own mood, and actively cooperate with the doctor's treatment.

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Nephrotic syndrome

1, nephrotic syndrome in the course of the disease a large number of immunoglobulin from the urine lost, plasma protein decreased, affecting antibody formation. Adrenal cortex hormones and cytotoxic drug applications, so that patients with systemic resistance decreased, prone to infection, such as skin infections, primary peritonitis, respiratory infections, urinary tract infection, and even induced sepsis.

2, nephrotic syndrome can induce cardiovascular and cerebrovascular diseases, nephrotic syndrome patients usually have symptoms of hypertension, hypertension is one of the symptoms of nephrotic syndrome, or cause an important factor in many diseases, we must not ignore the , Nephrotic syndrome patients with severe hypertension, easy to induce cardiovascular and cerebrovascular diseases and so on. Therefore, the harm caused by high blood pressure can not be overlooked.

3, the incidence of nephrotic syndrome often hyperlipidemia or hypercoagulable state of blood, which can easily lead to coronary heart disease. According to some reports, nephrotic syndrome patients with myocardial infarction than the incidence of 8 times higher than normal people

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Why is the nephrotic syndrome swollen?

(1) decreased plasma colloid osmotic pressure: the exchange of blood vessels inside and outside the body by its osmotic pressure on both sides of the regulation. Osmotic pressure, including osmotic pressure and colloid osmotic pressure, the former from the crystal material (mainly electrolyte), because it is free to pass through the capillary wall, it has little effect on the exchange of blood vessels inside and outside the body; the latter mainly from the protein (which is mainly Albumin), because it is not free through the capillary wall, which is the main factor in the exchange of blood vessels inside and outside the main factors. Nephrotic syndrome, due to a large number of plasma protein loss from the urine, causing hypoproteinemia, resulting in decreased plasma colloid osmotic pressure, when the normal 3.3 ~ 4kPa down to 0.8 ~ 1.1kPa, the blood vessels Water to hypertonic interstitial fluid movement, and edema occurred.

(2) effective blood volume reduction: the removal of plasma water to reduce the effective blood volume, which led to the following changes in the body: through the capacity of the sensor to increase antidiuretic hormone (ADH), renal tubular reabsorption of water increased; - angiotensin - aldosterone system, resulting in secondary aldosteronism, renal tubular reabsorption of sodium increased; inhibition of natriuretic factor production, the kidney to reduce sodium. So the body of water, sodium retention, further aggravated edema.


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IgA nephropathy is a reasonable diet

IgA nephropathy is a very high incidence of disease, in addition to timely scientific treatment, the daily diet is also another treatment of IgA nephropathy medicine, IgA kidney disease diet should pay attention to what?

First, IgA kidney disease diet protein: acute glomerulonephritis onset 3 days to 6 days, glomerular filtration rate decreased, there will be a transient azotemia, and therefore should pay attention to protein diet, choose high-quality protein food , Such as milk, eggs, lean meat, fish and so on.

Second, low salt and low sodium diet: accompanied by edema and high blood pressure in patients should be low salt, salt or low sodium diet. Low salt diet ordinary daily use of less than 3 grams of salt or soy sauce 10 ml to 15 ml, IgA kidney disease diet where the salt and more food should be to prevent consumption, such as pickles, pickles, salted egg, egg, bacon, seafood, salty Looking, noodles, etc. should be prevented. Salt-free diet is cooking without salt and soy sauce.

Third, pay attention to high potassium food: When showing oliguria, anuria or potassium decreased, should pay attention to potassium-rich vegetables and fruits, such as bean sprouts, leeks, garlic, celery, cauliflower, toon, spinach, bamboo shoots, Lily, dried red dates, fresh mushrooms, seaweed, mustard, Chuanxiang vegetables, magnolia film, mushrooms, apricot, lotus root, sorghum, corn, lentils, tomatoes, loofah, bitter gourd and so on.

Fourth, pay attention to the amount of liquid: should be in accordance with the daily urine volume to control the amount of fluid. IgA nephropathy diet Note that the general method of supplement is to add the day before the discharge of urine, the intake of liquid 500 ml to 1000 ml.

Patients should be for their own condition, to find the cause of IgA nephropathy, timely to the regular hospital for treatment, and pay attention to develop good eating habits, so that is conducive to treatment and recovery.

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Lupus nephritis etiology

The etiology of SLE and lupus nephritis (LN) is not yet fully defined. Mainly due to a number of factors, such as genetic, viral infection, immune abnormalities, sunlight or ultraviolet radiation, some drugs induced and estrogen and other autoimmune inflammatory diseases. Its induced kidney disease (ie, LN) is typical of autoimmune complex nephritis.
     1. immune genetic defects
SLE and genetic factors related to the incidence of the family as high as 3% to 12%, there is a clear tendency to gather the family. In the SLE patients with a wide range of studies found that SLE closely related genes found in some of the HLA gene sites, especially the HLA DR region, HLA phenotype was polymorphic. Studies have shown that haploid HLA B8 / DR2 in the population is more likely to produce hypersensitivity to cellular and humoral reactions; this may be due to the presence of HLA-encoded polymorphisms in T and B lymphocytes and antigens For T inhibition of cell dysfunction, autoantibodies and globulin increased. It is now believed that the SLE susceptibility gene is a gene of different structures of T cell antigen receptors. Recent studies have found that some of the T cell B chain polypeptide structure and HLA DR in the same individual at the same time, improve the possibility of the pathogenesis of SLE. In addition, SLE also has a variety of complement defects, such as C2, C1q, C1r, C1s, C4, C5, C8 and Bf, TNF, C1 esterase inhibitor deficiency. These complement components or genetic defects, can affect the traditional complement activation pathway, increase the body's sensitivity to infection and other factors and SLE susceptibility related.

2. external environmental factors
Induced or aggravated SLE many external factors, including chronic infection, drugs, physical factors, emotional stimuli, living environment and so are more important.
Commonly known as chronic viral infection, under the electron microscope found in patients with SLE patients with tube-like inclusion bodies, and vice mucin nuclear protein and core tubular structure similar, but further study that this is a cell damage non-specific which performed. It was also found in SLE patients with glomerular endothelial cell plasma, vascular endothelial cells, lesions were found similar inclusion body material. But the inclusion of body-like substances from the organization has not been able to separate the virus, so the relationship between these substances and virus infection to be confirmed. In SLE patients, there are a variety of high titer antiviral antibodies, such as anti-measles, anti-rubella, anti-parainfluenza, anti-EB virus, anti-epidemic mumps, anti-stick virus and other antibodies. In patients with serum ds-DNA, dsRNA and RNA-DNA and other retrovirus antibodies. It has also been suggested that the incidence of SLE and C-type RNA virus is closely related. In general, there are many indications that viral infection may be one of the causes of SLE, but has not yet confirmed the virus infection and SLE patients with immune regulation abnormalities and autoimmune. In addition, some people think that the incidence of SLE and tuberculosis or streptococcal infection.

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Prevention of chronic nephritis

Prevention of chronic nephritis is the most fundamental way to improve the body disease prevention and disease resistance and reduce the chance of infection, for the cause of prevention.

1) to avoid overwork,
Mental stress: overwork, open night car, exam pressure and so on, can make chronic nephritis worse. Have a good living habits, to maintain a regular life. Usually have to arrange a reasonable living system, and more to participate in appropriate activities to strengthen physical exercise, but should avoid fatigue. Reasonable nutrition, enhance physical fitness and body resistance. Pay attention to personal hygiene and environmental sanitation clean, to develop good living habits, and keep the mood relaxed and happy, and strengthen self-care awareness.

2) Beware of bacterial or viral infections:
Bacteria or virus infection is the most common cause of acute nephritis, especially upper respiratory tract infection, asymptomatic bacteriuria, influenza, pharyngitis, bronchial bronchitis, etc., may increase the symptoms of chronic nephritis.
Active prevention and treatment of infection lesions, and actively prevent acute nephritis. Reduce the chance of infection, to prevent cold and cold, to prevent colds, suppurative tonsillitis, skin purulent infection and other diseases; once infected with the above disease or acute nephritis and other primary glomerular disease, to give timely and thorough Treatment, acute nephritis patients with chronic infection in patients with stable disease in 3 to 6 months, if necessary, surgery and other methods can be used to prevent the development of such diseases continue to develop chronic nephritis.

3) attention to diet nutrition:
Nephritis patients to avoid high-protein diet, pay attention to food safety, eat more fresh fruits and natural food. To species diversity, with a reasonable, light and delicious for the principle.Pay attention to their own monitoring. Consciously when the body discomfort, such as the emergence of nocturia, loss of appetite, waist discomfort or soreness, especially in the morning after eyelid facial edema and voiding abnormalities, suggesting that there may be kidney disease, to the hospital Check, in order to facilitate the early diagnosis and treatment, the prevention of the disease also has an important role.

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For dialysis patients with kidney disease diet should pay attention

Because the early kidney disease has not been the fundamental treatment, and finally developed into uremia embarked on the dialysis of the road. Dialysis is only the use of external factors to replace the function of the kidney, kidney damage, the body of some metabolites can not be normal discharge.

1, dialysis patients pay attention to protein intake: the use of high quality bio-potent animal protein-based, such as milk, eggs, fish, lean meat, add all kinds of essential amino acids. Plant soybeans, although peanut contains high protein, but must contain less amino acids, should not eat.

2, dialysis patients pay attention to protein calorie intake: under normal circumstances 30 ~ 45kcal / kg / d, depending on individual differences.

3, dialysis patients pay attention to protein calcium and other substances added: calcium, zinc and iron, and a sufficient amount of B vitamins

4, dialysis patients pay attention to protein water limit: the general daily control weight gain 0.5kg is appropriate, dialysis interval too much water can lead to water poisoning and cardiovascular complications.

5, dialysis patients pay attention to protein sodium: sodium should be limited to 2 ~ 3g per day to prevent high blood pressure and heart failure.

6, dialysis patients pay attention to protein potassium limit: limit the intake of potassium to prevent hyperkalemia.

7, dialysis patients pay attention to protein phosphorus: high phosphorus and low calcium can cause metabolic bone disease, to avoid eating high phosphorus foods such as animal heart, brain, kidney, liver, plant soybeans, peanuts and other food.

8, dialysis patients pay attention to protein Diabetic nephropathy in patients with dietary considerations in addition to follow the principles of diabetic nephropathy treatment, the following should pay attention to the following:

After dialysis due to improved condition, increased appetite, diet, the total calories and protein should be appropriate before dialysis increased. Each dialysis about lost protein 2 ~ 3.5g. After dialysis, the protein content of the diet is given from 1 to 1.2 g / kg body weight per day, and 2 eggs per day, 5OOml of milk, and the amount of fish, meat, etc. are large for hemodialysis, and the diet should be supplemented with rich iron content And vitamin C food to eat low-phosphorus diet, but also add aluminum hydroxide to reduce the absorption of phosphorus dialysis a large number of vitamin loss should be given enough vitamin B and vitamin C.

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