Kidney disease proteinuria hazards

Nephrotic patients is a common symptom is the emergence of proteinuria, most of these symptoms occurred in patients with chronic nephritis and nephrotic syndrome patients. Protein is a necessary substance in the human body, the occurrence of proteinuria means that patients with a large number of proteins with urine discharge, affecting the health of the body. So what is the risk of proteinuria in kidney disease? See how our experts are introduced.

Kidney disease, the risk of proteinuria: proteinuria mesangial toxicity, glomerular mesangial protein accumulation will continue to lead to mesangial cells are damaged, hyperplasia of mesangial matrix synthesis increased, and ultimately cause glomerular sclerosis. And glomerular apolipoprotein A and apolipoprotein B deposition will eventually cause glomerular sclerosis.

Kidney disease, the risk of proteinuria: proteinuria can cause renal failure, mainly due to its biological changes caused by tubule cells caused by non-adaptive response. According to the current data, the protein can directly regulate the function of small tube, change its growth characteristics and its cytokines and matrix protein phenotype expression, but also the release of PDGF, FN and MCP-1 on the basal side of the tubule, induced fibrosis process.

Kidney disease, the risk of proteinuria: proteinuria toxic effects will affect the proximal tubule, increased into the renal tubular epithelial cells within the amount of protein, thereby increasing the activity of lysosomes, which means that the protein lysosome overflow into the tubules Pulp, and then the damage caused by cell damage caused by inflammation and scar generation. There may be caused by interstitial hypoxia aggravated, leading to small tube cells hypoxia, to damage.

Proteinuria will not only make a lot of protein loss, there may damage the renal tubules, glomerular. And therefore must be effective in preventing and control work, to avoid the above described kidney disease proteinuria hazards, so as not to affect your healthy life.

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Affect the prognosis of chronic renal failure

Renal failure can be divided into acute and chronic, acute renal failure disease progression is rapid, usually due to kidney blood supply (such as trauma or burns), the kidneys caused by a certain cause of damage caused by damage or poison damage caused by Acute renal failure. And chronic renal failure, also known as chronic renal failure, is caused by a variety of chronic diseases, kidney damage and progressive deterioration of the results, so that the body in the excretion of metabolic waste and regulation of water, electrolyte, acid-base balance and other aspects of the clinical syndrome group The Is one of the important diseases that threaten life. The end of chronic renal failure, often referred to as uremia. Factors affecting the prognosis of chronic renal failure, the following are more common:

(1) primary renal disease itself is closely related to the prognosis of chronic renal failure.

(2) various infections are the most common factors affecting the prognosis of chronic renal failure, of which the respiratory and urinary tract infections are the most common.

(3) urinary tract obstruction is also a common prognostic factor, and often coexist with urinary tract infection.

(4) the use of nephrotoxic drugs.

(5) causes a variety of causes of renal insufficiency, such as severe vomiting, diarrhea caused by shock, low blood pressure, long-term excessive use of diuretics and so on.

(6) heart failure caused by various causes.

(7) renal hypertension on renal function has a direct damage.

(8) water and electrolyte disorders and so on.

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Differential diagnosis of kidney disease

NS complications are important factors affecting the long-term prognosis of patients should be actively prevention and treatment.

1. infection

Usually in the hormone treatment without the use of antibiotics to prevent infection, or not only fail to prevent the purpose, but may induce fungal infection. Once found infection, should be timely selection of pathogenic bacteria sensitive, potent and no renal toxicity of active treatment of antibiotics, a clear infection should be removed as soon as possible. Severe infection is difficult to control should be considered to reduce or disable the hormone, but depends on the specific circumstances of the patient.

2. Thrombosis and embolism complications

It is generally believed that when plasma albumin is less than 20 g / L (idiopathic membranous nephropathy less than 25 g / L) anticoagulant therapy can be given heparin (also available low molecular weight heparin) subcutaneous injection or oral warfarin. Anticoagulation at the same time can be supplemented by antiplatelet drugs, such as dipyridamole or aspirin orally. On the occurrence of thrombosis, embolism should be as early as possible (6 hours the best results, but still effective within 3 days) to give urokinase or streptokinase systemic or local thrombolysis, combined with anticoagulant therapy, anticoagulants should generally continue to use More than six months. Anticoagulation and thrombolytic therapy should avoid excessive drug lead to bleeding.

3. acute renal failure

NS complicated with acute renal failure such as improper handling can be life-threatening, if given timely treatment, the majority of patients is expected to recover. The following measures can be taken:

(1) loop diuretics on loop diuretics are still effective should be a larger dose to wash the blocked tubular tubules;
(2) hemodialysis diuretic ineffective, and has reached the dialysis indications, should be hemodialysis to maintain life, and after the appropriate addition of plasma products dehydration to reduce renal interstitial edema;
(3) the original disease treatment because of its pathological type mostly small lesions of kidney disease, should be actively treated;
(4) alkaline urine can be oral sodium bicarbonate alkaline urine, in order to reduce tube formation.

4. Protein and fat metabolism disorders

It is often difficult to correct metabolic disorders before NS remission, but should adjust the amount and structure of protein and fat in the diet, and strive to minimize the impact of metabolic disorders. At present, many drugs can be used to treat protein and fat metabolism disorders. Such as: ACEI and angiotensin Ⅱ receptor antagonists can reduce urinary protein; studies have suggested that traditional Chinese medicine Astragalus can promote liver albumin synthesis, and may also reduce the role of hyperlipidemia. (HMG-CoA) reductase inhibitors, such as lovastatin statins, or lower triglyceride-based clofibrate Class, such as fenofibrate and so on. NS remission after hyperlipidemia can be natural relief, you do not need to continue drug treatment.

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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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