Caring For The Kidneys And Preventing Acute Kidney Failure

What is acute kidney failure?

 Acute kidney failure (also referred to as acute kidney failure) refers to the sudden and progressive decline of kidney function in a short period (hours to weeks) caused by various causes, when the glomerular filtration rate decreases by more than 50%, causing a rapid increase in blood urea nitrogen, creatinine, water, electrolyte, acid-base balance disorders and uremia symptoms. This concept is a concept that has been used in our medical textbooks in the past, and it is also very easy to be understood and accepted by the general public. However, in 2005, relevant international medical experts held an academic symposium in Amsterdam, the Netherlands, and changed the name to acute kidney injury. The coverage of acute kidney injury is significantly larger than that of acute kidney failure. Acute kidney structural and functional abnormalities within 3 months of age include, in addition to acute kidney failure, patients whose kidney function begins to decline and patients with normal kidney function but acute kidney injury.

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According to changes in urine output, acute kidney failure can be divided into oliguria, anuric, and non-oliguric. According to the different etiologies, acute kidney failure can be divided into prerenal, renal, and postrenal. For patients with acute kidney failure, if early detection, early diagnosis, and early treatment can be achieved, kidney function may be fully recovered; on the contrary, delay in diagnosis and treatment may lead to irreversible disease progression to uremia and even death. In recent years, with the advancement of kidney replacement therapy technology, the success rate of the rescue of acute kidney failure has been greatly improved. However, in patients with multiple underlying diseases or even multiple organ failures at the same time, it is still extremely difficult to restore kidney function and even maintain life.

How dangerous is acute kidney failure?

What is the risk of acute kidney failure? Does it happen occasionally, or is it common? According to epidemiological data, the global incidence of acute kidney injury (AKI) is 21 million/1 million, especially in hospitalized patients. The mortality rate of AKI patients requiring kidney replacement therapy is as high as 50% to 80%, and about 2 million people die of AKI every year in the world. Moreover, compared with non-AKI patients, AKI patients had up to 9 times the risk of developing chronic kidney disease and up to 2 times the risk of death. The incidence of AKI varies widely across regions of the world. China has 1/4 of the world's population and is the largest developing country, but China still lacks complete epidemiological data on AKI. Most of the existing reports are the findings of single-center studies with small sample sizes. Therefore, in general, there are low detection rates, low awareness rates, low treatment rates, high missed diagnosis rates, insufficient attention to AKI, lack of health education and early screening, and the overall situation is not optimistic.

What are the common causes of acute kidney failure?

There are many causes of acute kidney failure, which can be divided into pre-kidney factors, kidney factors, and post-kidney factors from the perspective of medical specialty.

01

Prekidney factors: Simply put, any factors that can lead to kidney hypoperfusion and kidney ischemia are very likely to cause AKI. Since there is no problem with the kidney structure itself, AKI is mostly reversible if these risk factors can be corrected. Common pre-kidney factors that lead to AKI include a decrease or insufficient effective circulating blood volume in the human body, which is mainly caused by the loss of blood and fluid in the human body. Examples, massive hemorrhage and gastrointestinal hemorrhage caused by trauma or surgery; massive loss of gastrointestinal fluid caused by vomiting and diarrhea; massive exudation and fluid loss caused by skin burns; profuse sweating and dehydration in high temperature and high-temperature environments; persistent use of diuretics for diuresis and dehydration, resulting in excessive fluid loss through the kidney s; water leakage from the blood circulatory system to the third space caused by disease, such as leakage of fluid from the blood into the pleural cavity, resulting in a large amount of pleural effusion and leakage into the peritoneum A large number of ascites caused by the cavity, or a large amount of fluid leakage caused by the cause of kidney disease to the parts of the trunk and limbs with loose tissue, resulting in high edema, and so on. In addition, patients with cardiac insufficiency may suffer from insufficient blood supply to the kidneys and AKI due to the decrease in cardiac pumping function; and long-term use of vasodilatory drugs may lead to blood distribution in peripheral tissues, lower blood pressure, and insufficient kidney blood perfusion. , causing AKI.

02

kidney factor: refers to AKI caused by some pathogenic factors. Depending on the nature of the action, it may act on the glomerulus, as well as on the kidney tubule, kidney interstitium, or kidney blood vessels. For healthy people, the occurrence of AKI is often related to the following factors: example, inappropriate use of some drugs (such as antibiotics, analgesics, proprietary Chinese medicines, decoctions made from traditional Chinese medicines, etc.), or health products, including natural Invasion of biological toxins released by organisms (such as bee venom, snake venom, fish gallbladder), or ingestion of toxic substances (such as heavy metals, pesticides), etc. It may also come from kidney damage caused by bacteria, viruses, and other microbial infections, such as Staphylococcus aureus, Escherichia coli, mold, viruses, etc., which directly invade the kidney parenchyma. Bacterial toxins may also cause inflammation of the kidney interstitium, leading to AKI.

03

Post kidney factors: Refers to the failure of urine to be excreted due to obstruction of the following parts of the kidney s. If post-kidney factors can be removed in time, most of them are reversible. Common causes include compression or direct blockage of urinary tract stones, urinary tract tumors, prostatic hypertrophy, pelvic tumors, and abdominal fibrotic lesions. Urinary tract obstruction causes bilateral hydronephrosis, increased kidney interstitial pressure, and damage to the kidney parenchyma. Prolonged obstruction can cause reflex kidney vasoconstriction, resulting in ischemic damage to the kidneys. And after urinary tract obstruction, it is easy to cause urinary tract infection, further aggravating kidney damage.

How to tell if you have acute kidney failure

The occurrence of acute kidney failure is relatively sudden and insidious. If you do not pay attention, it is difficult to detect, and the disease is often serious when it is found. However, if you have some knowledge about acute kidney failure and pay attention to some changes in yourself, you can still find some clues, to prevent or terminate it in time

 01

Pay attention to changes in urine volume: the daily urine volume of healthy people varies depending on how much water they drink, generally between 1000ml and 2500ml. If the urine volume is less than 400ml, it is called oliguria in medicine, and less than 100ml is called anuria. If there is oliguria or anuria, there are usually reasons and problems, especially after increasing the water intake, the urine does not increase significantly, or the oliguria or anuria persists. At this time, you should be alert to the possibility of acute kidney failure. Therefore, to prevent the occurrence of kidney failure, we must pay attention to the changes in our urine volume.

02

Observe accompanying symptoms: In addition to changes in urine output, with the progression of acute kidney failure, patients often experience some accompanying symptoms, such as swelling of the lower limbs and eyelids, fatigue, anorexia, nausea, chest tightness, palpitation, dizziness, and increased blood pressure, chest tightness often has to sit up at night, etc. The above changes may be related to the rapid progress of acute kidney failure. At this time, the most important thing is to go to the hospital for medical treatment in time.

03

Pay attention to the test results: is there acute kidney failure in the end? Simple examinations can quickly help confirm the diagnosis, blood routine, urine routine, kidney function electrolytes, and urinary system B-ultrasound, do these checks, and it will be clear soon. Early detection, early diagnosis, and early treatment are conducive to the timely termination of the occurrence and progression of acute kidney failure.

04

Check whether there are incentives: everything in the world has cause and effect, and most of the above changes have incentives. You should calm down and think carefully about whether you have suffered from any disease (cold, diarrhea, etc.) in the past 3 months. , What drugs have you used (antibiotics, analgesics, diuretics, traditional Chinese medicine, decoctions, health products, etc.), whether you are overworked, strenuous exercise, etc. Elderly people with underlying diseases should pay attention to the changes in some indicators (blood, blood sugar, uric acid, blood lipids, cardiac function, etc.), whether they are effectively controlled, whether there is a recent fluctuation or increase, whether the drugs they are taking have been adjusted, and so on.

How to prevent acute kidney failure

To prevent acute kidney failure, you must start by regulating your daily behavior. Just like you must obey the traffic rules when you go out and drive, there are many precautions to be followed in the prevention of acute kidney failure.

01

Living rhythm, maintaining good living habits, quitting smoking and drinking: binge drinking, overeating, smoking, drinking, staying up late, overworked, overdrawing the body, these are not only the kidneys, but all the organs of the body are a kind of loss and damage, all possible become a risk factor for direct or indirect damage to the kidney s.

02

Exercise and exercise moderately: Exercise helps to strengthen the body, but there is a premise that the exercise must be carried out under healthy conditions, without excessive exercise, and gradually. Ultra-long, high-intensity exercise is detrimental to the body and organs, and it is also easy to cause muscle damage, rhabdomyolysis, and other complications, and induce acute kidney failure.

03

Do not take health products, supplements, and trace elements at will: First of all, the quality is not guaranteed, and it is difficult to evaluate the therapeutic effect after taking it, and it may even cause damage to organs such as the liver and kidneys. In addition, these supplemented substances are not necessarily what the human body needs, because in most cases, the human body does not lack these ingredients. If there is no shortage in the body, continue to supplement it. Excessive supplementation may also cause damage to the body and kidneys.

04

Avoid the use of nephrotoxic drugs, and use traditional Chinese medicine and decoction with caution: most of the drugs are metabolized by the kidneys, and the drug concentration further accumulates after reaching the kidney tubules. There are many drugs with certain nephrotoxicity, which can induce acute interstitial nephritis and acute tubular necrosis, so medication must be used under the guidance of a nephrologist. In addition, the use of traditional Chinese medicine or decoction of Chinese herbal medicine must be used with caution. Many people think that traditional Chinese medicine has no side effects. This view is wrong. It is very common to take traditional Chinese medicine to induce acute kidney failure in clinical practice. It is not allowed to take traditional Chinese medicine casually, nor to take traditional Chinese medicine as a daily health care product to make wine or add it to diet or drinking water.

05

Pay attention to the control of risk factors and drug compatibility: patients with underlying diseases such as diabetes and hypertension are more likely to develop acute kidney failure than healthy people. Therefore, attention should be paid to the monitoring and control of risk factors such as blood pressure, blood sugar, blood uric acid, and blood lipids. These factors themselves can lead to kidney damage and may become a direct factor leading to acute kidney injury under specific conditions. In addition, for patients with a variety of underlying diseases, the compatibility of drugs is also very important. Some drugs can reduce kidney perfusion and cause kidney ischemia, and some drugs have toxic side effects on the kidney. If these drugs are used at the same time, under certain conditions, it may be It can induce acute kidney failure, and it is recommended to take them under the guidance of a nephrologist.

06

Pay attention to the damage caused by the superposition of risk factors to the kidneys: Sometimes, the risk factors for damage to the kidneys will occur in the same person. May also happen. I once treated a college student who had acute kidney failure. When he came to see the doctor, his serum creatinine was 1200. He was healthy before and had no disease. The reason for acute kidney failure may be the superposition of several risk factors: cold + antipyretic. Pain medicine + staying up late + 1000-meter sports compliance test + insufficient liquid calorie intake, think about it, in this case, the iron-beaten kidneys may not be able to support it. So, cherish the body, love the kidneys, and enjoy life.

for more information:ali.ma@wecistanche.com