Creatinine Was 904, Heart Rate Was 38, And Two Bowls Of Mushroom Soup Sent Him To The Emergency Room!

As an important metabolic and filtering organ of the body, the kidneys play a role in regulating the balance of water, acid-base, and electrolytes. The quality of kidney function will directly affect the regulation function and the stability of corresponding indicators.

Elevated blood potassium is one such indicator. Hyperkalemia is one of the common electrolyte disorders in clinical work and one of the common fatal complications in patients with renal failure.

Click to Cistanche for kidney disease

The blood potassium level in the normal human body is in a dynamic state, generally 3.5 to 5.5mmol/L. If the blood potassium is >5.5mmol/L, it is hyperkalemia [1].

Two bowls of "mushroom chicken soup" sent someone to the emergency room?

On an ordinary afternoon, in the office of the nephrology doctor, everyone is doing their own thing, writing cases, talking, and doing scientific research. It looks busy but not chaotic.

A phone ringing broke the calm of the office. The emergency department called and said that a patient had been admitted. His heart rate was only 38 beats/min, his limbs were numb, and his creatinine was 904 μmol/L. He requested consultation.

I rushed over when I was on duty and found that the patient's condition was quite complicated. The patient is a 60-year-old man with a history of hypertension and diabetes for many years. His blood pressure and blood sugar levels have recently stabilized.

He also had a 5-year history of coronary heart disease and a 6-year history of hepatitis C cirrhosis. I was diagnosed with chronic kidney disease 7 months ago. I did not receive any systemic treatment. I only took oral kidney-protecting drugs intermittently and did not have regular re-examinations.

Chronic kidney disease and sudden decrease in heart rate, hyperkalemia is first considered. At the same time, considering the patient's history of coronary heart disease, myocardial infarction is also possible. In short, let's take ECG monitoring first.

While waiting, I learned that the patient had symptoms of fatigue two days ago after taking furosemide, spironolactone, and potassium chloride sustained-release tablets due to liver cirrhosis and ascites, but he did not pay attention to it at the time. Both spironolactone and furosemide are diuretics, which can remove excess water from the body. However, long-term use is prone to electrolyte imbalance, so potassium ions need to be replenished in time. The patient's fatigue symptoms may be related to elevated potassium ions in the body.

Considering the possibility of hyperkalemia, I asked the patient's family if the patient had recently eaten fruits with high potassium content such as oranges, bananas, and oranges. The patient's family quickly denied it, saying how dare they eat that.

After digging into the matter, the family members revealed the truth. Sure enough, the problem was caused by the food they ate.

I asked what else I ate today and yesterday.

"He had a bad appetite last night. He drank rice porridge but didn't eat any fruit. He ate two steamed buns this morning and at noon..." the family member said hesitantly.

The patient's family suddenly remembered, "Oh, my son brought mushroom and chicken soup at noon, and he ate two more bowls."

This is related to hyperkalemia. Mushrooms are a food with high potassium content. Each 100g of mushrooms contains about 1225 mg of potassium.

According to my country's dietary guidelines, healthy adults should consume about 2,000 mg of potassium per day, but for patients with chronic kidney disease, the potassium in the diet should be adjusted according to individual circumstances.

If symptoms such as oliguria or anuria occur, potassium in the diet should be limited to less than 40-60mmol/L per day;

If you urinate a lot or need to use diuretics, you can appropriately increase your intake of potassium-containing foods, preferably above 80mmol/L every day.

In patients with kidney disease, the ability of the kidneys to break down potassium is weak, causing potassium to accumulate in the blood for a long time. Some patients have weak self-control or lack of awareness of the potassium content of food, and eating high-potassium foods for a long time or in large amounts often leads to hyperkalemia [2].

The condition is clear and the situation is urgent. How should we treat it?

Sure enough, the electrocardiogram showed hyperkalemia and sinus bradycardia. At the same time, the laboratory department reported a critical value, serum potassium 7.7mmol/L. Severe hyperkalemia can manifest as ventricular fibrillation, and in severe cases, sudden cardiac arrest can lead to death!

Serum potassium >6.5mmol/L is an indication for renal dialysis. During treatment, a suitable treatment plan should be selected according to the patient's severity. Among many methods, dialysis is the most effective method, combined with the use of drugs. It will increase the cure rate of hyperkalemia to a higher level.

After detailed communication with the patient and his family, he was immediately transferred to the hemodialysis room for further hemodialysis treatment. After 40 minutes of dialysis treatment, the patient gradually regained consciousness, his breathing returned to normal, his heart rate was 75 to 80 beats/min, and his blood oxygen saturation was 96%. After 3 hours of dialysis, the patient's blood potassium concentration dropped to 4.9mmol/L. After adequate hemodialysis treatment, the patient was in good mental condition.

How is hyperkalemia treated?

The main causes of hyperkalemia are the following:

(1) Reduced potassium excretion by the kidneys: long-term use of potassium-sparing diuretics, acute and chronic renal failure.

(2) Excessive intake of potassium: Long-term overdose of potassium-containing drugs and foods. Such as kidney beans, seaweed, mushrooms, etc. Enter a large amount of stock blood.

(3) Metabolic acidosis: When the pH in the human body is excessively acidic, potassium ions in the cells will be replaced by hydrogen ions, and a large amount of potassium ions originally in the cells accumulate outside the cells, leading to hyperkalemia.

(4) Other reasons: such as infection or trauma, which will accelerate the decomposition of cell tissues in the body and may cause an increase in blood potassium to a certain extent. Part of the reason is due to insufficient dialysis.

The cardiovascular system and the neuromuscular system are the two main systems most susceptible to hyperkalemia.

The myocardium will be inhibited due to high blood potassium, which will affect the conduction of the heart, so arrhythmias are prone to occur. There are often characteristic changes in the electrocardiogram, typically with high peaks in the T wave.

In terms of the neuromuscular system, in the early stage, symptoms of numbness, fatigue, muscle aches, pale and clammy skin, loss of tendon reflexes, and muscle weakness are common in the limbs and around the mouth. Symptoms of weakness often begin in the legs first. Acute patients should take prompt and active rescue measures.

The following measures can be taken:

(1) First stop potassium intake: stop all oral or intravenous potassium-containing drugs and foods, and stop blood transfusions.

(2) Use drugs to excrete potassium: Diuretics are commonly used clinically, which can excrete excess potassium ions in the blood from the body.

(3) Calcium: The emergency measure in clinical practice is to immediately intravenously inject 10-20ml of 10% calcium gluconate. Depending on the condition, another intravenous injection can be given at intervals of one to two minutes.

(4) Glucose plus insulin: In clinical practice, 500 ml of 10% glucose injection is usually added to 10 units of insulin for continuous intravenous infusion. The effect usually takes 20-30 minutes. Changes in serum potassium and blood sugar should be closely monitored during the infusion process to prevent patients from experiencing hypoglycemic reactions.

(5) Sodium bicarbonate: Sodium bicarbonate has been used clinically for many years to treat hyperkalemia. Hyperkalemia is often complicated by acidosis, and sodium bicarbonate is an alkaline solution that can be used to correct acidosis and thereby correct hyperkalemia. On the other hand, sodium bicarbonate can expand blood volume and temporarily reduce the concentration of potassium ions in the blood.

(6) Dialysis: The most direct and effective solution for uremic patients with hyperkalemia is hemodialysis. Serum potassium >6.5mmol/L is an indication of renal dialysis [4].

How Does Cistanche Treat Kidney Disease?

Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.

Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.

Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.

Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.

Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.

Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.

Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.

In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.

In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.