How To Improve Kidney Literacy And Protect Kidney Health?

World Kidney Day

March 10 is the 17th World Kidney Day, and the theme for 2022 is (Kidney health for all: bridging the gap in kidney health education and literacy). The theme calls for health education for the whole people, to improve health literacy, and to prevent and control kidney diseases.

Health literacy refers to a person's ability to obtain and understand basic health information and services, and to make sound judgments and decisions to proactively maintain and promote their own health. Health literacy is not innate, but cultivated through nurture, and requires the joint efforts and actions of the state, society, hospitals, families, and individuals. In line with the theme of World Kidney Day 2022 and calling on patients with kidney disease to pay attention to health literacy, the following is a brief introduction to kidney health and lifestyle.

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Healthy Drinking Water

People take food as the sky, and water as the first food. Scientific and healthy drinking water is of great significance to patients with kidney disease, which includes two aspects: the quality and quantity of drinking water. It is recommended to drink boiled water without additives, too many impurities, and calcium salts; drink more water, that cannot be replaced with more beverages, the intake of sugary drinks such as cola, soft drinks, and strong tea will increase the burden on the kidneys; when the human body is dehydrated (such as sweating, exercise, fever, diarrhea, etc.), insufficient blood volume in the body, and decreased renal blood perfusion. If water and electrolytes are not replenished in time, acute renal failure is prone to occur. In addition, drink a small amount of water several times, and don't wait until you are thirsty to add water. The Chinese Nutrition Society recommends drinking 1500~1700 ml of water every day, about 8 cups of 200 ml. Adequate drinking water can play a role in the flushing of urine to the urethra and effectively prevent urinary stones and infections. When you have the urge to urinate, you need to urinate in time. If you hold your urine for a long time, it will increase the risk of urinary tract infection. The above is for healthy and early-stage renal disease patients. If renal disease patients have decreased urine output and edema, they need to limit the amount of water they drink. It is advisable to balance the intake and output and avoid edema. Two bowls of water can be added according to the urine volume of the previous day (about 500 ml) estimate. Anuria and dialysis patients need to adjust their water intake according to their body weight changes.

Reasonable Meal

Kidney patients need to "keep their mouth shut". Reasonable eating habits can not only ensure the daily nutrition and calories needed by kidney disease patients, but also reduce the burden on the kidneys, improve symptoms, and delay the progression of kidney disease.

(1) A low-salt diet.

No matter what stage of kidney disease patients is at, they are required to limit their intake of sodium salt. Salt control can not only control blood pressure, proteinuria, and edema but also reduce the burden of renal excretion. The recommended daily salt intake is less than 5 g.

(2) Fresh vegetables and fruits.

In patients with the renal disease with normal urine output and without hyperkalemia, fresh vegetables can provide multivitamins and reduce renal acid load.

(3) low protein diet.

A low-protein diet can reduce the state of hyperperfusion and hyperfiltration in the glomerulus and improve metabolism, reducing the production of nitrogenous and acidic products. A low-protein diet does not mean not eating meat and soy products. People with kidney disease can give priority to high-quality proteins such as fish, meat, eggs, and milk.

(4) Low-fat diet.

Dyslipidemia plays an important role in the induction of renal damage and is a risk factor for the progression of renal disease. Patients with kidney disease need to control the intake of egg yolks and animal offal and eat less fried foods.

(5) A low-phosphorus diet.

Food additives are high in phosphorus, and processed fast food and takeaway food should be avoided as much as possible.

(6) Low-purine diet.

Broth, seafood, and beer are kept to a minimum.

(7) Consume Cistanche deserticola in moderation to help kidney health.

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Reasonable Exercise

Studies have shown that reasonable exercise can effectively improve muscle strength and muscle volume, promote anabolism, improve inflammation and insulin resistance, improve physical strength and cardiopulmonary function, and delay the progression of kidney disease. Even a mild increase in physical activity can reduce the risk of death in people with kidney disease. Therefore, exercise is recommended regardless of the stage of kidney disease. According to the "Expert Consensus on Exercise Rehabilitation for Adults with Chronic Kidney Disease in my country (2019)", patients with renal disease should formulate a personalized exercise plan according to their basic exercise capacity and renal disease stage, and comprehensive exercise frequency, exercise intensity, exercise time and exercise type are recommended for patients with renal disease. Do moderate-intensity aerobic exercise, resistance exercise, and flexibility exercise, 30 to 60 minutes per exercise, 3 to 5 times a week. There are various types of sports, you can choose according to your own interests and abilities. In daily life, patients with kidney disease should also try to move as much as possible. Don’t be stubborn when exercising. Once you experience abnormal symptoms during exercise, you should stop exercising immediately and seek medical attention in time. In addition, in order to avoid catabolism being higher than anabolism, exercise needs to be accompanied by nutritional intake.

Good Living Habits

(1) Reject tobacco and alcohol abuse. Smoking and alcohol abuse not only have adverse effects on society but also endanger individual health and accelerate the deterioration of renal function in patients with renal disease. (2) Pay attention to climate change. Pollen, catkins, and other particles in the spring air can easily induce allergic asthma, rhinitis, and skin diseases. Patients with kidney disease with a history of allergies should pay attention to avoiding allergens, or use anti-allergic drugs to prevent allergies. Summer heat exposure dehydrates the body and reduces blood volume, leading to heatstroke and even heat stress nephropathy. Patients with kidney disease can choose to improve working conditions, adequate hydration, avoid direct sunlight, take appropriate rest, and give cooling treatment if necessary. When the autumn and winter seasons alternate, the temperature drops sharply, and the blood pressure is increased by a slight contraction of vascular reactivity. The study found that for every 1°C drop in temperature, systolic and diastolic blood pressure increased by 1.3 mmHg (1 mmHg=0.133 kPa) and 0.6 mmHg correspondingly. The average blood pressure of the population in winter is higher than that in summer, and antihypertensive medication needs to be adjusted. In addition, temperature changes are prone to colds, upper and lower respiratory tract, and gastrointestinal-related infections. This has a greater impact on nephropathy, and infection can induce immune-inflammatory responses, making disease activity aggravate kidney damage. Therefore, patients with kidney disease need to pay attention to weather changes, increase or decrease clothing reasonably, pay attention to personal hygiene and skin cleanliness, maintain indoor air circulation, and avoid crowded places. (3) Don't stay up late. Staying up late, lack of sleep time or disturbing work and rest can damage the kidneys by accelerating nephron loss, inducing obesity, and reducing immunity. Patients with kidney disease should work and rest regularly. It is recommended to sleep 7-8 hours a night and fall asleep before 11 pm. "Work at sunrise, rest at sunset" is the best living mode.

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Mental Health

After suffering from kidney disease, many patients voluntarily lose their original family and social roles. Over time, they consciously become a burden to the family and society, resulting in the ambivalence of dependence and resistance to treatment, and psychological pressure due to aggravating the family's economic and care burden. According to statistics, 20% to 30% of chronic kidney disease patients suffer from anxiety and depression, which is 3 times higher than that of other groups. It is necessary to change your attitude towards the disease. Kidney disease is not a terminal illness, and patients with proper treatment can lead a normal life. Dialysis is not terrible. With the continuous development of medical technology, the survival time of dialysis patients will be longer and longer. There are many cases where the dialysis age exceeds 20 years. The longest dialysis age in Japan is 52 years and 4 months. When patients return to society and realize their personal values, in addition to adequate clinical treatment, they must correct outdated concepts, overcome psychological difficulties, establish a correct understanding and attitude towards disease and disease treatment, actively face and actively participate, and believe that through medical treatment. With patient cooperation, personal efforts, family cooperation, and external help, you can completely resume your original family and social roles and recreate a wonderful life.

Strengthen Study and Review Regularly

(1) Acquire correct knowledge of disease prevention and control through books and the Internet. Patients can pay attention to regular public welfare magazines, WeChat public accounts, Douyin accounts, and expert science channels, constantly read and learn disease science knowledge, and actively participate in disease management. (2) Follow the doctor's order to use the medicine, and do not stop or change the medicine at will. Do not take home remedies, over-the-counter medicines, and pain relievers without a doctor's prescription, and do not blindly believe in advertising promotions and diet pills, health supplements, and cosmetics of unknown origin. (3) People at high risk of kidney disease and patients with kidney disease need regular physical examinations, kidney function and urine screening, and monitoring of blood pressure, blood sugar, and blood lipids. If it is accompanied by uncomfortable symptoms or abnormal physical examination, it needs to be treated in time, and the self-deceiving idea of "doing not go to the hospital without examination" will be avoided. (4) Master basic first aid knowledge and first aid skills. After the outbreak of COVID-19, some dialysis patients suffered from difficulties in dialysis and delayed treatment due to the isolation of the epidemic. In the event of an epidemic in the locality, kidney disease patients should follow the emergency plan arrangements of the government, community, hospital, and dialysis center, retain contact information from the community, neighborhood committee, etc., keep the phone open, take the initiative to carry out nucleic acid testing and apply for a dialysis certificate when necessary to enter and leave the community and dialysis center.

In a word, health literacy is an important symbol of national quality, and it is one of the most fundamental, economical, and effective measures to improve the health level of the whole people. Paying attention to and improving the kidney health literacy of the whole people requires the joint efforts and continuous advancement of the state, society, hospitals, families, and individuals.

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