Some Useful Knowledge Of Kidney Disease

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How to detect kidney disease early?

Most of the early stages of chronic kidney disease have no obvious symptoms and are not easy to pay attention to. If urine, blood, and imaging tests are not carried out, it is difficult to detect. Some patients have already entered end-stage renal disease when they are discovered, and can only wait for dialysis and transplantation. Therefore, early detection and diagnosis are very important, so how to detect kidney disease as early as possible?

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1. Regular and regular physical examination

In the early stage, the main clinical manifestations of chronic kidney disease are proteinuria and microscopic hematuria. Unless there is a lot of proteinurias, there will be edema of the eyelids or limbs. Under normal circumstances, there will be no obvious symptoms and discomfort. Therefore, it is recommended to Healthy adults should undergo a comprehensive physical examination once a year. Kidney damage, such as proteinuria, microscopic hematuria, or elevated serum creatinine, can be detected early only through urinalysis and blood tests. Therefore, regular physical examination is the key to the early detection of kidney disease. In daily clinical work, I encounter some patients with severe renal disease who have never had a physical examination before, thus missing the opportunity to detect the disease early. When obvious symptoms or physical discomfort occur, such as edema, nausea and vomiting, Chest tightness and suffocation, etc., only to find out that the kidney disease has developed into an advanced stage. In addition to proteinuria, renal function is also severely damaged. It is chronic renal failure and uremia, and dialysis treatment is required. If kidney damage is found in the physical examination, such as proteinuria, hematuria, or a mild increase in serum creatinine, you should go to the nephrology department of a regular hospital as soon as possible. In clinical practice, some patients are also encountered. Although the physical examination found kidney damage, they did not pay enough attention and did not go to the hospital in time, thus delaying the best time for treatment. It's a pity.

2. Pay attention to the secondary factors of kidney disease

In addition to the factors of the kidney itself, there are many secondary factors, such as diabetes, hypertension, gout, obesity, tumor, hepatitis, and so on. Long-term hyperglycemia can lead to abnormal renal hemodynamics. In the early stage, hyperperfusion and hyperfiltration occur, and microalbuminuria gradually occurs. As the course of the disease prolongs, the glomerular filtration rate decreases and symptoms such as persistent proteinuria and hypertension appear. Also known as diabetic nephropathy; long-term poor control of blood pressure increases intravascular pressure, causing the protein to leak into the urine, destroying the renal filtration system, causing glomerular arteriosclerosis, renal failure in severe cases, and eventually uremia. Therefore, for high-risk patients with underlying diseases such as diabetes and hypertension, controlling their underlying diseases is also an important part of preventing and treating kidney disease. At the same time, tests should be performed at least twice a year or more, including urine routine, blood routine, blood biochemistry (including liver function, renal function, ion, etc.), and renal imaging. Among them, the detection of urinary microalbumin (urine albumin/creatinine) is more sensitive than urine routine, and can detect early diabetic nephropathy, hypertensive renal damage, and other renal diseases, and is one of the sensitive indicators for the early diagnosis of renal damage.

3. Pay attention to typical symptoms of kidney disease

Learning to identify common clinical manifestations of kidney disease is also helpful for early detection and diagnosis. Common symptoms of clinical kidney disease include edema, increased foamy urine, and hematuria. Among them, the edema mostly occurs in the front tibia or ankle of the lower extremity, which can be concave by acupressure. It can also appear in the eyelids, and even the whole body is swollen in severe cases. If there is a large amount of protein in the urine, the urine foam will increase, and it will be in the form of fine foam, and it will not be easy to dissipate for a long time; some patients with acute kidney disease will have soy sauce-colored and strong tea-colored urine. Unlike urinary tract infection, it is generally not accompanied by There are bloodshot or blood clots, and there are no symptoms of urinary tract irritation such as frequent urination, urgency, and dysuria; some patients with kidney disease also have changes in urine volume, such as normal drinking water, urine volume decreases <400 ml per day, or nocturia Increased (nocturnal urine output > daytime urine output) all suggest that the kidneys may be damaged; hypertension is also one of the common symptoms of kidney disease patients, especially young people who have unexplained dizziness and elevated blood pressure, need to be alert to renal hyperactivity the presence of blood pressure. Once the above symptoms appear, you must seek medical attention as soon as possible to confirm the diagnosis.

In today's society, the pace of life is accelerating, and many people neglect routine physical examinations because they are busy or too troublesome, or they do not pay attention to the symptoms, and miss the early treatment of kidney disease, resulting in aggravation of the disease. Therefore, in order to protect the health of the kidneys, please adhere to regular physical examinations, learn to identify typical symptoms, and early detection and early treatment, so as not to miss the opportunity.

How much water should people with kidney disease drink each day?

When it comes to drinking water, many kidney disease patients feel confused and don't know how much water they should drink every day. Some patients think that they should drink less water when they have kidney disease, otherwise it will increase the burden on the kidneys and induce edema, so they blindly limit the amount of water they drink; Drink plenty of water. These are all wrong practices. So how should kidney disease patients drink water scientifically?

1. How much water should a normal person drink?

One of the main physiological functions of the kidneys is to produce urine and expel metabolic wastes from the body. A normal person needs to excrete 1800-2000ml of urine every day to ensure that the metabolic wastes in the body are excreted from the body. To ensure that the kidneys produce so much urine, a normal person needs to drink about 1500-2000ml of water every day.

2. Do people with kidney disease need to limit water?

For patients with kidney disease without obvious edema, heart failure, and other symptoms, it is possible to maintain normal water intake, and ensuring sufficient water intake can reduce arginine vasopressin, thereby lowering blood pressure and improving glomerular entry. and the pressure difference of the efferent arterioles, reduce the burden on the kidneys, promote the production of urine to effectively remove metabolic wastes, and help maintain the stability of renal function.

3. Which kidney disease patients need water restriction?

Patients with kidney disease need to limit their water intake when they have the following conditions: (1) high edema; (2) oliguria (less than 400ml of urine in 24 hours) or anuria (less than 100ml of urine in 24 hours); (3) patients undergoing dialysis patients; (4) hypoalbuminemia; (5) chronic heart failure. If the above patients drink too much water, it will increase the water retention in the body, increase the burden on the heart and kidneys, and aggravate the disease.

4. What principles should be followed for water restriction?

The daily water intake of patients who need to limit water should follow the principle of "paying for what you use". For non-dialysis patients with edema, the daily water intake should be "urine volume + (500-700ml)", and at the same time, it should be combined with food. The moisture content is generally to the extent that it does not cause edema. For dialysis patients, it is necessary to calculate the water intake according to the change in body weight, and it is advisable that the weight gain during two dialysis periods does not exceed 5% of the standard bodyweight.

In short, patients with kidney disease need to drink an appropriate amount of water according to their own conditions. Patients without obvious contraindications do not need to deliberately limit the amount of water they drink. Patients with obvious edema, decreased urine output, chest tightness, suffocation, and heart failure should consciously reduce the amount of water they drink. illness.