This Kind Of Kidney Disease Has Blood in The Urine For A Lifetime, But The Doctor Said That There Is No Need To Treat It?

A 41-year-old female teacher, at the age of 28, was found to have hematuria (red blood cells in the urine) during the physical examination. There was no high blood pressure and edema, and there was no physical discomfort. After several re-examinations, there has been hematuria and occasionally microalbuminuria. The local doctor had given the patient antibiotics and traditional Chinese medicine, but it was ineffective. The patient was very afraid of "blood" in the urine, so he sought medical treatment in many ways, and has been taking traditional Chinese medicine treatment, but the hematuria has not been eliminated.

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After the blood in the urine was found in the examination, the patient felt that his body was getting worse and worse, his energy decreased, his body was weak, his waist was sore and his legs were weak, and he felt uncomfortable in many parts of his body. Eventually developed to be unable to do their job, often on sick leave.

At the age of 33, the patient went to a large hospital for treatment. The doctor performed a kidney puncture for her. The pathological result was "thin basement membrane nephropathy." However, the patient could not let go of his hematuria and was worried that he would develop chronic renal failure, so he continued to take traditional Chinese medicine for treatment.

In the end, because of this disease, the patient was under a lot of psychological pressure, and his workability was not as good as before, so he was transferred to logistics work.

What is thin basement membrane nephropathy?

Thin basement membrane nephropathy, also known as benign familial hematuria and familial hematuria syndrome, is clinically characterized by repeated hematuria, normal renal function, and positive family history. The pathological feature is thinning of the glomerular basement membrane.

The disease is familial. In recent years, 40% of those reported a positive family history (including parents, brothers, sisters, and children, etc.) at home and abroad. Most scholars believe that the disease is inherited in an autosomal dominant manner.

The disease can be seen at any age, but it is most common in young and middle-aged people, mainly in women, and the ratio of male to female patients is about 1:2~3. Analysis of foreign research data shows that thin basement membrane nephropathy accounts for 26% to 51% of patients who undergo renal puncture because of persistent microscopic hematuria to find the cause.

In urine sedimentation tests after centrifugation of urine, more than 3 red blood cells per high power field is hematuria, called microscopic hematuria. Do urine phase contrast microscopy, if most of the red blood cells are abnormal red blood cells of different sizes and various shapes, it is called renal hematuria. This is due to the deformation of red blood cells from the kidneys after being "squeezed" by the glomerular filtration membrane.

The main clinical manifestation of thin basement membrane nephropathy is hematuria. Most of the patients have persistent microscopic hematuria. Very few patients may have gross hematuria (hematuria that can be seen in the eyes) after upper respiratory tract infection or strenuous exercise. Hematuria. About half of the patients had mild proteinuria at the same time, blood pressure was generally normal, and a small number of patients (<20%) had mild hypertension.

Renal pathology in thin basement membrane nephropathy is characterized by diffuse thinning of the glomerular basement membrane on electron microscopy. IgA nephropathy also manifests as hematuria, but hematuria is heavier, and gross hematuria often occurs. At the same time, it is combined with proteinuria and hypertension, which is prone to renal failure. Mild IgA nephropathy is sometimes difficult to differentiate from thin basement membrane nephropathy, and renal biopsy is the most definitive method of identification.

Can thin basement membrane nephropathy develop into chronic Kidney failure?

Thin basement membrane nephropathy is called benign familial hematuria because it is a benign disease that persists throughout life, does not worsen, and rarely progresses to chronic renal failure. For patients with only hematuria, no proteinuria, normal blood pressure, and normal renal function, no specific treatment is required. Patients with elevated blood pressure can be treated with sartans or prickle-type antihypertensive drugs.

Usually, a low-salt diet, avoiding colds and overwork, regularly monitoring blood pressure, urine routine, and renal function, avoiding unnecessary treatment, and the application of nephrotoxic drugs.

To sum up, thin basement membrane nephropathy is a familial genetic disease, only manifested as microscopic hematuria, no proteinuria, and renal hypertension, and it is lifelong, neither good nor bad, and will not develop into chronic renal failure. , no special treatment is required. In fact, for patients with non-thin basement membrane nephropathy and pure microscopic hematuria, if there is no proteinuria and hypertension, there is no need to worry about it, and no special treatment is required.

Optimism is just as important for disease treatment

Looking back on this patient, the kidney puncture has been diagnosed as thin basement membrane nephropathy. The doctor also suggested that she does not need special treatment, but the patient still insists on taking traditional Chinese medicine treatment. In fact, it is not the problem of the disease itself, but her psychological problem. . The blood in the urine itself did not affect her body, but the fear of blood in the urine hurt her physically and mentally.

There is no perfectly healthy body, just as there is no one who does not make mistakes; the heart can tolerate disease just as it can tolerate the mistakes of others. It is the correct way of life to live healthy and happy with illness.

for more information:ali.ma@wecistanche.com