Pelvis beside cyst - laparoscopic surgery

Laparoscopic surgery for renal pelvic cyst next to the surgeon's technical requirements, we should note the following:
( 1 ) the relationship between preoperative cyst location, size , number and with peripheral vascular , renal collecting system
; ( 2 ) Due to parapelvic cyst near the renal hilum , separated parapelvic cysts should be careful ; laparoscopic renal vein and inferior vena cava wall of dark blue , similar to the top of the cyst , attention should be identified , careful operation , avoid kidney damage vascular pedicle ;
( 3 ) If the cyst and the expansion of the renal pelvis can be difficult to distinguish when squeezed pelvis , pelvis becomes empty, the cyst did not change , it could be given before surgery followed by cystoscopic retrograde ureteral catheter inserted for guidance , intraoperative injection of methylene blue , identifying cysts and pelvis, and whether pelvis incision ; further guidance on laparoscopic puncture pale yellow liquid verifiable cyst ;
( 4 ) should be resected from the substance of the wall 3 ~ 4mm, so as not to cause renal bleeding is difficult to control ;
( 5 ) anatomy encountered poor visibility , variability , bleeding should be promptly converted to open surgery
; ( 6 ) the renal pelvis in the door next to fat filled cysts may further prevent recurrence ;
( 7 ) after abdominal anatomy urologists familiar with unilateral renal pelvic cyst can be next after retroperitoneal approach , bilateral cysts can be processed simultaneously by the intraperitoneal route , give full play to its advantages of minimally invasive . Laparoscopic treatment of parapelvic cyst safe, reliable, fully embodies the advantages of minimally invasive laparoscopic surgery. With the growing popularity of laparoscopic techniques and the development of laparoscopic cyst cyst will become the preferred method of treatment parapelvic .

Pelvis beside cyst - check

The disease is more common in patients over the age of 50 , a similar proportion of men and women next to asymptomatic patients with cystic renal pelvis , clinical symptoms are more common in men . Clinical manifestations may include lower back pain and discomfort , hematuria , hypertension or with intracapsular stones, some patients are asymptomatic, discovered by chance during examination . According to B- , IVU and CT examination can confirm the diagnosis. There is a liquid dark area near the B- visible renal hilum , and can display the size of the cyst , but extends to the renal sinus cyst causing hydrocephalus renal pelvis , or renal sinus cysts located deep when misdiagnosed as hydronephrosis . IVU examination can be found in the kidney or renal sinus door with a circular mass oppression of the renal pelvis , ureter or renal calyx , there arc pressure trace , deformation, displacement or stretched, such as cysts and renal pelvis is no traffic , then swollen no matter contrast agents, small cysts can be no such changes . CT examination is the most reliable method of diagnosis , clear boundaries can be displayed beside the pelvis oval uniform mass density , CT value of 0 ~ 2 0HU, after little change in the value of enhanced CT , can be diagnosed as benign cysts pelvis next ; parapelvic cysts in the renal sinus , large cysts may apply to the renal hilum prominent ; whereas renal cysts were located in the renal cortex , round, can be single or multiple. B -ultrasound and CT examination can help in the differential diagnosis .

Pelvis beside cyst - Treatment

Pelvis due next cysts are benign lesions, cysts are small and asymptomatic, can be regular follow-up, when the cyst diameter> 5cm, or compression symptoms and complications, should take active surgery. Surgical methods are open cyst decortication, B ultrasound-guided aspiration of cyst fluid injection sclerotherapy and laparoscopic cystectomy and so on. Gate structure is complex due to renal cysts deep aspiration of cyst fluid injection sclerotherapy can easily lead to complications and recurrence rate and therefore should not be used. Traditional open surgery requires a large incision line waist, large body injury, postoperative recovery was slow, long hospital stay. Laparoscopic due to multiple angles and have amplification, fully exposed to surgery, bleeding effect, minimally invasive, worthy of promotion.

Pneumonia in the elderly with end-stage diseases easily confused with what?

1 Early failure of left heart failure have cough, frothy sputum , dyspnea more significant , not supine, lungs wet ? Sounds more widely , and may vary with position. 2 . Lung cancer associated with obstructive pneumonia after adequate antibiotic treatment is not ideal or lung shadows unknown nature , should be sputum examination cells, carcinoembryonic antigen , X-ray radiography layer , CT and bronchoscopy , etc., there help diagnosis. 3 Tuberculosis Tuberculosis elderly often lack the typical symptoms, signs and X -ray findings , unexplained fever , X-ray shadow obviously exist, generally ineffective against infection , should consider the possibility of tuberculosis . Careful retrospective history, old TB lesions and the presence of acid-fast bacilli sputum examination can help diagnose the X -ray film . 4 pulmonary embolism have surgery, trauma, heart disease ( in particular, those with atrial fibrillation ) and move, phlebitis history , manifested as sudden difficulty in breathing, coughing, coughing up sputum and chest pain significantly . Help to identify typical ECG changes . 5 other gastrointestinal symptoms should be accompanied with acute gastroenteritis, acute abdomen identification ; shock pneumonia should be caused by cerebrovascular accidents and their causes shock were identified.

End-stage renal disease - prevention

People suffering from kidney disease far more than people imagine . In clinical practice, many patients ignore the early signs of chronic kidney disease , and once the development of ESRD , although it can take dialysis , transplantation and other ways to sustain life , but seriously affect the quality of life, resulting in heavy financial burden.

Apart from a few patients will appear facial swelling , gross hematuria and other symptoms , it is easier to clear their renal insufficiency , but a significant proportion of patients do not know they have kidney disease , the doctor in quite a few detours . Some patients experience nausea, vomiting, and thought he was suffering from stomach problems , some malaise, thought he was anemic ...... these to medical complications is widespread , often delay the disease .

Hypertension, diabetes , high cholesterol , obesity and other groups at high risk of kidney disease. Note that if the people in addition to their frequent appearance of nocturia , urinary observed color changes in urine outside of the routine urine examination to detect early kidney disease is the easiest and most economical way , and to find kidney function tests from blood problems , most of the patients had lost about 50% of kidney function. If you can not block the early discovery and early development of the ESRD , known as uremia , renal function must be an alternative treatment, although the long term to sustain life, but quality of life is seriously affected. In China, an ESRD patient per year funding for treatment is very expensive.

Older people with end-stage pneumonia - Pathogenesis

End-stage patients with pneumonia in the elderly as much. With increasing age , the degeneration of the respiratory system structure, function and respiratory mechanics , upper respiratory humidification dysfunction, decreased ability expectoration , particularly cerebrovascular disease, patients with swallowing reflex and cough reflex of consciousness stimulation thresholds were significantly increased , throat dysfunction, sleep prone to aspiration pneumonia caused by aspiration . Nasogastric tube stimulation by the patient can also lead to vomiting, aspiration pneumonia . Therefore, in end-stage pneumonia , aspiration pneumonia occupies considerable proportion. There is also partly due to low immunity , bacteria from other parts of the body through the blood into the lungs , causing lung infections , including fungi. Final year-end due to pneumonia often old expectoration diminished capacity , or because of disturbance of consciousness, no satisfactory sputum samples , and thus the pathogen is not clear and more cases of pneumonia than the general , general damage to the immune factors associated with susceptibility to certain pathogens relationship. Caused by the abnormal T cell immunity in patients with end-stage damage to susceptible Listeria , Mycobacterium , slave card spp, Salmonella ( except typhoid outside ) , Legionella , fungi including Cryptococcus neoformans , Histoplasma capsulatum , Mucor , coccidioidomycosis . Viruses include cytomegalovirus , herpes zoster virus , herpes simplex virus . Pneumocystis carinii parasites including worms, stercoralis . B cell abnormalities caused by the immune damage in patients with end-stage primary infection bacteria Streptococcus pneumoniae , Haemophilus influenzae . Agranulocytosis in patients with primary infection Escherichia coli, Pseudomonas aeruginosa , Klebsiella , Serratia , and other Gram-positive bacteria, fungi. Splenectomy in patients with end-stage susceptible Streptococcus pneumoniae, Staphylococcus aureus , Haemophilus influenzae , Escherichia coli . Hormone or bacterial infection of cytotoxic drugs in patients with end-stage Staphylococcus aureus , Listeria monocytogenes , Pseudomonas aeruginosa and other Gram-negative bacteria, fungi, cytomegalovirus , herpes zoster virus, Pneumocystis carinii insects, Toxoplasma , stercoralis . Barrier damage and end-stage patients intubated with various primary infection Staphylococcus aureus, Pseudomonas aeruginosa .

Children with nephrotic syndrome - relapse

Children's use of hormone therapy is very easy to relapse, relapse once you have re- use of hormone therapy , this way is certainly not conducive to the development of a large number of hormonal children ! Below to tell you about how to prevent the recurrence of nephrotic syndrome in children !
Prevent recurrence of nephrotic syndrome in children :
Hypertension is a major complication of nephrotic syndrome , the monitoring of blood pressure , low-salt diet is very important. For protein , a lot of people think that since there is proteinuria , the body will certainly lose a certain amount of protein , so be sure to add protein , eat more protein foods. In fact, this is a misunderstanding. If renal proteinuria compared to a leaky kettle , pour more inside , more powerful kettle leak . Kidney , too, eat more protein , more heavy burden on the kidneys , if you limit the intake of protein , will reduce the burden on the kidneys , the gradual recovery of renal function.
It is estimated that each egg contains 7 to 8 grams protein , 250 ml milk contains 7 grams protein , a two lean protein containing 7 g . Try not recommended fat meat, seafood must be fresh , but also to limit , do not eat cold food, like ice cream, raw food, especially in summer, so as not to cause diarrhea, caused by disease recurrence. Best to eat spicy food , if the cause of pharyngitis , can lead to disease recurrence.
Experts stressed that the movement of the body , the kidneys also is movement, only adhere to exercise, really conducive to the recovery of the disease. As long as the body allows , you do whatever things of life should be the law , can not stay up late.

Children with nephrotic syndrome - Nursing

Children with nephrotic syndrome , also known as pediatric kidney disease, clinical features are: height edema , proteinuria , hypoalbuminemia , hypercholesterolemia sign. Children with nephrotic greatly affect the growth and development of children , is not easy to treat , and more repeatedly, pediatric kidney disease resistance is low , prone to infection , leaving sicker, should actively prevent infection , then how should the children have skin damage care, in order to obtain satisfactory clinical effect?
Children with nephrotic highly edema, severe edema in children with nephrotic syndrome can lead to secondary infection , there is the risk of skin damage , the relevant care measures are as follows :
1 scrotal edema when male children , can hold the bag and keep a local hygiene
2 regular turning and alcohol use safflower massage pressure areas to promote local blood running . Avoid turning drag, pull, pull and other actions to prevent skin abrasions.
3 children nails regularly to prevent scratching the skin , causing infection .
4 children bathing regularly to keep the skin clean. When operating action should be gentle, so as not to damage the skin .
5 children clothes should be soft and loose , the timely replacement pollution. Beds to keep clean and dry, smooth and no wrinkles .

Glomerulosclerosis - pathological changes

Into the kidney after repeated branch , the final form afferent artery. After entering the glomerular afferent arterioles , and then branch repeatedly , and finally into many lobular capillary loop shape , and among the various branches of the capillary formation of vascular anastomosis have mutual goals . Finally, each lobular capillary arterioles and then merged into a ball leaving the glomeruli. General efferent than the afferent arterioles fine arteries , resulting in a higher pressure in the blood vessels ball. Outside glomus package has renal capsule , renal capsule has outer and inner layers of epithelial cells, kidney cells between two small cysts . Renal capsule outer cells connected with the proximal tubule epithelium, renal cysts and proximal tubule lumen tube connected . Renal capsule layer is constituted by the projection of podocytes .
Ball thin capillary endothelium of blood vessels . Electron microscope soma capillary endothelial cells have many round holes, called hole, diameter of about 50 ~ 100nm, distributed more regular. Between the capillary endothelial cells and podocytes renal capsule with a layer of the basement membrane , which is mainly composed of mucopolysaccharides and reticular fiber network composed of interconnection voids , like paper . That is, outside the base film podocytes . Small protrusions podocytes intertwined to form many holes , hole size of about 20 ~ 40nm. Podocytes shrink or swell projections can change the size of the hole , thereby regulating the permeability of the filter material renal corpuscles .
Blood flows through the substance of glomerular capillaries , must have a hole through the capillary endothelium, basement membrane , protruding foot hole between the secondary cell membrane to reach the renal capsule , these three films constitute a filtration membrane or filter over the barrier. After filtration membrane filtration of blood , renal cysts reach the original urine or liquid called glomerular filtration solution .
If human urine protein found in blood cells and macromolecules for glomerular lesions : renal capsule only play the role of receiving the original urine .

Renal hypertension - clinical symptoms

1 available in about half of the signs on the abdomen, lower back or ipsilateral costal margin and hear a continuous vascular systolic murmur, or with mild tremor.
(2) After the symptoms before the age of 30 or 50 years old, long-term high blood pressure or hypertension suddenly appeared suddenly intensified, short duration, rapid development, especially diastolic blood pressure, lower back or ribs with abdominal pain, drug therapy.
(3) Check the following special circumstances may occur singly or in combination:
a. Renal angiography, showing arterial filling defect, stenosis of the distal vessel lumen without vascular dilation or part;
b. IVP displays suffering from kidney compared Jianshen small 1.5 ~ 2.0cm, irregular, slow and short of early development, late developing doctrinal;
c. Percutaneous catheter inserted into the inferior vena cava, bilateral renal venous blood were taken for determination of renin, a higher risk of renal vein renin;
d. Of renal function test, showing less suffering from kidney urine, low urinary sodium, creatinine or inulin clearance rate decreased;
e. Show suffering from kidney ultrasound smaller.
f. Figure showing ipsilateral renal vascular segment curve low and delayed excretion prolongation.

Oliguria - Prevention

Proper prevention oliguria
(1) has caused significant edema oliguria should strictly limit the amount of water into the salt and sodium are sometimes limited to 0.5 to 1 g / day
(2) severe edema oliguria should limit physical activity because rest can reduce energy consumption increased renal blood flow and thus increase the amount of urine
(3) avoid eating raw fruits quit alcohol Jichi hardened fatty fried foods
(4) Eat light and dampness sweet and sour vegetables such as celery, garlic, ginger, melon, carrot, etc.
(5) if accompanied by renal dysfunction should reduce protein intake less urine therapeutic side:
1 gourd shell melon skin peel 30 grams, 50 grams of red dates 10 gram of water and cook until 150 ml 400 ml serving soup to the residue
2 shoots Chen scoop each 100 grams of melon skin 150 grams decoction apply urination

Renal osteodystrophy - Classification and Definitions

The bone conversion rate , renal osteodystrophy can be divided into 4 types .
One, known as osteitis to hyperparathyroidism , osteoblasts , osteoclasts active proliferation and fibrosis is characterized by trabecular bone surrounding the high turnover bone disease pathology.
Second, the low conversion includes two types of bone disease osteomalacia and non- dynamic bone disease. The former refers to the newly formed osteoid mineralization defects , often caused by aluminum deposition. The latter phalanx formation decreased more with hypercalcemia, using 1,25 (OH) D3 suppress excessive PTH secretion and diabetes and other factors.
Third, the mixed bone disease also has a high conversion and low conversion characteristics of bone disease , is caused by hyperparathyroidism and bone mineralization obstacles to increased osteoid and marrow fibrosis is characterized by the coexistence of bone fluctuating conversion rates .
Four , β2- microglobulin amyloidosis Edit this paragraph osteoarthritis symptoms of renal osteodystrophy bone
Renal osteodystrophy be slow , when it is already late onset of symptoms , and the clinical to bone pain , fractures , bone deformation as the main feature . One of the symptoms of sudden pain , often systemic , occur in discreet parts of the lower body ( waist, back , hip, knee ) , movement or pressure increase, can not even get up to walk shaking . Pathological fractures , mainly in the ribs, but also other parts of the external force caused due to a slight fracture . More common in low -and accept the transfer of glucocorticoid therapy in renal transplant patients , high transport -type rare. Adult prone vertebrae , thoracic and pelvic distortion , caused by height in patients with severe shortening and ventilation barriers called back person syndrome, can occur in children with growth delay.

Renal failure, uremia it is

Many outsiders would ask uremic kidney failure is it, for lack of knowledge of the disease , not a human problem , the status of the whole society is like this, in fact, this is a very significant problem in patients with these two friends easily kind of sick confusion, this time , it is necessary to ask a professional industry that is authoritative experts to answer them nephropathy is kidney failure if uremia !

To know whether renal uremia is the answer , we can analyze the symptoms , different clinical symptoms of both. Into chronic renal failure , renal failure, especially in the period after the clinical symptoms are apparent. While uremic chronic end-stage renal failure , so some of the more severe clinical symptoms . Chronic renal failure is usually between serum creatinine 133umol / L to 707umol / L, serum creatinine in patients with uremia 707umol / L or more.

Second is about whether uremic kidney failure , we can analyze the progress of a different direction from the direction of both progress . Renal failure occurs because of the kidney nephron damage health , the gradual loss of function , along with the progression of disease , kidney damage to the unit from the damage until the apoptosis , the damage is the pathological process of renal fibrosis progression process. If not for the treatment of renal failure, renal fibrosis effectively blocked, even after the application of some drugs appear temporary condition improved , we can only say that this is an illusion , the ultimate is still progress to uremia.

Here on " renal uremia it is " both experts in different phases . Final stage chronic renal failure is uremia, two different phases . According to the degree of renal dysfunction , can be divided into four phases , namely, renal decompensation , decompensation ( also known as azotemia ) , renal failure, end-stage renal failure - uremia .

Finally, from treatment to assess renal uremia is right, we can easily draw treatments differ. Acute renal failure can be subjected to dialysis or drug therapy can be restored to health. If in the early chronic renal failure , there are many ways of treatment , dialysis, renal transplantation, some drugs can treat kidney failure. But if to uremia , dialysis or kidney transplantation and then adopted the method , the effect is less than satisfactory .

Girls actually suffering from uremia due to cold

Girls actually suffering from uremia due to cold ! Perhaps many people do not pay attention to this issue , that this is impossible, but indeed the case, a cold, let girls as young as 10 years old suffering from uremia, from disease began to be discovered up to now , only a short period of eight months, and now she can only rely on life-sustaining dialysis treatment three times a week . Experts point out that , while often a bacterial or viral infection such incentives kidney disease .

Perhaps many people will ask, how cold will put uremia on it? My door first to know about the girl 's story !

Because of severe edema, she has two months did not get out of bed , her face still swollen emaciated with . And like dialysis, a very young age , she has to go to the hospital for a week three times , once the body would continue dialysis four hours . Although the doctor said the child is doing well one week hemodialysis 4-5 times , but each time fee of $ 400 dialysis has been so overwhelmed by the family .

According to his family introduction , the children first cold , then both eyes swollen up, then the whole body swelled up . The doctor told reporters that the girl had come 42.4 kg , after dialysis dehydration, now only 25 kg . Because of edema , the girl's body a large area of peeling, while the right foot is cracked because of edema .

There are 10 dialysis patients come to the hospital every year

" Every year, many children in our hospital for dialysis , a year can have 10 children ." The doctor said , he also told reporters that some of the child's illness is caused by congenital genetic problems , while others are acquired pathogenic .

In September this year, the girls would have been the fifth grade should be , and because of the lack of local medical standards , suspension came here for treatment. The original lively she now rarely speak, as long as she gently move will hurt. Hospital doctors and nurses who do not have the heart to give up this little girl , who has launched many donations , donated a total of 5,000, but for long-term treatment , which is not enough.

How uremia caused by cold reason

"The girl is already in stage renal failure , requiring long-term dialysis ." Physician told reporters that she only came dozens of milliliters of urine every day , all rely on dialysis to maintain normal metabolism.

Why after a cold, sharp decline in renal function on it ? Experts said that at present , there is no firm conclusions could be congenital kidney function is poor, itself kidney disease, immune dysfunction , flu viruses. Of course , does not rule out a cold cause kidney disease, the more likely reason is that , had the kidney " fundamentals" backward , continuous cold and sepsis led lesions.

PD can live?

There are many kidney dialysis patients are not able to correctly recognize the potential hazards of dialysis treatment . So for these kidney patients, the choice of treatment must be repeatedly carefully to minimize the opportunity to receive dialysis . So long-term dialysis patients with kidney disease What are the dangers ? Let our hospital specialists to find out more answers.
1 , dependence
Long-term kidney dialysis , will produce dependence. Dialysis treatment is only an auxiliary tool on the kidneys , but can ease the pain as soon as possible and not be able to dig up the roots , and for a long time dialysis, the body will produce dependence , a long time will have side effects on the human body .
2 , complications
Kidney dialysis can save lives, but can not cure . Dialysis timely rapid detox toxins, complications can be many and serious dialysis after the passage of time will be life crisis .
3 , delay treatment
Kidney dialysis delay treatment , missed treatment opportunities. If after dialysis, kidney will no longer be used to start slowly , over time will be completely destroyed, at that time there is no way of re-treatment and repair it.
4 , kidney loss
Kidney dialysis causes gradual loss of kidney . If you rely solely on the long-term patients to dialysis, only because of the long-term kidney function will not shrink , scrap, and after dialysis no longer fertile .

Kidney transplant patients immunosuppressive drug selection and application guide

I immunosuppressive therapy
An induction therapy
1.1 is recommended before surgery or kidney transplant surgery begins combination of immunosuppressive drugs .
1.2 is recommended to use the biological agents into induction therapy in renal transplant recipients (Kidney Transplant Recipient, KTR) initial free Fuzhou General Hospital of Nanjing Military Region, Department of Urology, Zheng Kai
Immunosuppressive programs.
1.2.1 Recommended interleukin 2 receptor antagonist (IL2Ra) as first-line induction therapy medication .
1.2.2 For a high risk of rejection in renal transplant recipients , it is recommended not to use anti-lymphocyte preparations interleukin 2 receptor antagonist.

2 Initial maintenance phase of immunosuppressive drugs
2.1 Recommended maintenance therapy in combination with immunosuppressants including calcineurin inhibitors (CNI) and anti-proliferative drugs, or does not contain
Sugar corticosteroids .
2.2 recommends the CNI tacrolimus as first-line treatment .
2.2.1 is recommended before surgery or kidney transplantation began using tacrolimus or cyclosporine A (CsA), rather than wait until the beginning of graft function
Recovery began to use . (2D tacrolimus ; 2B cyclosporine A)
2.3 is recommended that mycophenolate antiproliferative drugs as first-line treatment .
2.4 for low -risk patients and excluded patients received induction therapy , 1 week after transplantation is recommended to stop the use of corticosteroids .

2.5 To use the mammalian target of rapamycin inhibitors (mTORi), recommended full recovery of renal function in transplant surgery wound healing
After use .
3 long-term maintenance phase of immunosuppressive drugs
3.1 Failure of acute rejection after transplantation proposal within two to four months using the lowest maintenance dose of immunosuppressive drugs.
3.2 recommends continued use of CNI, rather than withdrawal.
3.3 If the transplant is still in use prednisone week recommended the continued use rather than withdrawal.

Kidney transplant can live for many years after the general

About kidney transplant centers , although the technology of water equal in all aspects of advanced than other regions , but also the combination of excellent and experienced experts , but kidney transplantation drawbacks stop the normal development of kidney transplants , such as kidney doubt late kidney transplant rejection reactions. Uremic kidney transplant specialist rehabilitation expert guests answer questions about "kidney transplant kidney transplant ," the symptoms, treatment of common sense . Detail " ," give some relevant content herein by reference. Related elected : How long can live kidney transplant kidney transplantation in general can survive years of transplant renal cyst how to do how to do cold after kidney transplant kidney transplantation can live a long Jiaotong University Affiliated suitable kidney transplant kidney transplant patients on : ( uremia patient age range 12-65 years of age is appropriate ; patients older than 65 years , such as the heart , lungs and liver organ function , blood pressure was stable , in good spirits who can be considered for renal transplantation . so really the best choice for renal transplant patients with uremia it? Indeed, people who enter the kidney end-stage renal dysfunction after gradual loss of kidney function , then there are a variety of replacement therapy , their advantages and disadvantages, it is just a kidney transplant one of them. , after kidney transplantation in general can live for many years . uremia at most can live many years? clinical practice is adopted by dialysis and renal transplant, so uremic patients to significantly prolong the life , but not everyone can have the opportunity to kidney transplantation , to uremia , a series of symptoms occurs . uremic symptoms mainly accumulation of harmful substances occurring hormone poisoning and reduce anemia in renal bone disease occur together . early is the most everyday nausea, vomiting, loss of appetite and other gastrointestinal symptoms. uremia after entering the late stage of systemic involvement will , heart failure , psychosis, severe cases coma , life-threatening , then, at most, to live uremic many years? . a 13 -year-old girl , unexplained rapid deterioration of renal function , progress uremia (uraemia), daily urine output of less than 100 ml, usually pretty active child suddenly becomes dull in debilitating . heard of the need for a lifetime of dialysis or kidney transplantation, parents face gloomy forecasts all day and she was 13 years old ah ! real life has not yet begun , on the back of this heavy burden , how about the days ahead may be too ah ! Integrative after months of treatment, children greenish yellow face turned rosy and full of vitality , and daily urine output drops to calculate increased to 1500 ml daily , uremia (uraemia) has become in the past I do not know the history , you can not imagine that she had been a uremic (uraemia) patients with renal transplantation in general can live for many years . had serious uremia not serious? uremic kidney failure (renal failure) of a series of symptoms that occur late in general. early most common are nausea, vomiting loss of appetite and other gastrointestinal symptoms. uremia after entering the late stage of systemic involvement will , heart failure , psychosis, coma and other serious conditions , dangerous and life . uremia past that is incurable , and then carry out dialysis kidney transplant , so uremic patients to significantly prolong the life in uremia , in addition to the above water, electrolyte , acid-base balance disorders , anemia , bleeding tendencies, such as hypertension aggravated , it can also occur each organ system functions clinical manifestations and physical barriers to metabolic disorders caused by the nervous system , digestive system , cardiovascular system, respiratory system, skin , metabolism will be affected, and somewhat tired .

Living donor kidney transplants knowledge introduction

What is a living donor kidney transplant ?

Currently, kidney transplantation and live donor kidney transplantation of cadaveric renal transplant two kinds. Living donor kidney transplant from a donor kidney is the body with life . Generally, a properly functioning kidneys sufficient to meet normal physiological needs of the body , so for healthy people to donate a kidney will not affect future life. Living donor kidney is a dedication , a great price. Kidney donors gave their lives to save the patient 's kidneys , preferring to undergo a painful surgery , this noble spirit of sacrifice is worth admiration.

Why living donor kidney transplant ?

Living donor kidney is one of the effective ways to promote internationally in recent years to solve the donor shortage .

Compared with cadaveric renal transplantation, living donor kidney transplantation has the following advantages :

1 can be affected by the needs and physical condition reasonable arrangements operative time , do not due to the long wait for a donor transplant lost opportunity .

2 living donor kidney has a good physical condition , hot and cold ischemic time is short, the quality is higher than cadaveric donor kidney.

3 before transplantation of donor blood transfusion .

4 Preoperative have enough time to do a detailed inspection before transplantation immunity , including mixed lymphocyte culture and detailed crossmatch tests. Blood relatives with kidney tissue adaptation rate, tissue compatibility , significantly reduced renal graft rejection reaction .

5 reduce the amount of immunosuppressive drugs after surgery , not only to reduce the financial burden on patients , but also reduces the side effects of drugs on the body .

In short, the living donor kidney transplant success rate is high , less rejection , fewer complications , and its people / graft survival rate was significantly higher than cadaveric renal transplantation, and to alleviate the problem of a serious shortage of cadaveric donor kidney , should be vigorously promoted .

How to choose a live donor kidney ?

Living donor kidney transplantation is usually divided relatives and other volunteers live donor kidney categories to choose related kidney better. Choosing a suitable donor kidney transplant is the key for the relatives . Recipient 's parents , brothers, sisters and spouses can be used as a candidate donor . Among them, among identical twins compatriots is the best, followed by fraternal twins , siblings, parents and blood relatives . For those 18-65 years of age in general , given the current situation of family planning , multi- donor kidney relatives from their parents , age may be relaxed . General requirements for physical health, emotional stability , voluntary donor kidney , normal blood pressure , no diabetes, kidney disease , cardiovascular disease, infectious disease , hepatitis , cancer and other medical history .

Preoperative improve various laboratory tests for kidney donors for a comprehensive examination of the urinary system , kidneys and retained for understanding the function of the kidneys . Excretory urography disease and find out if there is obstruction, renal arteriography clear trunk and branches of the renal artery morphology and walk the line , Select single kidneys . If the conditions can first DSA, such as multi- root revascularization for renal arteriography . In most cases the choice for those who left kidney ; If the donor is a woman , then the choice of the right kidney is appropriate.

Acute nephritis - Prevention

Mostly caused by acute nephritis after streptococcal infection , so a good season streptococcal infection is acute nephritis good season . In northern China , winter and spring are pharyngitis , upper respiratory tract infection, tonsillitis good season , so more than 90 % of acute nephritis have occurred in these two seasons. In the south, hot and humid summer weather , mosquitoes and more prone to scratching the bites, skin to skin infections , but also prone to skin Boil . So, in the South, 30% to 80 % of acute nephritis occurs in the summer.
Learn more laws , we must prevent the occurrence of acute nephritis : First, to prevent colds, flu, had an upper respiratory infection should be treated as soon as possible ; Second, pay attention to the skin clean, avoid skin Boil . Experiencing measles, scarlet fever and other epidemic season , but also to pay attention to improve personal hygiene to prevent the occurrence of acute nephritis . Children, young people most likely to suffer from acute nephritis, generally more than 80% incidence of acute nephritis . In terms of gender , acute nephritis is more common in men , male to female ratio is approximately 2:1. Increase with age , the incidence of acute nephritis gradually reduced, but the adults and the elderly will also have acute nephritis.

Whether acute nephritis can be cured

I believe there is acute nephritis treatment of patients with acute nephritis lack of confidence , but also in patients experiencing acute nephritis preliminary examination , but the results after a period of treatment of chronic nephritis indeed checked again , then check the result is wrong or natural changes in the disease it ? Let the reputation of the United States and kidney hospital experts to explain to everyone , the treatment of acute nephritis , acute nephritis look can be cured? And acute nephritis will become chronic nephritis.

    Acute nephritis can be cured . Because of acute nephritis is a benign self-limiting disease , with timely removal of the cause , given appropriate symptomatic treatment can often heal itself. In the acute phase should instruct patient bed rest, low-salt or salt-free diet , to have throat or skin infection focus should be given 10-15 days penicillin treatment for oliguria , edema were given diuretics , who was resting , water restrictions salt , diuretic and blood pressure is still high antihypertensive drugs should be given , if the occurrence of acute renal failure , dialysis treatment should be with . After the treatment, the patient's condition improved and more quickly . Gross hematuria usually disappear first , 1-2 weeks after the onset of urine color to yellow , about two weeks on their own diuretic swelling , azotemia and hypertension also will return to normal. Urine recovery is slow, often persisting for several months , about half of adults and most children in the patient's urine protein negative about six months , one year later almost all patients urinary protein can be negative, but microscopic hematuria may be delayed for several months or l ~ 2 years . According to statistics, over 90% of children's cases , more than 70 % of adult cases were about 2-8 weeks , the symptoms gradually improved, until healed. Only a small number of patients ( 0.1% to 5% ) due to complicated by heart failure , hypertensive encephalopathy , acute renal failure, severe infection and death. About the problem of acute to chronic nephritis , there was controversy , according to a long-term follow-up observation , and by observing the kidney biopsy , and has found that part of the acute nephritis patients can develop into chronic nephritis. Some patients even if clinical symptoms have disappeared , and was considered to have been cured by biopsy , you can still see the inflammation persists and can develop chronic . Statistics based on a set of cases , pediatric patients 10 years of age , to chronic accounted for 2 % to 14% , 20% become chronic adult to 30 %. And found where the slow onset , in the acute phase of nephrotic syndrome, hypertension, long duration , serum anti-streptolysin "O" is not high titer who transformed into a high percentage of chronic nephritis . In recent years, also found that HLA system HLAA10, A2, BW35 , such as type , are prone to chronic after suffering from acute nephritis.

Beware of young women with acute nephritis

In 2004 , the Hong Kong movie star Cecilia hospitalized suffering from acute nephritis message conveyed uproar , an argument is to say that she had chronic fatigue caused by decreased resistance , suffering from acute bacterial infection nephritis ; others say about her taking diuretics to lose weight . So what exactly are these two factors will lead to acute nephritis it? Experts believe that either fatigue or taking diuretics , have a bad effect on the kidneys will be , will induce acute nephritis. Especially women, because of physiological characteristics, suffering from acute nephritis may be more men than women and young women and other age segments.
Experts advise: a day of work , family bustle worry about women be more concerned about their own bodies , not too tired , meanwhile, do not blindly to lose weight, if you feel there is something wrong with the body , the best time to the hospital, do not wait unbearable degree before going to a doctor because of a disease such as acute nephritis is no obvious early symptoms .

■ fatigue can induce acute nephritis

Also known as acute glomerulonephritis acute nephritis is a common disease , mostly after infection , especially after hemolytic streptococcal infection , also seen in other infections , is an inflammatory glomerular damage arising after .
Many causes of acute nephritis , the incidence of nervous system , endocrine system disorders caused by the regulation of immune dysfunction , causing the immune glomerular injury , fatigue can induce acute nephritis . Because fatigue can lead to decreased immunity , known as the emergence of immune system dysfunction medicine, can cause renal dysfunction caused by the immune system in acute glomerulonephritis. The function of the immune system resulting in decreased fatigue , make people loss of appetite, lack of blood flow to the body , the whole body will be affected. And on the kidneys , it can cause inadequate blood flow to the kidney , the renal arteries , causing tubular necrosis , the clinical manifestations of acute nephritis.

■ diuretics also lead to acute nephritis

Cecilia diuretics to lose weight would cause acute nephritis this argument, Professor Zhang said that this is justifiable in medicine . Since taking diuretics to lose weight can cause body water loss, dehydration due to diarrhea, intestinal , making weight decreased significantly in a short time , which causes the body water and electrolyte acid-base balance disorders, kidney damage . Currently there are many diuretics , some action points in the renal tubules , and some hot spots in the glomeruli. For heart patients, taken under the guidance of a doctor , can reduce the burden on the heart , but dehydration can occur if the body lose weight by taking diuretics , blood viscous, leading to reduced blood flow , will produce renal tubular damage , can cause acute nephritis.

Polycystic kidney dialysis can penetrate many years

Polycystic kidney dialysis can penetrate many years . Medicine showed that commonly causes uremia were sugar kidney, hypertensive nephropathy , glomerulonephritis chronic nephritis, polycystic kidney disease , etc., and those suffering from kidney disease and hypertension Tangshen mostly elderly, in our country need to be only dialysis or kidney transplant patients with end-stage uremia have more than 130 million people, is the artificial kidney dialysis , dialysis is that people say , simply, that the blood in the body lead to a dialysis machine , the blood toxic metabolic waste and then returned to the eradication of the body, so that the dialysis machine replaces the function of the kidneys to eradicate toxins . Polycystic kidney disease with uremia rehabilitation expert guest (http://ndz.shen99.com/) explain such " polycystic kidney dialysis " diet common sense. Detailed " polycystic kidney dialysis can penetrate many years ' relevant content see the following.

Polycystic kidney dialysis can penetrate many years associated elected :

Polycystic kidney dialysis patients can do grapes / polycystic kidney dialysis several times one week * Good hemodialysis pruritus how to get out how else to do peritoneal dialysis dialysis dialysis patients with diabetes should eat what medicine

. Polycystic kidney dialysis can penetrate many years . .

Polycystic kidney dialysis can penetrate many years , through many years of dialysis can . "Treatment of uremic * What is the good way ," and so are the majority of patients with problems , kidney disease hospital for a brief introduction " treatment of uremia * What is a good way to " cure uremia * What is a good way ? Uremia can cure Why ? chronic kidney disease has become the " invisible killer" one of the world * terrible , but as long as less than 5 percent of the world's public to understand the location and function of the kidneys , the risks of illness is poorly understood. According to data provided by the Chinese Society of Nephrology show , the rate of chronic kidney disease by 10% . Due to the extreme powerful metabolic function of the kidneys , even the loss of kidney function has been more than 50% of kidney patients still may not have any symptoms, coupled with kidney disease patients due to lack of knowledge on prevention and treatment of kidney disease , until the first time to the hospital when the disease is often found to have final . According to statistics , the global chronic kidney disease caused by the final number of patients with advanced renal failure is growing at an annual growth rate of 8% , there are currently 1.5 million people rely on beyond dialysis and kidney transplant to survive. Therefore , various early chronic kidney disease, renal function should be spared aggressive treatment to emerge with injury ; once already with renal damage , renal function should be actively maintained in order to escape or delay the emergence of uremia ; undertaken to uremia should seize suitable opportunities uremia . Aggressive treatment of chronic kidney disease , the key is to eradicate the origin of uremia . Many chronic kidney disease, if not active treatment, and more can cause chronic renal insufficiency. On the one hand chronic glomerulonephritis and pyelonephritis, polycystic kidney disease , etc. can cause uremia , a lot of people think that drug treatment of glomerulonephritis poor or do not need medication, the current practice of some new treatments or drugs for kidney small ball nephritis have better results. The other hand, diabetes, hypertension , lupus, hyperuricemia and gout has become a common cause of uremia , drew enough attention to the needs , must pay attention to the situation in the treatment of kidney disease in those processes . Various common kidney disease such as nephrotic syndrome, hiding nephritis, nephritis , lupus nephritis (Ipusnephretis, LN), each with its own pathological types , and each type of pathology have mild, moderate and severe points ; About mild to moderate fluctuations pathology , treatment is more pessimistic , most can be treated ; rather severe fluctuations in the treatment of difficult pathology , disease easily repeated , but after positive Chinese and Western medicine treatment of separation , many patients arrive improved or stable or able to do. So once had kidney disease, do not panic , thinking that an incurable illness , prosecutors should be early and early treatment for a speedy recovery . Maintain kidney function, immune or delay the emergence of uremia . The following measures have a clear role in the maintenance of kidney , should have experience under the guidance of specialist physicians correctly applied . Limiting, proper diet protein ; ideal control high blood pressure , and apply extra medication to reduce blood pressure in the kidneys ; correction of anemia , diabetes control , treatment of hyperlipidemia and hyperuricemia and gout ; prevent the application of nephrotoxic drugs ; prevention of various infection.

There are daily kidney "coup"! ! !

Kidney disease recur after a cold spring
Chronic kidney disease often relapse in the spring , is a major cause of colds and allergies. This is due to the cold kidney disease , reducing the body 's resistance, resulting in other bacterial invasion , causing secondary bacterial infection , further weakening the patient's resistance , through a series of reactions caused by immune complex glomerulonephritis , made ​​it worse ; for patients with renal insufficiency may even lead to uremia. Thus , patients with kidney disease must prevent colds spring , once found himself appear as the cold has edema, hematuria and other symptoms must rush to a doctor.
Second Thursday of March each year is World Kidney Day , this year's theme is " to protect the kidneys , heart salvation ." This is because the heart and kidneys are a pair of " loser" , kidney disease will worsen heart disease , and heart risks may manifest themselves in the form of kidney disease. In this regard, experts have warned that when the kidneys no " to force" , but also to guard against the joint attack with heart disease.
Kidney mostly " eat out"

Kidneys regulate body water balance , but also expelled from the body of metabolites and toxic substances, regulate electrolyte and acid-base balance, plays an important role in regulating life activities . With the improvement of the material conditions of life and work , people too little physical activity , and eating too many carbohydrates, fats , salt , etc. , plus a variety of infectious hepatitis, tuberculosis , abuse of painkillers , antibiotics and other drugs , leading to kidney disease patients increased. Also, due to changes in lifestyle , making diabetes, hypertension , high cholesterol, high uric acid , high incidence of obesity and other diseases , but also contributed to the increased incidence of kidney disease .
Cardiovascular very bad kidney injury
Inseparable relationship between the heart and kidneys , kidneys and even be regarded as part of the circulatory system can be synthesized by a variety of active substances , regulating cardiovascular function and metabolism . Therefore, kidney dysfunction, cardiovascular often " being damaged " vicious circle ring formation . Poor kidney function or kidney will affect at least three areas in the cardiovascular system : first , the impact of cardiac power , resulting in a heartbeat , weakness, abnormal ; Second , the impact of the quality of blood , so that the amount of blood even more, heart and brain still missing blood hypoxia ; third , accelerate the speed of atherosclerosis , vascular aging fast. Many patients with renal failure before entering the period , they premature death from cardiovascular disease.
    Protect the kidneys from three aspects to start
Healthy eating and drinking is simply eat less greasy fat , eat more fresh vegetables ; edema , hypertension symptoms, light salt should be controlled at about 2 g daily ; kidney patients to strictly control the intake of protein , depending on protein in the urine how much discretion , and generally to 20  30 grams per day is appropriate, the choice of quality protein such as milk , eggs, meat , etc. ; eat foods rich in B vitamins , vitamin C and iron foods such as animal liver , egg yolk, tomatoes , carrots, sweet potatoes, oranges and so on.
Appropriate to drink pee in the bladder does not hold for too long it is easy to breed bacteria , bacterial infection is likely through the ureters to the kidneys. Full day to drink, do not hold back , so that the occurrence of kidney stones is not easy .
Even without regular checkups are the key symptoms generally require a screening urine, renal function annually. If you already have high blood pressure , diabetes , etc., should be regularly checked more urine, kidney function and other projects twice a year.

How reasonable adjustments polycystic kidney dialysis patients diet?

Polycystic kidney dialysis patients diet quality directly affects the quality of a patient 's nutritional status , and therefore , dialysis patients to grasp knowledge about diet , pay attention to caloric intake and a variety of nutrients . Specifically should do the following:
    Polycystic kidney dialysis patients diet quality directly affects the quality of a patient 's nutritional status , and therefore , dialysis patients to grasp knowledge about diet , pay attention to caloric intake and a variety of nutrients . Specifically should do the following:
    ( 1 ) protein intake : protein intake in uremic patients not on dialysis is 0.8g / (kg · d), and after hemodialysis protein intake should be 1.29 / (k9 · d), of which 50 % of high biological value protein , BUN before each hemodialysis should reach 26.8mmol / L, body weight maintained at the desired level. Peritoneal dialysis , protein intake should be 1.2 ~ 1.5g / (kg · d), serum BUN should reach 28.6mmol / L.
    ( 2 ) the total energy intake include: protein, fat and sugar , the general dialysis patients calorie intake should be 96.3 ~ ll. 3u / ( boat · d). Wherein the thermal energy provided by the sugar should be 55% to 60% of total calories , and a complex carbohydrate -based ( such as fibers, polysaccharides, etc. ) ; calories from fat does not exceed 30% , in which the saturated fatty acids does not exceed 10% o
    ( 3 ) water and sodium intake : normal daily sodium intake of about 2 ~ 6g, dialysis patients should , as the case may be. There are residual renal function , daily urine output over 1L, can be mild water restriction (<2L / d), sodium restriction (<3 ~ 4g / d), while diuretics ; without hematuria patients should limit water penetration ( < 1L / d), sodium restriction (<2g / d), the control period is less than 5% weight gain dialysis dry weight . Peritoneal dialysis patients can continue to remove moisture , if UF is better, should be limited to water (<2L / d), sodium restriction (<3 ~ 4g / d). If ultrafiltration badly, water restrictions limit sodium in hemodialysis patients with no urine o
    ( 4 ) potassium calcium and phosphorus intake : renal failure due to the excretion of potassium , phosphorus and vitamin D converted row functional limitations or disappear , so hemodialysis patients should potassium, phosphorus, calcium diet and supplemented with appropriate activity vitamin D; dialysis patients due to potassium dialysate does not often cause hypokalemia, potassium event in a timely manner .
    ( 5 ) vitamin intake : dialysis may lose water-soluble vitamins , so Ronc and put forward all dialysis patients must supplement of folic acid and B vitamins, vitamin-rich diet foods to choose , to reduce the incidence of anemia and cardiovascular disease.
    In short , despite polycystic kidney dialysis patients are more dietary restrictions , but should be adjusted according to the patient's compliance, complications , economic conditions and dietary habits, and try to make individualized.

Pyelonephritis dietary health is important

Acute pyelonephritis and acute exacerbation of chronic pyelonephritis should stay in bed , drink lots of water , daily intake of more than 2500 ml of water should be to increase the amount of urine , promoting bacteria, toxins and inflammatory secretions quickly discharged . Pyelonephritis is a bacterial invasion of the renal pelvis , calyces and renal parenchyma caused by suppurative inflammation . Commonly known as pyelonephritis and ureteritis upper urinary tract infection, and urethritis , cystitis is lower urinary tract infection. Pyelonephritis mostly concurrent lower urinary tract inflammation. The disease occurs in women, male and female prevalence ratio of 1:10 , common in older women and the incidence of elderly men . General rapid onset of acute pyelonephritis , fever, chills , headache , nausea , vomiting, body aches, lower back or dull pain, the main symptoms of urgency, frequency , dysuria , etc. ; chronic pyelonephritis patients have recurrent or prolonged unhealed history, clinical manifestations vary, may have a urinary tract irritation, intermittent episodes of asymptomatic or only mild symptoms onset to the late severe renal damage can occur , hypertension , anemia , polyuria, night urine, acidosis, and even uremia . Urine tests to check hematuria , a large number of white blood cells in urine or pus , etc.

Pyelonephritis dietary health is important

1 , acute pyelonephritis and acute exacerbation of chronic pyelonephritis should stay in bed , drink lots of water , a daily intake of more than 2500 ml of water should be to increase the amount of urine , promoting bacteria, toxins and inflammatory secretions quickly discharged .

2 , adjust the pH of urine . Sulfonamides, aminoglycoside antibiotics in alkaline urine antibacterial enhanced to eat some alkaline foods or sodium bicarbonate ( baking soda ) ; while the tetracycline family , furan Constantine and other antibacterial drugs in acidic urine enhanced to oral consumption of acidic foods or large amounts of vitamin C, urine acidification .

3, the diet should be light , easy to digest .

4 , provides a wealth of nutrition, including adequate supply of heat , a sufficient number of high-quality protein and vitamin A, vitamin B1, vitamin B2, vitamin C , etc. .

Pyelonephritis care what measures

Pyelonephritis is divided into acute and chronic . Patients with acute pyelonephritis If not treated will be transformed into chronic renal failure. Since the treatment of chronic pyelonephritis or rest and other factors, can also cause acute, and more common in female patients , especially women of childbearing age . So pyelonephritis care measures are there? Below please nephropathy experts explain in detail for everyone .

Pyelonephritis care measures :

1 , acute pyelonephritis or acute exacerbation of chronic pyelonephritis should drink more water , the daily intake of 2500 ml or more. Aim to increase the amount of urine , promoting bacteria, toxins and inflammatory exudates discharged. At the same time pay attention to strengthening nutrition and physical activity ;

2 , observe whether the fever and urinary tract irritation . Chronic pyelonephritis late , watch for symptoms of kidney damage ;

3, after drug treatment, pay attention to whether the side effects of drugs, such as oral medications cause nausea , loss of appetite and other reactions after asking a doctor before they switch to other medications . Original acute pyelonephritis can be so treated. Please click to view.

4 , emphasis on maternal and child health , women with pyelonephritis should keep the vulva clean , caution tub . Menstrual period , pregnancy and infant pay special attention to hygiene to prevent ascending infection . Women with acute pyelonephritis , within one year after treatment should contraception to avoid pregnancy and worse ;

How acute pyelonephritis disease in nursing

Life, many people have been troubled by illness nephritis . It is a very common kidney disease, bring a great impact patient health. Let's look at presentation experts.

For acute pyelonephritis illness to how to care ? Kidney experts, as in life common kidney disease , pyelonephritis acute and chronic diseases of the points, in patients with acute pyelonephritis which accounted for a large proportion . For the treatment of acute pyelonephritis , patients should be conducted. In order to achieve the best therapeutic effect , in addition to taking a scientific and effective method of treatment , but also need to actively care .

Experts tell us that, for the treatment of acute pyelonephritis , many of them general treatment including :

① acute phase with high fever should rest in bed , to encourage more water, urinating frequently , prompting bacteria and inflammatory exudate rapidly excreted .

② control high blood pressure , anemia and correcting water and electrolyte , acid-base balance disorders .

③ righting supportive treatment : Proper attention to nutrition and rest.

Meanwhile , experts also pointed out that acute pyelonephritis care knowledge : first, to provide a good environment to rest , to ensure adequate sleep patients . Good explanation , given my heart support. Giving high fever cooling , to observe and record , given the appropriate care . Close observation of the general condition of the patient and the temperature changes . Prescribed use of antimicrobial drugs, adverse reactions were observed . Explain the significance of various checks to patients and methods , proper specimen collection .

In addition, patients should be reasonable arrangements for their diet , because the diet is also the treatment of acute pyelonephritis support measures . Patients with light diet rich in protein, high vitamin diet, fever, systemic symptoms should be given liquid or semi-liquid diet. Gastrointestinal symptoms may intravenous rehydration , and good oral care , if necessary, with a prescribed antiemetics . In the absence of contraindications situation and advise the patient intake of water , urinating frequently .

The clinical diagnosis of gouty nephropathy What?

Gout is a metabolic disease is closely related to life. Modern living standards, eating and drinking is the norm , I do not know much about diet and gout onset of eating , making the increasing cases of gout attacks . Gout recur after repeated attacks , involving multiple joints and lead to joint deformity , and even can cause severe kidney damage , eventually leading to gouty nephropathy , therefore , timely diagnosis is one of the first principles of cure of the disease, so gout What are the main nephropathy of common inspection items ?

The clinical diagnosis of gouty nephropathy What ?

1 routine inspection

( 1 ) blood: blood cells increased, often 10 × 109 --- 20 × 109 / L, may have mild to moderate anemia ;
( 2 ) Urine: may have proteinuria, hematuria , pyuria , occasionally urinary tube , PH <6.0;
( 3 ) blood biochemical examination :
① vast majority of elevated serum uric acid ( men > 416μmol / l; women > 357μmol / l)
② uric acid : excretion > 74.1mmol / d;
③ ESR: faster , but often <60mm / h;
④ renal function : Late to decline.

2 , auxiliary examination

( 1 ) gout nodules : specific urate can be found ;
( 2 ) synovia : intra-articular puncture examination showed urate crystals ;
(3) X line : mixed urinary stones can display shadows ;
(4) B super : renal visible light group , followed by the visible comet tail sign , ureteral stones and hydronephrosis ;
( 5 ) biopsy : Find Anti refractive needle urate crystals in the renal interstitium and tubules can be confirmed.

What are the complications of peritoneal dialysis

Due to peritoneal dialysis several times a day to operate , there are a lot of liquid out of the abdominal cavity, it is prone to complications , common complications following items .
1 intubation complications : bleeding wound for example , dialysis fluid leakage , poor drainage and other dialysis tube blockage .
2 peritonitis : is the most common complications, including infection , biodegradability and eosinophilic peritonitis. Infections from dialysis pipeline , and occasionally from the blood , intestinal and female reproductive systems.
3 missing protein, amino acids and vitamins : daily peritoneal dialysis patients will lose 8 to 10 grams of protein , amino acids 2 to 5 grams , and water-soluble vitamins . If you use peritonitis occurs when hypertonic dialysate or protein loss can be significantly increased. If the leak is not protein albumin and immunoglobulin , it can cause hypoalbuminemia, malnutrition, edema and low resistance, clinical manifestations of malaise, and weakness , poor appetite , lethargy . Therefore, care must be taken to strengthen the peritoneal dialysis nutritional intake.
4 Water and electrolyte balance : Dialysis low concentration , the resulting water into the blood vessels , increasing the blood volume occurs cerebral edema and pulmonary edema , hypertonic dialysate available to dehydration. Long-term use of hypertonic dialysate , excessive dehydration can hypovolemia, hypotension , infusion of saline or plasma can be corrected .
5 hyperglycemia : when hypertonic dialysate due to the absorption of glucose , can increase blood sugar. Occurrence of hyperosmolar nonketotic coma , dialysis should be stopped immediately , hypotonic fluid input and give insulin.
6 abdominal pain : a common cause of peritonitis , abdominal over-expansion , dialysate PH improperly configured , the temperature is too low or too high , the dialysis tube improper position or shifted . Appropriate measures should be taken for different reasons, can be added to procaine or lidocaine pain in the dialysate .
In addition , infants, children and elderly patients peritoneal dialysis has its particularity, pay more attention to the emergence of various complications.

Fast food, let kidney "bad" faster and faster

In recent years, more and more prosperous fast food , McDonald's, KFC and Pizza stores in China opened numerous stores. Children eat more addictive , adults also feel fast and easy . On the one hand the need for people to meet different tastes of food , on the other hand , in a way, but also increases the potential health hazards on .
According to a survey of renal Society found that Hong Kong is a total of more than 5400 patients with kidney disease , kidney failure is "Ten killer" one of Hong Kong . Over the past seven years the number of patients with kidney disease on the rise , with an average increase of 7 % per year , I believe that the causes of eating fast food like with the people concerned .
According to People News , Chairman of the Hong Kong Nephrology Dr. Li Jintao pointed out, in 1995 , about more than 2,700 kidney patients , gradually increasing number of patients annually thereafter . Diabetes , glomerulonephritis, hypertension and other diseases may be due to disease progression becomes renal failure, renal failure, diabetes patients have Yu Sancheng result , I believe that with the people like to eat fast food and high- sugar foods and other factors .
Fast food, let kidney " bad" faster and faster

U.S., UK, Australia, New Zealand and Hong Kong 5 to the maximum number of kidney failure is # 2 U.S., Hong Kong , 139 per 100 million people suffering from kidney failure.

Potential causes of kidney failure?

Mentioned diseases, we have to fear is infectious and chronic diseases, chronic renal failure, then what is it ? Chronic renal failure is a result of a variety of chronic kidney disease worsening renal function , and regulation of secretion caused by renal excretion function decline, water and electrolyte disorders and appear in a normal diet azotemia . That whole decompensated stage renal insufficiency may be referred to as chronic renal failure. A very broad concept , and even kidney disease in itself is a chronic disease you , of course, from the point of view the course .
Renal failure is a very long process, especially chronic renal failure. Early renal failure , in addition to elevated serum creatinine is often no clinical symptoms, but only showed symptoms of the underlying disease , to the progression of the disease can not be adjusted to the residual renal unit when the body adapt to the minimum requirements will gradually manifested symptoms of kidney failure . Rely mainly on the early stages of imaging and biopsy , a larger diagnostic significance. So is kidney wraps , if not properly treated early , it is estimated could not escape the kidney .
Why would the development of kidney disease to kidney failure do better ? What factors have led to this evil it? In the initial stages of kidney failure , usually no symptoms to warn the patient's kidneys are not working properly. Sometimes even if the patient feel good , but the results of the medical examination will show some signs of suffering from kidney disease . However, when the complete loss of kidney function has been close , the physical changes and symptoms of the patient's illness will be very obvious. This is what the pros and cons of both kidneys , then unified together, it does not seem contradictory.
Why is it so troubling about kidney failure , right ! The main damage is only half of our kidneys , even after more than 60% , we can obviously feel uncomfortable , so uncomfortable which requires attention to detail , from the subtle to start preventing kidney failure , this can effectively restrain kidney failure.

Potential reasons for the incidence of acute renal failure which

Potential reasons for the incidence of acute renal failure have? Potential causes of the onset of acute renal failure have? Acute renal failure is a common kidney disease , great bodily harm , on this point , everyone has become an accepted fact of ! Therefore, we must pay more attention to the appearance of acute renal failure , the effect must not otherwise suffer suffering will be your own ! Of course , many reasons to induce the disease , following the Beijing kidney hospital experts to explain in detail !
Acute renal failure is a syndrome. Caused by a variety of causes, the rapid decline in the glomerular filtration rate to below 50% of normal , blood urea nitrogen and serum creatinine increased rapidly and cause water, power quality disturbances and acid-base balance disorders and acute symptoms of uremia .
Potential reasons for the incidence of acute renal failure have? Experts made ​​the following explanation : cause of chronic renal failure occurred mainly as a potential risk factor for the following three aspects:
1 , hemodynamic changes in the human body : the lack of blood perfusion , such as shock, congestive heart failure , heart disease , thrombosis (dic), stroke , vascular excessive contraction , time dilation of the disease, the amount of blood through the kidneys on the relative lack of waste relative metabolic rate decreases, resulting in the accumulation of nitrogenous waste , increase the burden on the kidneys and cause kidney failure.
2 , toxic substances Damage: daily life for many drugs have considerable damage the kidneys , such as certain antibiotics, chemotherapy drugs, non-steroidal analgesics , X-ray developer , alcohol, heavy metal poisoning ( lead, mercury , arsenic, thallium ) , or insects, snake venom and so on, can produce varying degrees of renal toxicity, resulting in renal dysfunction , causing kidney failure.
3, the body 's own disease : leptospirosis infection , autoimmune nephritis, liver failure , bacterial endocarditis , pyelonephritis, and lymphosarcoma , etc. , when the body itself, the presence of these diseases, often lead to kidney damage, thus has also become a major cause of kidney failure occur.

iag kidney, what is the underlying cause of proteinuria

What are the underlying causes of proteinuria is ? Jingdong experts, proteinuria is a big typical symptoms of kidney disease , but the number of leaking urine protein and does not reflect the severity of kidney disease . So, what are the underlying causes of proteinuria ? Here we ask the experts for everyone Jingdong detailed introduction about it !
Proteinuria protein leakage renal pathological damage does not necessarily mean less light ; massive proteinuria can not explain the severe kidney disease pathology damage. Such as minimal change glomerulonephritis and mild mesangial proliferative glomerulonephritis , mild kidney disease , but the daily amount of protein in the urine and even a few grams up to a dozen grams.
Proteinuria generally divided into selective proteinuria , non-selective proteinuria. Selective proteinuria , refers to a protein electrophoretic characteristics are mainly low molecular weight proteins , such as albumin , α -globulin , γ -globulin and transferrin . Large molecular weight proteins such as α less globulin, fibrinogen , β lipoprotein levels .
In minimal change nephropathy, mild mesangial proliferative glomerulonephritis , membranous proliferative glomerulonephritis and focal segmental sclerosis glomerulonephritis membranous nephropathy in patients with partial and early lesions showed more selective proteinuria , indicating a small network ( kidney small ball filtration membrane ) less damage . Non-selective proteinuria, characterized by means of protein electrophoresis protein macromolecules and small molecules simultaneously , indicating a small network ( glomerular filtration membrane ) damage is more serious .

Chinese and Western medicine dialectical treatment of chronic nephritis

Certain chronic diseases who are relatively difficult to treat , especially chronic nephritis . Chronic nephritis can be described as a difficult disease, chronic nephritis treatment often requires a long and difficult process , there is a cure , recurrence of such phenomena . Therefore , more and more patients will have an immediate eye toward the Western medicine .
Chinese medicine treatment of chronic nephritis is actually the application of traditional Chinese medicine treatment of nephritis disease outside the government 's approach to the drug 's active ingredient input lesions play a role. In fact , this method of Chinese medicine in the treatment of chronic nephritis early 1980s began , and has accumulated a wealth of experience. In the late 1990s due to the formation of kidney fibrosis updated theory , for the application of Traditional Chinese Medicinal kidney provides a new thinking. Of course, Chinese medicine treatment of chronic nephritis is still more than those listed above , further research is necessary in order to expand its range of applications, improve clinical outcomes .
Chinese medicine treatment of chronic nephritis is the use of Chinese medicine blood in the etiology of chronic nephritis on the basis of meridians, anti-inflammatory , anticoagulant to eliminate the infection, reduce inflammation factor for kidney damage. To this end , Chinese medicine treatment of chronic nephritis in the field of clinical treatment of chronic nephritis played a significant role. Chinese medicine treatment of chronic nephritis is how to play a specific role in it ?
Chronic nephritis is an autoimmune disease associated with infection , belongs to the motherland medicine " edema ", " back pain" , "Consumption " category , and is closely related with the cult poison infection . Exogenous , wet, blood stasis , emotional , etc. can induce and aggravate the disease. Edema , proteinuria , hematuria, hypertension and renal dysfunction based disease , with longer duration, easily repeated , difficult recovery characteristics. Western medicine is currently no cure for this disease . In recent years found that Chinese medicine for the treatment of chronic nephritis have a good effect . But traditional Chinese medicine treatment of chronic nephritis process is not a blind drugs at work.
Patients with chronic nephritis , renal renal fibrosis will occur . With the occurrence of renal fibrosis continues to expand the scope of chronic nephritis patient's condition will continue to deteriorate progress , the development of renal failure, eventually leading to the occurrence of uremia . Renal fibrosis theory deep in the " Yellow Emperor" , "Classic " and " Febrile Diseases " , in essence, refers to some of the chronic refractory chronic illness , the application of collaterals law, that law to clear the access road . In addition to the qi and blood circulation , especially in heavy applications zhongjing of insect drugs , such as rhubarb worm pills, Biejiajianwan , arrived when the balls . To Ye Tianshi , that " in the beginning of the disease was angry , hurt long illness blood into the network ," and that " for the network to Sim vent " , so with Xin Yun Tong Luo , Xin Wen meridians , spicy meridians, Sim Xiantong network dharmas , in particular, advocates with the blood of the goods, as deep as collaterals to search tick stubborn phlegm dead blood .
Stagnation collaterals
That long illness qi stagnation , poor blood , blood stasis in stubborn phlegm dead collaterals can be the equivalent of platelet aggregation , erythrocyte degeneration, elevated blood lipids , thrombosis and atherosclerosis . Collaterals stasis, common in nephrotic syndrome, edema , when massive proteinuria, often associated with renal vein thrombosis or micro glomerulosclerosis , in line with chronic illness into the network, rather than remain stubborn phlegm dead blood to the pathogenesis, At this point the general blood circulation poor drug efficacy . Studies have shown that the drug can dissolve blood circulation in general microthrombus the surface , but can not reach the core of the site, its leading role is the anticoagulant ; unique micro- penetration of the active ingredients of traditional Chinese medicine therapies can be as deep as the core of the dissolved microthrombus of reach expansion and improvement of blood vessels surrounding the purpose of systemic blood circulation .
Collaterals acute deficit
That 's disease for a long time in the wind sprout , context constraints anxious contracture , equivalent microvascular ischemia spasm , and vascular endothelial dysfunction , increased endothelin , nitric oxide reduced penetration of traditional Chinese medicine treatment therapy micro vasodilator meridians. Collaterals deficit anxious common in primary or secondary glomerular diseases, no edema and proteinuria diminished long-term , high blood pressure , in line with chronic illness into the network, the wind sprout , collaterals of the pathogenesis of acute deficit , so to expand vascular spasm in Xifeng meridians .
Virtual network without glory
Blood fluid depletion has been sick for a long time , is not sufficient collaterals , lost in the wing support, Stagnation or collaterals collaterals deficit caused acute disease, since when in righting the main treatment .
Treatment of chronic nephritis, which should be based on the different stages of solving edema , proteinuria, hematuria , anemia , hypertension and advanced stage of uremia.
1 , Lee edema, warm yang , complex real fire
The almost swollen water , yin end by saying that of water , the so-called " standard in the lung , spleen its system in its present in the kidney ." Opening and closing due to renal Division , chi Too often the doors closed , the water no less than hasten , through the output of the machine is not turned around , flood filled , Che Neiche , the group overcast Allusion , confused not really positive , when this occasion, open Cou management, through the triple burner, Lee waterways , non- borrowed Wenshen a method , it is difficult cloth Yang and the Board. Hematuria causes kidney yang really angry and temperature rise , mediation spleen , lung governance section Jieneng its functional complex , so the idea of ​​warming kidney flood , Meng Yi Yi Jun , otherwise it is difficult to receive power . Drugs such as attachment , Guangxi, Morinda , ginger, pepper head , back fragrant, hot and not fear for their heart , but should the disease lasts , edema, but the general trend has been that, when reduced or stopped . Commonly used in clinical yang by water to drink .
2 , eliminate proteins, new drugs with heavy wind gasification
Proteinuria is the treatment of chronic nephritis eliminate a major problem , Wise Men and more responsibility for the kidney letters remiss refined gas leaked from Gushen astringent essence of governance, although valid, then were mostly not effective . Glomerulonephritis often accompanied by many cell sediment , which was voicing , so one-sided emphasis on anti- Guse Shen stasis cementation , sewage can not be leaked, but refined gas leak . Therefore Yan old rule protein lies gasification, called "gasification and more persons , the more a natural ." In particular, the main one is the lung of the gas treatment section of the line , adjust the lung through gasification self , so use appropriate method to control lung proteinuria, ingenuity . Common Arthritic soup. Old Chang Wei Yan : " No wind is calm and the water clarification , in case the wind is from the turbid flood wave , chronic glomerulonephritis lingering puzzling , often the bane of wind cold for worship ."
3 , urinary bleeding , heavy heat , and distinguish the actual situation
On the causes of hematuria , multi- edge thermal storage kidney and bladder , forcing blood folly. However, the actual situation of the points have hot , real hot onset very urgent, due evils , "to treat patients on the" so-called " Feng Xie Shao into the blood in the urine in " gross hematuria or microscopic examination of the clinical manifestations of erythrocytes full vision , seen in chronic nephritis acute phase, when viewed from Qingreliangxue Xiaojiyinzi subtraction can build Shugong . Hot longer course, with the king of fire down the small intestine, blood contact burns , the ancient Yin Yuk Hom take possession of every true yin , Yan old from every legislative palace of the Qing Yuan Yang . Heart blood because the king fire a move, along with fire , injury context, then extravasation of blood , I want to stop their blood shall be flat which Kang , the Czech Republic, with a pure heart of the party in the yin . Common amber scattered.
4 , correction of anemia , cure coke good at Spleen
Nephritis lead to anemia , hematuria causes a lot, As per this , Zhu Zheng uprisings , treatment is often at a loss . Ye Tianshi that: " up and down the pay loss, when governance coke ." Yan old believes that the spleen is the key outcomes of anemia , spleen health complex , to improve the function of both parties benefit , because of " spleen four dirty" , a prosperity , a decline all bad, every clinical temper see a defeat, decline , strength gradually seep , it is often start from the spleen qi .
5 , Long blood pressure , treatment of kidney yin and tune in
Chronic nephritis, hypertension , diseases of the yin and yang imbalance lies in its marked as phlegm resistance . Kidney yin and yang apartment to the root of the reason in terms of yin and yang of each other , one with a calming liver yang , which for the sake of the end of the round , not the problem at source , when the nourishing yin yang hand , have both yin and yang wood gas the aid can then be reached Chang Mao 's sex , it intends to add and subtract from Immortals soup often can take effect .
Intensive medicine is affecting the medical profession , medicine treatment for any chronic disease are at the basis of fundamental research , chronic nephritis , the use of herbs to clear the meridians , promoting blood circulation , which play anti-inflammatory, anticoagulant effect. Practice has proved that TCM clinical treatment of chronic nephritis can be achieved to reduce infection, eliminating the role of inflammatory factors for kidney damage .