2014年6月13日星期五

How to judge is not kidney disease?

Hematuria, edema, back pain, urination, frequent urination, etc. are common symptoms of kidney disease. But does not explain the symptoms of kidney illness. If the above symptoms plus abnormal urine (proteinuria, hematuria, urinary tube, white blood cells in urine) or renal dysfunction, in order to be considered for kidney disease.
1 hematuria,
Of gross hematuria and microscopic hematuria. Blood or urine hematuria water or wash the meat with blood clots.
True and false hematuria hematuria:
Microscopic hematuria: centrifugal slag RBC ≥ 3 个 / HPF; calculate Fahrenheit or beef dish package count RBC ≥ 8000 个 / ml; excretion rate per hour or RBC> 100,000; or Addis' count RBC> 50 万 个 / 12h, Any of the above are true hematuria. Hematuria is true kidney, ureter, bladder, urethra and prostate lesions, but to exclude false hematuria.
False hematuria:
① like urine hematuria, not hematuria, such as paroxysmal nocturnal hemoglobinuria patients sauce or brown urine; certain foods (such as sugar beet, tomato leaf, pigments) can make the urine was red; certain drugs (Lee Fuping, Dilantin, phenothiazines, etc.) also allows the urine was red, but no check urine for the purpose of identification of RBC.
② transient hematuria, such as pollen, caused by chemicals or drugs, after strenuous exercise, viral infections (such as colds, etc.) can also occur, and only 1 to 2 times a check urine RBC ≥ 3 个 / HPF, several negative review, usually without significance.
③ forged hematuria, someone intentionally fake blood mixed with urine hematuria, remain excluded method is to observe the specimen.
④ pollution hematuria: Women's menstrual period pollution caused by the urine urine specimens. The above pseudo hematuria were not kidney disease. Only true hematuria before considering kidney disease.
2 edema
In addition to glomerular disease see edema, but also found in cardiac, hepatic, endocrine, malnutrition, edema.
Mind edema history of heart disease should have evidence of heart failure was significantly swollen and afternoon or evening, the next morning to alleviate the purpose of identification.
Have a history of liver hepatic edema, abnormal liver function, ascites, edema after extended limbs.
Endocrine edema common in women, have the disease, edema, no significant changes in the endocrine 24 hours, and by the non-significant depression.
Malnutrition, edema, malnutrition, weight loss and other manifestations due, and low serum albumin.
Identification of key points: whether the urine proteinuria.
Multiple renal edema caused by glomerular disease or other diseases caused by glomerular damage, loose tissue edema in place mainly to the eyelids and lower extremities obvious, and staggering the morning, afternoon or evening to reduce, accompanied by proteinuria, hematuria or granular casts. If edema patient urine is normal, basically ruled out kidney disease.
3 lumbago
In addition to the visible kidney disease, also visible muscle strain, lumbar three transverse process syndrome, lumbar disc herniation, lumbar osteoarthritis and gynecological diseases. Visible kidney stones kidney disease, obstructive nephropathy, a huge pelvis effusion, pyelonephritis, acute and chronic glomerulonephritis, renal vein thrombosis, nephrotic syndrome, renal cell carcinoma and renal inflammation around, but back pain caused by kidney disease should the following characteristics:

① tenderness in the spinal column and ribs or rib waist or upper ureter tenderness tenderness tenderness; ② significantly abnormal urine; ③ B-kidney, renal venography (IVP) had positive findings, further feasible CT. If these three points no tenderness tenderness, normal urine, further investigation of renal B-, IVP without exception, basically ruled out kidney disease.
4 Multi urine
Refers to the 24 hours urine over 2500ml, caused by a variety of reasons, non-nephrogenic diabetes insipidus, hyperglycemia diuretic, primary aldehyde steroids histiocytosis, primary hyperparathyroidism, psychological factors, heart failure recovery and so on. Chronic renal interstitial nephritis, acute tubular necrosis recovery, hypokalemic nephropathy, renal arteriosclerosis, kidney disease, such as calcium, renal and more conventional multi-pee or abnormal calcium or amino acid levels increased for the purpose of identification.

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