Post Date April, 15 2023
We usually know that many patients with renal failure are caused by medication, so for such patients, the choice of medication is the key to treatment effectiveness. When and what medication to use are all issues that doctors should consider, and it is also necessary for us to know some common knowledge in the treatment of renal failure. This is helpful for treatment, especially the basic knowledge of medication.
Renal failure is caused by various causes, causing a rapid decrease in glomerular filtration function to below 50% of normal, a rapid increase in blood urea nitrogen and creatinine, and causing water and electricity disturbances, acid-base imbalance, and acute uremic symptoms. Renal failure can be seen in various diseases. Acute renal failure is different from chronic renal failure. If diagnosed early and treated promptly, renal function can be fully restored. If diagnosis and treatment are delayed, it can lead to death. The prognosis is related to factors such as primary disease, age, early or late diagnosis and treatment, and the presence or absence of multiple organ failure.
Clinical manifestations of renal failure
1. Oliguria stage (1) three low (sodium, calcium, pH decrease) three high (potassium, phosphorus, creatinine increase) one edema; (2) Symptoms of uremia can include nausea, vomiting, gastrointestinal bleeding, difficulty breathing, cough, chest pain, hypertension, heart failure, drowsiness, confusion, tremors, and epileptic seizures, anemia, and bleeding tendencies; (3) Infection produces corresponding symptoms according to the site of infection. 2. Polyuria stage: Renal function has not been restored, blood urea nitrogen and creatinine can still rise, and dehydration, infection, hypokalemia, gastrointestinal bleeding, etc. are prone to occur. 3. Recovery period: Blood urea nitrogen and creatinine are close to normal, urine output gradually returns to normal, and glomerular filtration function usually returns to normal within 3-12 months.
Diagnostic basis for renal failure
1. Have a history of shock, intravascular hemolysis, drug poisoning, or allergies; 2. After correction or elimination of acute hypovolemia, dehydration and urinary tract obstruction, the urine volume is still ≤ 17/ml/h or ≤ 400/ml/24h; 3. The specific gravity of urine is below 1.015, and even fixed at 1.010; 4. Sudden and increasing azotemia; 5. Urine osmotic pressure<350mOsm ／ Kg.H2O, urine sodium>40mmol ／ L; 6. Excluding pre renal azotemia and post renal oliguria or anuria.
Treatment principles for renal failure
1. General treatment: bed rest, adequate nutrition supplementation, etc; 2. Maintain water, electrolyte, and acid-base balance; 3. Selecting sensitive antibiotics for infection control; 4。 Dialysis treatment includes hemodialysis, hemofiltration, or peritoneal dialysis; 5. Promote the regeneration and repair of renal tubular epithelial cells.
Principles of medication for renal failure
1. Early mild patients can use item A and pay attention to controlling fluid intake, supplementing vitamins and energy, and maintaining electrolyte and acid-base balance; 2. Severe cases should receive timely and early dialysis treatment, daily dialysis if necessary, and receive blood transfusions and human albumin; 3. When co infection occurs, the drugs in item C can be selected according to the specific situation; 4. When combined with hypertension, drugs in items A or C can be selected; 5. When combined with heart failure, cardiotonic drugs such as cedilanid can be administered for treatment; 6. When combined with bleeding, use drugs from item A or item C.
Auxiliary examination for renal failure
1. For patients with progressive oliguria or anuria, it is recommended to first check the box limit "A" and treat them while checking; 2. If the diagnosis is not confirmed, special examinations for "B" and "C" should be conducted successively.
In summary, through the step-by-step treatment steps mentioned above, we can fully help patients recover from kidney failure. Although drugs are an important means of treating renal failure, scientific medical methods are the key to successful treatment.
