Generally, the elderly and infants, patients after surgery (especially those undergoing cardiac surgery or major surgery), patients with diabetes, patients with long-term poor control of hypertension, patients with chronic cardiac insufficiency, and patients with chronic kidney disease are high-risk groups. They are more likely than ordinary people to experience acute kidney injury under certain specific circumstances due to potential factors.
Due to the natural aging of the body, elderly people often suffer from chronic diseases, kidney function degradation, and a decrease in their ability to detoxify drugs; Children or infants are more likely to suffer from dehydration, hypotension and other hypovolemia due to their small size and relatively small liquid storage. At the same time, due to the weak immune system of these two age groups, they are particularly susceptible to illness, and have high sensitivity and poor tolerance to nephrotoxic drugs. The safety range of drug application is narrow, so drugs with nephrotoxicity should be avoided or used as little as possible. If it cannot be avoided and must be used, it is necessary to adjust the dosage, reduce the dosage, and pay attention to protecting and testing kidney function.
In addition to age factors, when the body is exposed to certain acute or severe diseases, the kidneys often bear the brunt. In critically ill ICUs (intensive care units), acute kidney injury is one of the most common life-threatening factors, with a probability of occurrence of over 30%. The causes of acute kidney injury are complex and can be influenced and combined by multiple factors. When patients have the following conditions, special attention should be paid to the protection of renal function to avoid acute kidney injury.
1. Massive blood loss caused by various reasons (such as trauma, intraoperative blood loss, etc.)
2. A large amount of fluid loss due to various reasons and routes (such as vomiting, diarrhea, gastrointestinal dehydration, polyuria, renal dehydration, skin dehydration, etc.) can cause hypovolemia. At this time, the blood flow to the kidney is reduced, resulting in renal ischemia, which is easy to induce acute renal injury.
3. After undergoing cardiac surgery or other major surgical procedures.
4. Cardiovascular diseases such as cardiogenic shock, cardiac insufficiency, and hypotension.
5. Severe infections and sepsis.
6. Severe trauma, such as burns, crushing injuries, severe fractures, etc.
7. Severe obstetric complications such as pregnancy induced hypertension syndrome and eclampsia.
In daily life, taking medicine when sick is a common occurrence, but the harm of "taking medicine indiscriminately when sick" is profound. It is not uncommon for cases of acute kidney injury to occur due to headache and fever, indiscriminate use of cold medicine and painkillers. Little did they know that whether traditional Chinese medicine or Western medicine, most drugs need to be excreted from the body through the kidneys. It is a medicine with three parts toxicity, and most of the toxicity is caused by entering the kidneys. Excessive or long-term use can "harm the kidneys". Drugs have become the most common risk factor for acute kidney injury around us. There has long been a bad habit among the people of hanging salt water bottles when catching a cold, keeping antibiotics at home, taking painkillers at will, and using the traditional Chinese herbal medicine Sailing Dan. In medical use, if not taken seriously, it is easy to develop acute kidney damage caused by drugs, making the medicine used to treat the disease the "pathogenic" medicine. The most common types of drugs that cause kidney damage include:
1. Antibiotics: aminoglycoside antibiotics (gentamicin, amikacin, etimicin, isopalmicin sulfate, etc.) and vancomycin have strong nephrotoxicity. Cephalosporin antibiotics are also common drugs that can induce kidney damage.
2. Diuretics.
3. Ionic iodine containing contrast agents used in imaging examinations, such as meglumine diatrizoate.
4. Surgical anesthesia.
5. Traditional Chinese medicine, such as Mutong, Houpu, Fangji, Xanthium sibiricum, Cinnabar, etc. in weight loss pills and Paishi granules.
6. Anti malignant tumor drugs.
7. Antipyretic and analgesic drugs
These drugs are particularly dangerous when used in patients with dehydration, diabetes, cirrhosis, chronic kidney disease, the elderly and young children, and are prone to induce acute kidney damage. Before choosing to use them, renal function must be fully evaluated and regularly tested, and substitutes with similar efficacy and low renal toxicity should be selected as far as possible.
In addition, patients with chronic kidney disease who already have impaired self-regulation function of the kidneys can cause progression from chronic to acute kidney injury when combined with certain aggravating factors such as infection, urinary tract obstruction, water electrolyte disorders, and the use of nephrotoxic drugs.
In short, prevention and treatment of acute kidney injury should start from the small drops around us, with cautious medication.