On Sunday morning, a red-faced man and an aunt appeared in front of my house, saying, "I'm sorry, but I don't know."
I heard you're a doctor?
I rubbed my awake eyes and nodded blankly.
After a brief explanation, I realized that during the physical examination of this aunt, the doctor told her that she had found a kidney problem and had to go to the hospital quickly. But my aunt can usually eat, drink, and sleep, and she doesn't feel like she has a problem.
I received the physical examination report and took a look: creatinine 180umol/l, kidney B-ultrasound showed that both kidneys had shrunk.
There's really a problem, so I have to ask them to sit down and explain slowly.
What is chronic renal insufficiency?
Chronic renal insufficiency, in short, refers to the size of the organ, the kidney, or its weakened role in your body, and its duration is greater than three months. It is called chronic renal insufficiency, which is caused by various reasons, such as structural changes or dysfunction of the kidney.
What is creatinine?
During medical treatment, creatinine is an important indicator for doctors to evaluate renal function. Creatinine is the waste generated by muscle activity, which, along with other waste (toxins) in the body, circulates through the blood to the kidneys. The kidneys are responsible for extracting these wastes and excess water from the blood and allowing them to be excreted in the form of urine.
"If a person has kidney problems, these garbage and excess water can be trapped in the blood. The most commonly used test indicator is elevated creatinine.". "My aunt's current creatinine level is 180 umo/l, which is far above the normal range, indicating that the kidney's ability to clean up trash has weakened. This is called renal dysfunction.".
Why does the kidney shrink?
Generally speaking, if a kidney becomes ill, the tissue responsible for its work inside it gradually shrinks. In the later stage, it manifests as a narrowing of the kidneys. This is called a structural change in the kidney.
Kidney B-ultrasound indicates that both kidneys have shrunk, indicating that her kidney problem must have occurred for more than 3 months, just because it was discovered a few days ago.
Can this disease be cured?
If we compare the kidney to a factory, there are a total of 100 workers in the factory who do 100 tasks per day (cleaning up garbage and water generated by the body). Under normal circumstances, one third of the workers can be qualified for these 100 jobs.
However, with the aging of the human body, the impact of disease, or other reasons, workers will die one after another. When fewer than 30 workers are alive, 100 jobs cannot be completed (garbage and water are not removed enough)! The most commonly detected clinically is elevated creatinine.
For my aunt's current creatinine level of 180 umol/l, there are only about 20 workers still alive. People cannot revive after death, and dead workers cannot survive (atrophic renal functional units cannot be restored).
Auntie became anxious as soon as she heard this:
In this way, I only have more than 20 workers left in my kidney. What should I do? Is this uremia?
I quickly explained that renal insufficiency and uremia are not the same thing.
Although the final stage of chronic renal insufficiency is the uremic stage, it also takes creatinine to grow to 707 umo/l to be pronounced!
From now on, it may take several years or even longer for your 180umol/l creatinine to reach the level of uremia!
By then, your elderly may be in their 80s or 90s, and they will already have a very long lifespan.
Auntie asked again:
Since it cannot be cured, should it be cured?
Of course, treatment is needed, and the purpose of medical treatment is to make these workers die slowly, more slowly! Try not to develop creatinine to the level of uremia by the age of 80 or 90. In this way, as long as there are no other complications and follow the doctor's instructions, daily life will not be greatly affected.
Got chronic renal insufficiency, what should I do?
How can kidney function be maintained better? Keep these living workers?
1. Listen to the doctor
Patients with abnormal renal function should seek medical advice from a nephrology specialist in a regular hospital and take medication as instructed.
Don't buy drugs at the drugstore yourself, let alone listen to traditional or so-called ancestral recipes, to avoid misdiagnosis and mistreatment, and to prevent drug-related kidney damage.
2. Strictly control blood pressure
Under the guidance of a doctor, if it can be tolerated, try to control the blood pressure at<130/80mmHg (of course, the lower the better). Under the condition of closely monitoring renal function and blood potassium, ACEI or ARB antihypertensive drugs with greater renal protection can be selected (antihypertensive drugs that end in the drug name with satanpril).
3. Strictly control blood sugar
If you have diabetes, you should take hypoglycemic drugs or insulin under the guidance of your doctor. Develop blood glucose control goals based on specific situations;
4. Diet control
Don't think that whenever you get sick, you need to make up for it. This concept is completely wrong!
Advocate a low protein diet for patients with chronic kidney disease. Some vegetables, one or two lean meats, one egg, and one glass of milk are enough every day! Matching Applications α- Ketonic acid or essential amino acid can not only ensure the nutrition needed by the body, but also avoid increasing the burden on the kidneys.
Because almost everything you eat is metabolized through the kidneys. The more you eat, the more work the kidney factory does, and the faster workers die.
5. Lipid lowering treatment
This treatment is aimed at better preventing the high incidence and mortality of cardiovascular disease in chronic kidney disease.
To put it into practice is to lose weight! Or, after consulting a doctor, follow the doctor's instructions to take statins for treatment based on the specific condition.
6. Correct anemia
Anemia can increase the incidence of cardiovascular events. Most patients with chronic renal insufficiency are accompanied by anemia, so attention must be paid.
7. Adjust electrolyte balance such as calcium and phosphorus
The specific medication needs to be implemented after consulting a doctor, and do not take any medication on your own.
I emphasized it again:
Chronic kidney disease is an emotional disorder. If something goes wrong, the creatinine level will rise as a result of rubbing.
Be sure to work and rest regularly, avoid fatigue, stay up late, feel happy, avoid infection, and so on.
Some patients can even raise their creatinine by hundreds of points due to a small cold.
Auntie quickly understood:
In this sense, as long as there are no complications, I will just have an additional cap of chronic renal insufficiency.
Pay attention to blood sugar and blood pressure at ordinary times, take the medicine prescribed by the doctor, and don't live a heavy life.
Do what you can do well, and leave the rest to God.
Can this disease be prevented?
Unfortunately, there are no special preventive measures.
For the general population, maintain a healthy mindset, work and rest regularly, eat regularly, observe the shape of urine, and conduct regular physical examinations. Early detection and early treatment of the condition.
For friends whose parents or siblings have been definitely diagnosed with hypertension, diabetes, or chronic kidney disease, they should pay more attention to their own health and should not be taken lightly.
For patients who have been definitely diagnosed as hypertension, diabetes, hepatitis B, immune system diseases, nephritis, and nephrotic syndrome in the past, regular reexamination is required to pay attention to control the primary disease and be alert to possible renal function damage.
Aunties are also very concerned about the health of their children:
So, both my son and daughter may have this disease. How can I detect this disease early without any symptoms at ordinary times?
This is a good question!
The answer is simple: Pay attention to the annual routine physical examination. For kidney disease, a urine routine, renal function, and color Doppler ultrasound can determine whether there is a problem with the kidney. Once clues are found, early diagnosis and treatment can be carried out.
This article has been peer reviewed by the Clove Doctor Professional Review Committee
Editor in charge: Ji Lingyan
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