Post Date December, 03 2023
Yesterday, a patient told me that his creatinine is now 283. Last month, I went to a major hospital in Beijing for treatment. The doctor examined him and reported that he has CKD3 and there is no rule of law. Let's go home and wait for dialysis.
I couldn't help but feel angry in my heart: Who said CKD3 cannot be cured!?
And then this patient surprised me:
By the way, what is CKD3?
Okay, we went to the imperial capital together, but we haven't figured out the extent of our illness yet (⊙﹏⊙). I helped him with his glasses and gave him a form.
So today we will talk about the staging of kidney disease and see which stage you are in. Most patients are familiar with the blood creatinine value, so we use it as a reference standard:
Here, the last vertical column is creatinine, which can be compared with the staging of chronic kidney disease (CKD) in the second column.
Phase 1- Inflammatory Response Phase
At this stage, creatinine is normal and renal function has not been damaged. There are only some clinical indications such as urinary protein, occult blood, edema, and hypertension.
Except for edema and hypertension, which can cause obvious discomfort for patients, urinary protein and occult blood are all "quiet".
This stage is the easiest to cure, but many patients miss out on treatment opportunities due to their lack of pain or itching, so regular physical examinations are very important.
Phase 2- Renal function compensation period
The so-called compensatory period of renal function refers to the slight impairment of renal function, which can meet the daily needs of the body by relying on the compensatory function of the kidney itself.
At this stage, blood creatinine is basically between 133 and 177 μ Between moI/L.
About half of the nephrons are still functioning properly, so patients themselves do not feel much and often delay treatment.
If timely and formal treatment is obtained, the compensatory period of renal function can achieve clinical cure.
Phase 3- Renal decompensation phase
The so-called decompensation period refers to the severe impairment of renal function, where the compensatory function of the kidney itself is no longer able to meet the daily needs of the body.
At this stage, blood creatinine is basically between 178 and 442 μ Between moI/L, the damage to the nephron has exceeded two-thirds or even more.
At this point, the patient has begun to feel fatigue, but the symptoms are still not obvious. If timely and formal treatment is obtained, there is still a half chance of achieving clinical cure.
So the experience of the patient from Jilin in Beijing was unfair. Don't lose heart, hurry to cure it.
Stage 4- Renal Failure Stage
When blood creatinine exceeds 443 μ At the time of moI/L, one has already entered the stage of renal failure, which is also known as chronic renal failure.
At this point, the compensatory function of the kidney is no longer able to compensate for the necrosis of the nephron, and the decline in renal function has entered an irreversible stage, with large amounts of kidney cells being killed every moment.
At this stage, patients begin to experience obvious symptoms, such as anemia, dizziness, fatigue, nausea, etc. At this stage, some hospitals have even started recommending patients to undergo hemodialysis.
The focus of treatment has shifted to preventing further necrosis of kidney cells and protecting the remaining kidney function. If you are cured, it can only be said that your luck has exploded.
Stage 5- Uremia Stage
Everyone is familiar with uremia, and it should be noted that uremia is a stage and not an independent pathological type.
It should be emphasized here that creatinine exceeds 707 μ MoI/L is not necessarily a uremic phase!
It takes about 15 years for chronic kidney failure to develop into the uremic stage, at which time more than 90% of the nephrons have already died, the kidney volume has shrunk to below 6cm, and there is almost no urine produced.
At this stage, the patient's feelings will be very strong, with various symptoms such as dizziness, nausea, vomiting, heart failure, and fatigue occurring frequently. Due to excessive accumulation of toxins in the blood, other organs are also beginning to be affected.
At this stage, the significance of treatment has become to try to maintain the patient's normal life and reduce their pain.
