March 10
world kidney day
In the outpatient department of nephrology, there are quite a few such patients, who had already detected proteinuria in the physical examination earlier, but felt no pain or itching, no discomfort, and did not attract attention.
It is not until there are "alarm" signals such as edema, nausea, and general malaise that I go to the doctor in a hurry. However, often at this time, the kidney function has been seriously damaged, and I deeply regret it.
It is precisely because the onset of chronic kidney disease is mostly insidious, so it is often called the "silent killer", but in fact chronic kidney disease can be prevented and controlled, and early prevention, early diagnosis and treatment, and delaying the progress are particularly important.
▌Wang Song, Deputy Chief Physician, Department of Nephrology, Peking University Third Hospital
a lot of harm
Chronic kidney disease should not be underestimated
What are the functions of the kidneys in the body?
The main function of the kidneys is to urinate. By filtering the blood to form urine, the body does not need metabolic waste and excess water, and excretes it in the form of urine.
The kidneys of a healthy adult filter and clean about 180 liters of blood every day.
In addition, the kidneys can also regulate blood pressure; stimulate bone marrow hematopoiesis, promote red blood cell production; convert inactive vitamin D into active vitamin D, maintain calcium and phosphorus balance, and maintain bone health; regulate electrolyte, acid-base balance.
What is chronic kidney disease?
Chronic kidney disease (CKD) refers to structural and functional abnormalities of the kidneys for more than 3 months due to various causes, including abnormal blood or urine components, abnormal renal imaging examinations or pathological damage, or no evidence of renal damage but unexplained renal failure. Glomerular filtration rate (eGFR) decreased (<60ml/min·1.73m2) over 3 months.
Chronic kidney disease can trigger a "chain reaction" in the body if it is not actively treated.
Because the function of excreting metabolic wastes is impaired, metabolic wastes and toxins accumulate in the body, resulting in a series of symptoms of uremia, such as nausea, vomiting, loss of appetite, and malnutrition in the digestive system; malaise, headache, drowsiness, and tremor in the nervous system , or even coma; the cardiovascular system may experience hypertension, arrhythmia, left ventricular hypertrophy, cardiac insufficiency, uremic cardiomyopathy, pericarditis, etc.; the respiratory system may experience acidosis, deep breathing, pulmonary edema, and dyspnea; Severe anemia will occur in the blood system; water and electrolyte metabolism disorders may lead to severe edema, pleural effusion, ascites, pericardial effusion, hyponatremia, hyperkalemia, hypocalcemia, hyperphosphatemia, etc., among which hyperkalemia Can cause cardiac arrest, low calcium and high phosphorus can lead to hyperparathyroidism, further causing bone damage and vascular calcification.
The quality of life of patients with chronic kidney disease is generally lower, the life expectancy is shorter than that of normal people, and the family economic burden is also relatively heavy.
This shows that kidney problems should not be underestimated.
However, in daily life, many people unknowingly do some "kidney-injuring behaviors", such as heavy oil, heavy salt and high protein diet, poor blood pressure control, poor blood sugar control, obesity, especially abdominal obesity, smoking or frequent Exposure to second-hand smoke, drug abuse, not drinking water, often holding back urine, drinking beverages as water, etc., are high-risk factors for chronic kidney disease.
low awareness
Beware of kidney "injured" signals
In fact, chronic kidney disease has already become a global public health problem, the number of patients is increasing, and it is characterized by high prevalence, low awareness and low cure rate.
This is mainly because the kidney is a "hard-working" organ, unlike the stomach that feels hungry, bloated, and painful, the heart that feels stuffy and flustered, and the lungs that feel short of breath and suffocation. .
In the early stage of kidney damage, there are often no symptoms of discomfort, such as proteinuria, which is neither painful nor itchy, and does not affect eating and sleeping. If you don’t check your urine routine, you may not find it at all.
When many patients have "alarm" signals such as edema, nausea, and general malaise, the kidney function damage is often very serious, and even has progressed to uremia. Called the "Silent Killer".
How to detect chronic kidney disease early?
The easiest and easiest way to do this is to have a physical examination every year. Most kidney diseases can be detected through the tests of urine routine, renal function, and urinary system ultrasound.
Especially for people with high risk of kidney disease or those who have "slight signs" of kidney disease, it is recommended to do regular kidney examinations every year.
In fact, once the kidneys are damaged, they will also send out a lot of "calls for help" from the body.
For example, edema, edema of the face, eyelids and ankles is a common symptom of kidney disease; foamy urine, normal urination will produce some foam, but the foam is relatively large and dissipates quickly and easily. If the foam is small and dense, it floats on the surface of the urine , if it does not dissipate for a long time, it indicates that proteinuria is likely to exist, and urine routine and urine protein quantitative examination are required; the change of urine color, the urine color is like meat washing water, or like strong tea, indicating that it is likely to exist Hematuria; increased nocturia; loss of appetite, nausea, and vomiting, these symptoms are generally seen in digestive tract diseases, but are also very common in patients with renal failure; high blood pressure, the kidneys play a very important role in the regulation of blood pressure in the human body.
High blood pressure in daily life is common in people over 40 years old. If high blood pressure occurs at a very young age, it is recommended to check the kidneys to determine whether it is high blood pressure caused by kidney disease; unexplained anemia and fatigue; unexplained skin itching; decreased urine output Wait.
If the above symptoms appear, it does not necessarily mean that you have kidney disease, but it is recommended to go to the nephrologist to check the urine routine and kidney function.
Can the overdrafted kidney be "filled" back?
In daily life, the concept of "tonifying the kidney" is deeply rooted in people's hearts, but this is a "false proposition".
For example, many people think that eating black food such as black sesame can nourish the kidneys. However, black sesame itself has high oil, protein and potassium content. For patients with poor kidney function, eating too much has greatly increased burden on the kidneys.
In fact, there is no "good medicine" for nourishing the kidney at all, and maintaining a healthy lifestyle is the key.
Adhere to the "golden rule" and stay away from kidney disease risks
(1) Low salt, low oil, normal protein diet, eat more vegetables, fruits and whole grains
(2) maintain a reasonable weight
(3) Quit smoking and limit alcohol
(4) Adhere to exercise
(5) Emotional peace and optimism
(6) Adequate sleep
(7) Prevention of infection
(8) Strictly control blood pressure in hypertensive patients
(9) Strictly control blood sugar in diabetic patients
(10) Serious physical examination every year
(11) Do not use drugs indiscriminately
In the face of kidney disease, active treatment is the key
(1) Adjust the mentality and coexist harmoniously with the disease for a long time
(2) Determine dietary protein intake according to renal function
(3) Control urinary protein, target 24-hour urinary protein ≤ 0.5-1g, follow the doctor's advice, and there are different treatment plans for urinary protein control for different conditions
(4) Control blood pressure, blood pressure ≥ 140/90mmHg is an important factor leading to the development of nephropathy into uremia, and blood pressure should be controlled within ≤ 130/80mmHg as much as possible
(5) To stay away from uremia, regular review is essential, and the frequency of review is determined according to changes in the condition
(6) Don’t believe in remedies, there is no “magic medicine” for nourishing the kidneys