World Kidney Day is celebrated every year on the second Thursday of March, and this year, March 12 is the 15th World Kidney Day, with the theme “Kidney Health for All – Prevention, Treatment and Care for All”. -In the winter and spring of 2020, a new coronavirus pneumonia epidemic disrupted the lives of many patients with chronic diseases. Chronic kidney disease (CKD) patients are a large group of chronic disease patients, according to the latest statistics just published in The Lancet on February 13, 2020: the number of CKD patients worldwide reached 697.5 million in 2017, accounting for 9.1% of the world’s population, among which, the number of patients in China has reached 132.3 million. In the latest 6th edition of the Health Care Commission’s “Novel Coronavirus Pneumonia Treatment Protocol”, it is stated that: while the prognosis is worse in the elderly and those with chronic underlying diseases. Under the threat of new coronavirus, how should patients with underlying renal disease be followed up and cared for? Let’s listen to the answers from nephrologists. Patients with CKD have more risk of new coronary pneumonia Patients with chronic kidney disease (CKD) are at high risk of infections, the most common of which is respiratory infections. The reasons for this are mainly related to the following factors: 1. long-term massive proteinuria leads to the loss of immunoglobulin and complement in the body, which easily forms chronic malnutrition; 2. the need to take hormones and immunosuppressants aggravates the patient’s low immune function; 3. edema occurs, which easily causes the breakage of human barriers such as skin and mucous membranes, giving pathogens increased opportunities for infection; 4. CKD patients commonly have abnormal immune response: for example The most common IgA nephropathy in China is closely related to mucosal immune abnormalities. Clinically, patients with IgA nephropathy are mostly seen with long-term upper respiratory tract infections (e.g., recurrent pharyngitis). Recently, our research team found that the new coronavirus invades the human body mainly through human angiotensin-converting enzyme 2 (ACE2) receptor, so cells expressing ACE2 may be used as target cells and are vulnerable to infection by the new coronavirus, such as alveolar type 2 (AT2) cells. In contrast, ACE2 is highly expressed in renal tubular cells, mesangial cells, bladder uroepithelial cells, and testicular vas deferens cells; therefore, kidney, bladder, and testicular tissues are all potentially high-risk organs. In addition, clinical studies have found that acute kidney injury caused by coronavirus infection is not uncommon and mainly manifests as renal tubular injury. The mechanism, according to available studies, may be mediated directly by the virus or indirectly by cytokines released by abnormal immune response and other factors. Patients who develop it mainly show proteinuria, hematuria, oliguria, elevated blood urea nitrogen, blood creatinine, and renal imaging changes, and CT may suggest changes in kidney size or structure, with some patients developing acute renal failure. In short, CKD patients are susceptible to the new crown, the new crown patients are also prone to kidney injury, while the kidneys also undertake the important work of metabolism of drugs for the treatment of the new crown, so our “kidneys” are facing a severe test of the new crown pneumonia! Scientific protection Chinese medicine health care for kidney friends Under the threat of epidemic, CKD patients should strengthen the prevention, new crown patients also need timely monitoring of kidney injury. If infection is suspected, it is important to promptly visit the designated fever clinic and cooperate with the doctor for flow adjustment and treatment. The sixth edition of the treatment plan points out that respiratory droplet and close contact transmission is the main transmission route of neo-coronary pneumonia, and there is a possibility of transmission via aerosols in a relatively closed environment with prolonged exposure to high concentrations of aerosols. Therefore, it is recommended that all CKD patients must do a good job of personal protection: wear a mask in public places, wash hands regularly in daily life, disinfect the working environment regularly, ventilate more indoors, and avoid prolonged stays in crowded and more closed environments. CKD patients need to pay attention to their diet and mood, in addition to personal protection. It is recommended to combine work and rest to ensure 8 hours of sleep and rest every day; to have a diversified diet with regular rationing and reasonable energy distribution; to increase vitamin C-rich foods to enhance resistance to disease (kidney failure patients should pay attention to blood potassium monitoring); to pay more attention to low-fat and low-calorie diet during home time when energy consumption is low; not to believe in rumors and reduce panic. “CKD patients who live at home for a long time can improve the quality of their life by reading books, listening to songs, and enjoying the eight duanjin. 3. Necessary follow-up and medication need to be adhered to: hospitals are high-risk places for cross-infection, kidney disease is a chronic disease, so if your condition is stable and you only have questions to ask, you can choose the internet consultation method and contact your doctor, and try to avoid going out to the doctor. If there is a gap in medication at home, you can entrust your family to bring the patient’s medical insurance card and medical insurance book to dispense the medication on your behalf, do not stop the medication at will, for example, some kidney disease patients are taking hormones, if you take a large dose, suddenly stop using may occur adrenal crisis. If the condition changes, or if it is time for a review, the patient should go to the hospital for a review with good protection. During the current epidemic, hospitals are implementing a full appointment system and online epidemiological surveys. Patients are advised to fill out and make appointments in advance before visiting the hospital to reduce congestion at the hospital entrance. For CKD patients with immune deficiency prone to recurrent infections, thymopentin and other immune boosters can be used as appropriate under the guidance of doctors. 4, Chinese medicine health care to strengthen the body: Chinese medicine believes that patients with kidney disease are mostly based on “spleen and kidney deficiency”, and the spleen, kidney and lung are closely related. “The lung is the master of qi, and the kidney is the master of breathing. According to the theory that the five elements are in harmony with each other, the lung can be tonified with prescriptions that nourish the spleen and benefit the qi. Therefore, Chinese medicine often uses the method of “tonifying the kidney and strengthening the spleen” to nourish the lung and nourish the qi. The current epidemic is an “epidemic” evil, as the saying goes, “where evil comes together, its qi must be deficient”, and “when positive qi exists within, evil cannot dry up”. The Chinese medicine health care, pay attention to the unity of heaven and man, not only to take into account the kidney disease patients “spleen and kidney deficiency” body, but also to take into account the current cold and wet climate characteristics. Here are a few easy-to-use TCM health care methods for CKD patients: (1) Gorgonzola Huai Shan Wood Ear Soup: 50 grams of gorgonzola, 200 grams of iron stick Huai Shan, 10 grams of dried black wood ear, 250 grams of pork chops, 3 slices of ginger, a pinch of salt, and a little yellow wine. 1 bowl daily. This health soup has the health benefits of tonifying the kidney and nourishing the qi, strengthening the spleen and resolving dampness, moistening the lung and relieving cough. (Patients with kidney failure prone to high potassium need to take it less frequently and reduce the intake of potassium in the diet). Main ingredients: 50 grams of gravy, 200 grams of iron stick Huai Shan, 10 grams of dried black fungus, 250 grams of pork chops Supplementary ingredients: 3 slices of ginger, a little salt, a little yellow wine. Preparation: Gorgonzola, fungus soak an hour in advance to wash soaked, Huai Shan peeled and cut small sections put in water to prevent oxidation, ginger slices cut thin slices standby Cooking steps: Step 1: wash pork chops clean cold water into the pot, boil over high heat for a minute to blanch. Step 2: Take out and wash the impurities with water, put into the rice cooker with soup-making function. At the same time put the prepared gravy, fungus, add an appropriate amount of water, a small amount of yellow wine and ginger, ready to do after the power according to the soup-making function. Step 3: When the gravy and pork chops are cooked for nearly an hour, add the iron stick yam and boil the soup together until the ingredients are cooked and delicious. Step 4: After the soup is ready, mix in a little salt to enjoy. (2) warm moxibustion “spleen acupoint” and “kidney acupoint” points: acupoints are the person’s qi, blood and qi parade in and out of the transfer, in the human waist and back of the bladder meridian, is an important point of health care, warm moxibustion “spleen acupoint” and “kidney acupoint” points can The “kidney acupoints” can be used to tonify the kidneys, strengthen the spleen and warm the dampness. For patients who are afraid of heat, constipation, yellow tongue and damp heat, moxibustion should not be used to avoid dryness and heat.