What are the “three early signs” of kidney disease?

  With the development of society, people’s lifestyle and dietary structure as well as environmental changes, the incidence of kidney disease has a significant upward trend. According to the World Health Organization, one out of every 10 people in the world has chronic kidney disease on average. However, patients with chronic kidney disease are mostly seen at the stage of kidney failure, thus making it impossible for patients to receive effective treatment. The main reasons for this situation are as follows.  Firstly, the compensatory function of kidney is extremely strong, even if the kidney function is impaired by more than 40-50%, the patient may still have no clinical symptoms, let alone see a doctor.  Secondly, because patients have limited knowledge about kidney disease, so they cannot pay enough attention to the early symptoms.  Thirdly, even when abnormalities are found in urine examination during routine physical examination or unit physical examination, chronic kidney disease is easily missed due to the limited knowledge of doctors and patients.  Fourthly, diabetes, SLE, hypertension, gout and many other chronic diseases will involve the kidney in the development of the disease, and a large proportion of such patients with a history of chronic diseases do not pay attention to the protection of the kidney.  Therefore, when 20-30% of kidney disease patients first come to the hospital, their kidney function has already developed to a stage that is impossible to reverse. Only by “three early”, i.e. early detection, early diagnosis and early treatment, can we reduce the prevalence of chronic kidney disease, slow down the deterioration of kidney function, delay the time of patients entering dialysis and improve their quality of life.  Early detection: mainly through the education of patients’ related knowledge, so that patients can be alert when the following conditions are found  1. More foam in urine: It is often a precursor of kidney disease, which is mainly caused by a certain amount of protein in the urine, and the leakage of protein is mostly due to glomerular lesions. Therefore, if the occurrence of urination after a longer period of foam to be alert, should promptly seek medical attention to do urinary routine, 24-hour urine protein quantification and other tests.  2, hematuria: hematuria includes visual hematuria and microscopic hematuria. The amount of bleeding, which can be detected by the naked eye, is called carnal hematuria; the amount of bleeding is small, which cannot be seen by the naked eye and can only be detected by microscopic observation is called microscopic hematuria. There are many clinical causes of hematuria, but the majority of hematuria is caused by diseases of the urinary organs.  3, edema: edema is also a symptom easy to appear in the early stage of kidney disease patients, often appearing in the eyelids, face, ankles and back buttocks. In severe cases, it may be accompanied by hydrothorax, ascites and perineal (scrotum, labia) edema.  4, hypertension: young patients who do not have a family history of hypertension should be highly suspected of having kidney disease if their blood pressure is elevated. In addition, hypertensive patients should pay attention to frequent urinary routine and other related examinations. Attention should be paid to identify whether the hypertension is caused by kidney disease or the kidney damage caused by hypertension.  5.Little or no urine: Normal adult urine volume in 24 hours is about 2000ml, less than 400ml is little urine, less than 100ml is no urine. At this time, the kidneys can no longer discharge the metabolic waste and toxins from the urine, and cannot regulate the stability and balance of water, electrolytes and internal environment, so you should seek urgent medical treatment.  6.Other symptoms: if there is depression, loss of appetite, weakness, pallor, anemia, etc., chronic renal failure should be considered, and blood and urine tests should be done in time.  In short, the early detection of kidney disease still needs to be educated for the general public, so that patients can be alert when the above conditions are found and go to regular hospitals in time.  Early diagnosis: Kidney disease often causes a group of syndromes with similar performance, so the early diagnosis of kidney disease is mainly the diagnosis of various syndromes.  1, nephrotic syndrome: a clinical syndrome of massive proteinuria (>3.5g/d), hypoproteinemia (<30g/L), marked edema and/or hyperlipidemia due to various causes.  2.Nephritis syndrome: a syndrome characterized by proteinuria, hematuria and hypertension.  3, asymptomatic urinary abnormalities: including simple hematuria, asymptomatic proteinuria, and pusuria that cannot be explained.  4.Acute renal failure and acute renal failure syndrome: glomerular rate filtration decreases in a few days or weeks.  5, Chronic renal failure syndrome: progressive, irreversible loss of renal function due to various causes.  In conclusion, the early diagnosis of kidney disease mainly relies on the doctor's clinical experience and relevant examination results for comprehensive analysis. The Department of Nephrology of our hospital has a large number of nephrologists with rich clinical experience and international advanced testing equipment, and has rich experience in the early diagnosis of various kidney diseases.  Early treatment: The principles of treatment for renal diseases include removal of causative factors, general treatment, suppression of immune and inflammatory reactions, prevention and control of complications, delaying the progression of renal diseases and renal replacement therapy.  1.Application of glucocorticoid: it can exert its efficacy of diuresis and elimination of urinary protein by inhibiting inflammatory response and suppressing immune response.  2.Application of cytotoxic drugs: mainly used for "hormone-dependent" or "hormone-resistant" type, in cooperation with hormone therapy.  3.General treatment: rest, low salt and high quality protein diet.  4.Symptomatic treatment: actively control edema, blood pressure and proteinuria.  5.Complication prevention and treatment: It is an important factor affecting the long-term prognosis of patients, and should be actively prevented and treated.  6.Renal replacement therapy: for those who reach the indication of dialysis should be timely dialysis.  7.Prevention of relapse: many kidney diseases have a high relapse rate after improvement of treatment, so prevention of relapse is important for the treatment of kidney disease patients.  In conclusion, patients with kidney disease must receive timely treatment at regular hospitals, and our clinically experienced nephrologists will give individualized and comprehensive treatment plans for each patient, so as to reduce the pain of the disease and improve the quality of life.