1.What is chronic kidney disease?
Chronic kidney disease is defined as glomerular filtration rate less than 60ml/min/1, 73m2 lasting for more than 3 months or kidney injury for more than 3 months. Kidney injury is defined as abnormal kidney pathology or the presence of abnormal detection indicators, including abnormal blood and urine, and abnormal imaging tests.
Chronic kidney disease is a syndrome, not a specific kidney disease, is a common combination of many kidney diseases have. The concept of chronic kidney disease is an advancement in nephrology and a progress in nephrology, which has taken a great role in guiding the prevention, diagnosis and treatment of kidney disease.
2.What is the prevalence of chronic kidney disease?
The prevalence of chronic kidney disease is on the increase, and has been the 5th to 9th leading cause of death in the past 20 years. In China, the prevalence of chronic kidney disease is about 8-10%. With the increase in the elderly population, the average life expectancy and the improvement of living standards, the prevalence of diabetes, hypertension gradually increased, long-term poor blood sugar control, poor blood pressure control can appear diabetic kidney, hypertensive nephropathy, such patients are currently increasing year by year, and there is a trend of early age and younger.
3.What are the hazards of chronic kidney disease to the human body?
If chronic kidney disease is not detected in time, not treated in time, not adhere to dynamic monitoring and treatment, or the treatment is not effective, a large proportion of patients will have a decline in kidney function, kidney function will decline to a certain extent will develop into uremia, this time the need for kidney replacement therapy, which is commonly known as dialysis or kidney replacement, to maintain life, resulting in greater medical costs, life This leads to higher medical costs, lower quality of life, shorter survival time, etc. In addition, chronic kidney disease patients have a high incidence of cardiovascular complications, according to statistics, half of the patients with chronic kidney disease have cardiovascular complications, such as hypertension, decreased heart function, arrhythmia, atherosclerosis, cerebral hemorrhage, etc., resulting in increased mortality and shortened life expectancy.
4.What are the common chronic kidney diseases?
Chronic kidney disease is not a specific disease, but a clinical syndrome, which includes many kidney diseases. In our country, the common chronic kidney diseases include the following kidney diseases: chronic nephritis, IgA nephropathy, nephrotic syndrome, diabetic nephropathy, hypertensive nephropathy, chronic uric acid nephropathy, lupus nephritis, purpura nephritis, drug nephropathy, polycystic kidney, chronic renal failure, etc.
5.How to find out if you are suffering from chronic kidney disease?
For patients with chronic kidney disease, some symptoms or signs may appear, such as edema of the face, eyelids, both lower limbs, foamy urine, nocturnal hematuria, increased nocturia, back pain, anemia, high blood pressure, etc. When these conditions occur, you need to go to the hospital for examination. There are also some patients with chronic kidney disease who do not have the above-mentioned symptoms and usually have at most fatigue, weakness and other non-specific symptoms, and when they are found, they are in the advanced stage of chronic kidney disease. Generally speaking, routine urine tests, blood tests for kidney function and ultrasound of the urinary tract can detect common kidney diseases; for diabetic patients or hypertensive patients, tests such as urine microalbumin are also done. For women who want to get pregnant, a medical checkup is recommended before pregnancy; having chronic nephritis may lead to aggravation of kidney disease after pregnancy. At present, the urban population to the hospital for medical check-ups gradually increased; while living in rural areas to go to the annual medical check-ups less people, and even physical abnormalities do not go to the check-ups to the seriousness of the disease to treat many people, with the implementation of medical reform, this situation has improved.
6.How to prevent chronic kidney disease?
Prevention of chronic kidney disease can be divided into three levels of prevention.
(1) primary prevention: the detection and screening of high-risk groups susceptible to chronic kidney disease in the normal population, high-risk groups mainly include the elderly, low birth weight children, patients with hypertension, diabetes, autoimmune diseases, individuals with a family history of kidney disease, individuals with acute kidney injury, etc., to strengthen the monitoring and intervention of these high-risk groups.
(2) Secondary prevention: individualized measures to delay the progression of kidney injury and reduce the occurrence of cardiovascular complications in patients with chronic kidney disease.
(3) Tertiary prevention: mainly to reduce some complications of uremia, improve the survival rate and quality of life of patients, and reduce the rate of death.
7, chronic kidney disease patients in the treatment process to pay attention to what?
(1) regular treatment: patients suffering from chronic kidney disease should go to a regular hospital, preferably to a nephrology specialist for examination and treatment, do not believe in false advertising, do not believe in charlatans, do not rush to the doctor.
(2) Pay attention to monitoring: for patients who have improved in treatment, we should also strengthen monitoring in the future and do some tests regularly, such as urine routine tests, kidney function tests, blood pressure measurements, etc., to detect problems and seek medical advice at any time.
8, chronic kidney disease patients in daily life to pay attention to what?
(1) Pay attention to rest: chronic kidney disease patients should pay attention to rest, do not overwork, excessive exertion will aggravate the disease, generally to “do not feel fatigue” as the degree. When there are signs of nephritis activity, such as proteinuria, increased hematuria, edema, rapid decline in kidney function, etc., should be fully bed rest until the condition is alleviated, the condition is stable, you can properly get out of bed, but should pay attention to not overworked.
(2) moderate exercise: chronic kidney disease patients do not advocate strenuous exercise, low or moderate tension exercise, such as walking, tai chi, less strenuous ball games, etc., patients with diabetes is best to exercise under the guidance of a doctor. Proper exercise helps to improve the overall function of the body and increase the blood flow to the kidneys.
(3) Prevention and control of infection: chronic kidney disease patients due to the decline in their own resistance and the use of some immunosuppressants, prone to infections, such as bacterial infections, viral infections, fungal infections, hepatitis virus infections, etc., the occurrence of infection can lead to recurrence of kidney disease, aggravation of the disease. Therefore, patients with chronic kidney disease should pay attention to good hygiene habits, such as washing hands regularly before and after meals, ventilating rooms, going to and from densely populated areas, paying attention to the cleanliness of food, and keeping warm in cold weather to prevent infections of the respiratory tract, gastrointestinal tract, urinary tract and skin. Once the infection occurs, treat it actively according to the situation.
(4) Pay attention to diet: Dietary intervention is as important as drug intervention for patients with chronic kidney disease. Pay attention to what should be paid attention to diet, the following points are introduced to you.
Sodium-limited diet: All patients with chronic kidney disease should limit their sodium intake. Long-term excessive salt intake may lead to hypertension and even left ventricular hypertrophy, microalbuminuria, and increased arterial stiffness. The general daily intake of sodium converted into table salt should not exceed 6g, and when edema, high blood pressure and decreased heart function occur a low salt diet (2-3g per day) should be followed. This includes salt including ordinary table salt, sodium-containing seasonings, nutritional additives and salt in health products, etc. Eat less and try not to eat saltier foods such as chili sauce, bean paste, soy cucumber, soy radish, soy sauce, pickled mustard, salted fish, MSG, tofu milk, shrimp, and squash. It is difficult to implement a sodium-limited diet, so here are a few tips for you, such as not putting salt shakers on the table, cooking with less frying and more grilling, using spices instead of salt as a seasoning, paying attention to the sodium content on food labels, refusing all pickled foods, soy sauce and snacks containing salt, and sprinkling a small amount of salt on the surface of food instead of cooking a larger amount of salt in the food. A salt-restricted diet is not about not eating salt either. Not eating salt is definitely not an option, it’s about getting a handle on the amount. Salt is the common table salt available in the market.
Low purine diet: For patients with high uric acid in the blood and gout, they should have a low purine diet. First of all, do not drink alcohol, especially beer. Secondly, eat less seafood, animal offal, meat soup and shellfish, and eat more fruits and vegetables. In addition, you should drink more water every day. If you have normal kidney function and no obvious edema, you should generally drink 2000ml of water every day.
For patients with high blood lipids, they should eat less food with high saturated fatty acids, such as ham, salami, full-fat cheese, butter, etc. For patients with chronic kidney disease who are prone to hyperkalemia due to declining kidney function, they should eat less foods with high potassium content such as bananas, oranges, potatoes, raisins, kernels (such as melon seeds). On the issue of protein intake in patients with chronic kidney disease, this issue is complicated and should be treated specifically according to each person’s condition and should be done under the guidance of a doctor.
(5) Do not abuse drugs: It is better not to use some antibiotics (such as gentamicin, generation cephalosporins, etc.), non-steroidal anti-inflammatory drugs and antipyretic and analgesic drugs (such as ibuprofen, indomethacin), Chinese herbs (Guanmutong, Guang Fangji, Bone Seeker, Tian Xian Vine, Qing Mu Xiang, etc.) that have nephrotoxicity. Drugs should be used under the guidance of a doctor.
(6) Do not contact toxic substances: Patients with chronic kidney disease should not be exposed to heavy metals, organic solvents (gasoline, kerosene, diesel, turpentine, benzene, paint, etc.), pesticides, synthetic dyes, organic compounds, biotoxins (snake venom, bee venom, fish bile, etc.), etc.
(7) Limit alcohol and quit smoking: to limit the intake of alcohol, generally less than 30g of ethanol per day. The damaging effects of smoking on the kidneys are increasingly recognized. Some studies have found that smoking has certain nephrotoxic effects, which can affect renal hemodynamics and histological structure, causing an increase in the rate of urinary protein excretion, which in turn impairs kidney function and increases the risk of end-stage renal failure, and this nephrotoxic effect is particularly pronounced in the elderly, patients with primary hypertension, diabetic patients and patients with kidney disease. These findings suggest that smoking has become a very important factor in kidney damage.
9.What are the methods of Chinese medicine in the treatment of chronic kidney disease?
(1) Prevention: In the process of occurrence and development of Chinese medicine, the typical Eastern traditional holistic epistemology idea, i.e. the concept of the whole, has always been carried through. Through Chinese medicine can improve the functions of the human body, improve the immunity of the body and prevent the occurrence of disease. Due to the accelerated pace of life, changes in lifestyle, and increased social pressure, many people are in a subhealthy state, which will affect the overall function of the human body, affect the quality of life and lead to the occurrence of diseases in the long run.
(2) Treatment: For patients with chronic kidney disease, Chinese herbal medicine treatment has great advantages and is more effective. For example, for patients with nephritis, we can treat them with some herbal medicines that strengthen the spleen and kidney, benefit qi and nourish yin, nourish the liver and kidney, activate blood circulation and eliminate blood stasis, clear heat and dampness, and ventilate the internal organs and drain turbidity, so as to obtain the effects of reducing proteinuria, lowering blood creatinine and delaying the progress of kidney injury. In addition, patients with chronic kidney disease who use hormones or immunosuppressants can reduce the side effects of these drugs and improve the efficacy of treatment with Chinese medicine. In addition to oral Chinese medicine can also be used to treat kidney disease through some other Chinese medicine treatment modalities, such as Chinese medicine enema, Chinese medicine bath, Chinese medicine fumigation, acupuncture, acupressure, etc.
(3) Health care: In winter, the body’s yang collection, qi and blood tend to the inside, the skin is dense, water and moisture is not easy to drain from the body surface, but by the kidney, bladder gasification, a small part into fluid spread around the body, most into water, down the bladder into urine, invariably increased the burden on the kidneys, prone to nephritis, enuresis, urinary incontinence, edema and other diseases. Therefore, winter health care should pay attention to the maintenance of the kidneys. Diet should eat more warm and fluffy, bitter food. Sleep early and get up late. Pay attention to warmth: keep your head, back and feet warm. But as the saying goes: “winter move a move, less a disease; winter lazy a lazy, drink more medicine a bowl”, “summer training three volts, winter training three nine” these are instructions, winter adhere to physical exercise, very beneficial to health. “Winter does not hide the essence, spring will be sick and warm”. Winter, is the body’s energy accumulation stage, for weak people is a good season for tonic.
(4) waist exercise: two palms rubbing to the palms of the hands hot, respectively, put to the waist, palms to the skin, up and down massage waist, until there is a sense of heat. Can be morning and evening once each, each time about 200 times. This exercise can replenish the kidneys and nourish the qi.
Foot massage exercise: daily before going to bed with warm water soak feet, and then rub hot hands with each other, with the left hand heart massage right foot heart, right hand heart left foot heart, more than 100 times each time, to rub hot feet as appropriate. This method has the effect of strengthening the kidneys, nourishing Yin and lowering the fire, for patients with chronic kidney disease or normal people common deficiency heat disorder has a certain effect.
Nose rubbing exercise: both hands rubbed hot, fingers together, palms spread out, close to the face, the finger abdomen of both hands as a precursor, respectively, from the nasal wings on both sides of the Yingxiang point, along both sides of the nasal column edge upward push rub, by the eye canthus, eyebrows and other places to reach the forehead. Then the two hands are separated and pushed to the two temples, the two palms also cover the eyes, from the two temples and then down, through the temporal temples and the ears, cheeks and other parts, back to the starting point of the two sides of the nose. And then start again, according to the above route cycle. Effect: Bathing the face has a smooth flow of qi and blood, dispel wind and cold, brighten the eyes and open the orifices, wake up the brain and refresh the mind and beauty. For chronic nephritis of the body deficiency easy to catch a cold is more suitable.
10, suffering from chronic kidney disease can be injected with influenza A (H1N1) vaccine?
According to the Ministry of Health released some information related to influenza A H1N1 flu vaccination, which “influenza A vaccination contraindications” in this article: suffering from acute diseases, serious chronic diseases, the acute onset of chronic diseases, colds and fever are not suitable for vaccination. The Ministry of Health website issued by the experts to answer questions in such a message: nephrotic syndrome patients in the acute phase or the degree of seriousness should be prohibited from vaccination, the condition of mild should be carefully decided under the guidance of a clinician. China’s influenza A (H1N1) vaccination adheres to the principle of informed consent, voluntary and free of charge, and is currently used mainly for the vaccination of front-line staff. Therefore, whether patients with chronic kidney disease can be injected with influenza A (H1N1) vaccine should should be based on which kidney disease each person is, each person’s specific condition, some can be injected, some injections may lead to recurrence of kidney disease, aggravation of the disease, so it is best to ask the nephrologist, under the guidance of doctors to decide whether to inject.