Surgery and other treatments for primary tumors of the kidney inevitably remove or damage kidney units, thus potentially affecting kidney function after treatment. Therefore it is important to protect kidney function and avoid kidney damage. There are many unexpected kidney damages in daily life that patients and families are not very aware of.
Control of hypertension
This is the most important amount and the most overlooked measure to protect kidney function. Generally speaking, patients with chronic kidney disease should have their blood pressure controlled to near 120/80 mmHg, and numerous studies have shown that the rate of deterioration of kidney function is significantly accelerated accordingly when blood pressure is a little above this target value, which shows the importance of controlling blood pressure. Two points should be clear to patients regarding the use of antihypertensive agents in patients with kidney disease:
- One, there is a wide range of antihypertensive drugs, and different types of antihypertensives have similar blood pressure-lowering effects, but angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors are better for renal protection and should be used as much as possible if they are not contraindicated. Some patients have increased serum creatinine after using these antihypertensive drugs, so care should be taken after taking them.
- Second, try to choose a drug with a long duration of action, which is not only easy to take once a day, but also keeps blood pressure under control at the desired level within 24 hours. Drugs that have a short duration of action are taken multiple times a day and have high blood pressure fluctuations, which are an important cause of cardiovascular complications.
Long-acting blood pressure-lowering drugs often take several days to reach their maximum blood pressure-lowering effect; therefore, after taking such drugs, if the blood pressure is not well controlled, do not blindly increase the dose and adjust the medication under the guidance of your doctor. In addition, it is also very harmful to lower blood pressure too quickly or too low, especially in the elderly.
Dietary therapy
The general principle is a low-salt, low-protein diet.
- Salt intake should not exceed 6 grams per day, but this varies from person to person. Prolonged salt overload in some patients, especially in older patients with kidney disease whose kidneys have a reduced ability to retain sodium, can lead to severe hyponatremia.
- The increased metabolites of excessive protein intake can also increase the burden on the kidneys. Therefore the protein intake should be high quality protein such as eggs, fish, lean meat and milk, while minimizing the proportion of vegetable protein. To reduce the intake of vegetable protein, wheat starch can be used as a staple food instead of rice or flour. The daily calorie intake should be adequate, and no one food is absolutely forbidden.
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Of course, these are only general principles, but for a specific patient, a reasonable diet should be developed taking into account the nutritional status, coexisting diseases, renal function status, and medications applied.
Avoiding infections and preventing colds
The most common infection in winter and spring is a cold, when resistance drops sharply, and the Chinese perception is that a cold is trivial, or people think that a cold may cause heart disease, but people do not think that a cold can also threaten the kidneys. So a cold is not an insignificant and minor illness, it is related to the health of all the major organs of our body, including the kidneys.
The most common infections in the summer and fall are digestive tract infections and diarrhea that cause dehydration. Kidney function is maintained by blood flow to the kidneys, and dehydration can cause a decrease in blood flow to the kidneys, which can make kidney function inadequate.
Preventing urinary tract obstruction
Some older adults with an enlarged prostate who do not urinate well or who have urinary tract stones should be treated immediately. The poor flow of urine after an obstruction can easily cause bacteria to multiply and cause infection. Obstruction plus infection is a double damage to the kidneys.
Avoiding drug damage
Nephrotoxic drugs, such as aminoglycosides, have significant nephrotoxic damage. There are also anti-inflammatory analgesics, because anti-inflammatory analgesics are prostaglandin-inhibiting and often reduce renal blood flow, which, like the diarrhea just described, can damage kidney function. Be especially careful with medications for kidney disease.
A special reminder is that it used to be a common belief that Chinese medicine is taken from natural sources, so it is safe to take Chinese medicine because it is said to have no toxic side effects. The first time the company was found in Europe and Japan, it was also proven in animal tests. There was an old Chinese doctor who used gentian diarrhea liver pills to remove acne and clear heat and dampness. After using gentian diarrhea liver pills, the symptoms of dampness and heat were reduced and the skin was nourished, but the kidneys were inadvertently damaged.
Trauma and surgery
Surgery requires anesthesia, which may affect kidney blood flow, and there are drugs that can directly affect the kidneys, which may bleed during surgery, and tissue damage, which can affect the kidneys. Trauma and surgery often add to the burden on the kidneys, and it is important to pay attention to kidney function at this time, or the trauma surgery may be completed, but kidney function is damaged.
Preventing and correcting electrolyte disturbances
Disorders of electrolytes can also affect kidney function. Modern people party more, eat and drink a lot, eat a lot of protein, eat a lot of greasy things, and eat a lot of salt, all of which can cause changes in kidney function. For example, if you eat a lot of salt, it is easy to cause water and sodium retention. The water and sodium retention blood pressure will easily be high, edema increases because salt is excreted by the kidneys, which equals to increase the burden on the kidneys.
Regular kidney function checks
It is also very important to have regular blood tests of kidney function at the hospital. If early kidney impairment can be detected in time, you can also rely on medication from nephrology to correct or delay the impairment of kidney function.