Since March this year, the local epidemic in Shanghai has been spreading in multiple points and stealthily, which is the toughest test of the situation since the normalization of epidemic prevention and control in Shanghai. At present, Shanghai is actively preventing and controlling the epidemic and responding to it in an organized manner. Facing the normalization of epidemic prevention and control, how to follow up and take care of patients with underlying kidney disease? Let’s listen to the answer of nephrologist from Shanghai Longhua Hospital. CKD patients have more risk of new crown pneumonia Chronic Kidney Disease (CKD) patients are high risk of infections, and the most likely infections are respiratory infections. The reasons for this are mainly related to the following factors: (1) long-term large amount of proteinuria leads to the loss of immunoglobulin and complement, which is easy to form chronic malnutrition; (2) the need to take hormones and immunosuppressants to aggravate the patient’s immunocompromise; (3) edema occurs, which is easy to cause skin and mucous membranes and other barriers of the human body broken, to the pathogens to increase the chance of infection; (4) CKD patients generally have an abnormal immune response: for example, the most common in China, the immune response of the ICHD is not normal. Abnormalities: For example, the most common IgA nephropathy in China is closely related to mucosal immune abnormalities, and IgA nephropathy patients are often seen to be accompanied by long-term upper respiratory tract infections (e.g., recurrent laryngitis). Recently, our research team found that the new coronavirus invades the human body mainly through the human angiotensin-converting enzyme 2 (ACE2) receptor to invade the cells, so the cells that express ACE2 may serve as the target cells, which are susceptible to infection by the new coronavirus. ACE2 is highly expressed in cells in many parts of the urinary system, so kidney, bladder, and testicular tissues are potential high-risk organs. Renal injury caused by Neoguan may mainly manifest proteinuria, hematuria, oliguria, elevated blood urea nitrogen, blood creatinine, and renal imaging changes, and some patients may develop acute renal failure. In conclusion, CKD patients are susceptible to new crowns, new crowns patients are also prone to kidney injury, while the kidneys are also responsible for the metabolism of the drugs used in the treatment of new crowns. Scientific protection of Chinese medicine health care for kidney friends In the context of anti-epidemic normalization, CKD patients should strengthen the prevention of new crown patients also need to monitor the kidney injury in a timely manner. If infection is suspected, you must promptly go to the sentinel fever clinic and cooperate with the doctor’s flow and treatment. How to protect CKD patients scientifically, here nephrologists give you some suggestions: (1) Personal protection is the most critical: the spread of new crown pneumonia through respiratory droplets and close contact is the most important means of transmission, in a relatively closed environment for a long time exposed to high concentrations of aerosols, there is a possibility of transmission through aerosols. Therefore, it is recommended that all CKD patients must do a good job of personal protection: wearing masks in public places, washing hands regularly, disinfecting the work environment regularly, ventilating indoors, and avoiding prolonged stay in crowded and closed environments. (2) Diet and rest should be emphasized: correct living habits, healthy diet and nutrition, and a good state of mind are important to ensure that the body’s immune system works properly and resists the risk of disease; in addition to personal protection, patients with CKD also need to pay attention to diet and rest, as well as emotional and mental health. It is recommended to combine work and rest to ensure sufficient sleep and rest for 8 hours a day; dietary diversity, on time and in quantitative terms, with reasonable energy distribution, you can appropriately increase foods rich in vitamin C to enhance the ability to resist disease (patients with renal failure should pay attention to the monitoring of blood potassium), less energy consumption during the period of home, pay more attention to the low-fat, low-calorie diet; don’t believe the rumors, reduce panic, Chinese medicine believes that “fear injures the kidneys”, CKD patients need to focus on diet and living and emotional health. “CKD patients who live at home for a long time can improve the quality of their daily life by increasing the number of reading, listening to songs, eight pieces of brocade and other ways of physical and mental pleasure. (3) Necessary follow-up and medication should be insisted: hospital is a high-risk place for cross-infection, kidney disease is a chronic disease, if the condition is stable, there are enough medicines at home, and you only need to ask questions, you can choose the Internet consulting method to contact with the doctor, and try to avoid going out to see the doctor. If there is no medicine available at home, you can come to the hospital for on-site consultation and dispensing (or your family members can wait for the dispensing), or you can choose the internet platform of LWH (make an appointment with the “nephrology internet clinic of branch hospitals”) to follow up and dispense the medicine, and you should not stop the medicine at will. For example, some patients with kidney disease are taking hormones, if they take a large dose, suddenly stopping may occur adrenal crisis. If the condition changes, or when it is time for review, the patient needs to go to the hospital for examination and review under good protection. For CKD patients who are prone to recurrent infections due to low immunity, thymopentapeptide can be used to enhance immunity under the guidance of doctors. (4) Scientific vaccine against epidemics: vaccination is an important means of preventing new crowns, as it is particularly important for high-risk occupations such as those who have a lot of contact with people or are engaged in import trade. If the patient’s nephropathy proteinuria and renal function are stable condition, chronic kidney disease patients exclude contraindications can be vaccinated. If you are in the acute exacerbation of kidney disease and other diseases or there are contraindications to vaccination, vaccination is not recommended. It is recommended to bring the laboratory report to the nephrology clinic and consult the doctor for a decision. (5) Traditional Chinese Medicine (TCM): According to TCM, patients with kidney disease mostly suffer from “deficiency of spleen and kidney”, and the two organs of spleen and kidney are closely related to the lungs. “Lung is the main gas, the Division of respiration, the kidney is the main gas”, “the lung is the main gas, the kidney is the root of the gas”, kidney deficiency will affect the lung’s function of purging and descending; “Cultivation of the earth to generate gold”, according to the theory of the five elements of each other. According to the theory of the mutual growth of the five elements, the prescription of tonifying the spleen and benefiting the qi can replenish the lung qi. Therefore, Chinese medicine practitioners often use the method of “tonifying the kidney and strengthening the spleen” to replenish the lungs. This epidemic belongs to the “epidemic hostility” of the evil, the so-called “where the evil is, its gas must be weak”, “positive qi within, the evil can not be dry”, frail and old, the couper is not solid people are more susceptible to the evil. Chinese medicine, pay attention to the unity of man and nature, both to take into account the kidney disease patients “spleen and kidney deficiency” of the body, but also to take into account the characteristics of the climate of the current cold and wet. Here to CKD patients a few convenient operation of Chinese medicine to strengthen the health care method: 1) Gorgon fruit Huishan fungus soup: 50 grams of gorgon fruit, 200 grams of iron stick Huishan, 10 grams of dried black fungus, 250 grams of pork chops, 3 slices of ginger, a little bit of salt, a little bit of yellow wine. 1 bowl per day. The health soup has the health effect of tonifying the kidney and Qi, strengthening the spleen and resolving dampness, moistening the lungs and relieving cough. (Patients with renal failure prone to high potassium need to take it less frequently and reduce the intake of potassium in the diet). (2) warm moxibustion “spleen” and “kidney” acupoints: acupoints is a person’s qi, blood and qi procession in and out of the transfer place, in the human body waist and back of the bladder meridian, is the health care point, warm moxibustion “spleen” and “kidney” acupoints. “Kidney acupoints” can play a tonic kidney spleen, warmth and dampness effect. For fear of heat, constipation, yellow tongue, hot and humid patients, can not moxibustion, in order to avoid the emergence of heat.