What are the main physiological functions of the kidneys?
A: The kidney is an important organ of the human urinary system, which skillfully controls the metabolism of the human body, thus maintaining the constancy of the internal environment and ensuring that life activities are carried out normally. The main physiological functions of the kidneys are the following five aspects.
(1) Maintaining the balance of water and fluid in the body;
(2) eliminating metabolites and harmful substances from the body.
(3) Maintaining acid-base balance;
(4) Maintaining a constant fluid composition;
(5) regulating the physiological functions of the human body.
How do you know that you or someone around you has kidney disease ?
A: Some patients with kidney disease have mild symptoms in the early stage, so they are often easy to ignore. Therefore, recognizing some clinical manifestations related to kidney disease can help to seek early medical attention and early treatment. The symptoms are as follows.
(1) Increased frequency of urination|, urinary urgency and pain in the urethra;
(2) Blood in urine, i.e. hematuria, is a common symptom of kidney disease;
(3) Increased foam in urine, which often indicates increased protein excretion in urine;
(4) Eye and face and lower limbs are also common symptoms of kidney disease;
(5) pain in the lower back and abdomen, if there is no history of trauma or muscle strain in the lower back, attention should be paid to the kidneys;
(6) Hypertension;
(7) Unexplained anemia;
(8) Loss of appetite or even nausea and vomiting with normal gastric function;
(9) increased nocturnal urination, especially in young people with an increased number of nocturnal urination.
How to properly retain urine specimens?
A: It is very important to properly retain urine specimens, and the following 4 points should be noted for the retention of urine specimens.
(1) The first urine in the early morning is the most ideal specimen for routine testing. Because the morning urine is more concentrated and more acidic, the urine has more formed components than the daytime urine, can more fully reflect the kidney lesions, but also to avoid dietary interference, to ensure the accuracy of chemical composition determination.
(2) Retained urine specimens should be tested within one hour to avoid the effects of specific gravity and acidity to dissolve and destroy the cellular components crumpled and deformed.
(3) Female patients generally do not retain urine for examination during menstruation, so as not to mix with menstrual blood into and cause the illusion of hematuria.
(4) The container for collecting urine specimens must be clean, dry, marked with the patient’s name, female patients need to clean the vulva, male circumcision, the foreskin should be turned over and washed; all stay in the middle of the urine. In infants, urine is retained after the external genitalia are cleaned.
What is hematuria? Do normal people have red blood cells in their urine?
A: Hematuria is formed when blood is mixed into the urine through the damaged glomerulus, tubules or urinary tract. Due to the different amount of bleeding, it is divided into microscopic hematuria and naked eye hematuria. It is generally considered that when fresh urine of adults is centrifuged and examined by sedimentation, more than three red blood cells per high-powered field of view in the microscope is considered “microscopic hematuria”; in one liter of urine, the amount of hemorrhage exceeds one milliliter, which can be presented as sarcohematuria. In normal urine, there are no red blood cells or occasional traces of red blood cells. For routine urine examination, there should be less than 3 red blood cells per high-powered field of view, and for 12-hour urine red blood cell count, the number of red blood cells should be less than 500,000 or less than 8,000 red blood cells per milliliter of urine. After strenuous exercise, heavy physical labor or long standing, there may be a temporary mild increase in red blood cells in the urine, which can also be considered normal. However, if red blood cells appear frequently in the urine or the number of red blood cells per high-powered field of view on microscopic examination of the urine sediment is greater than 3, and the 12-hour urine red blood cell count is greater than 500,000, it is called hematuria, which is mostly abnormal and should be promptly referred to a doctor.
What are the kidney function tests?
A: It is important to determine the degree of kidney disease damage and the speed of development for the diagnosis, treatment plan and prognosis of kidney disease. The more commonly used methods of kidney function tests are as follows.
(1) Measurement of nitrogen metabolites in the blood: blood creatinine,, blood urea nitrogen and uric acid.
(2) Renal clearance: This refers to the ability of the kidneys to completely remove how many milliliters (or raw) of a substance contained in plasma per unit of time. Commonly used are: inulin clearance, endogenous creatinine clearance and ammoniacal uric acid clearance. Functional tests, including phenol red exclusion test, urine glucose, urine lysozyme and β2 microglobulin test. (2) Distal tubular function tests, including
(3) Renal tubular function tests: ①Proximal tubular including urine specific gravity, urine osmolality, urine concentration and dilution test and uric acid assay, etc.
Do elevated blood creatinine and urea nitrogen indicate renal function impairment?
A: Urea nitrogen and creatinine are the products of protein decomposition and metabolism in human body. When the kidney function is normal, the metabolized urea nitrogen and creatinine can be excreted out of the body, so that they can maintain a constant concentration in the blood. When the kidney function is severely damaged, the excretion will be affected and the urea nitrogen and creatinine in the blood will be increased for a long time. Therefore, creatinine and urea nitrogen in blood is one of the important methods to check kidney function.
The normal value of urea nitrogen is 1.7 – 8.3 mmol/L. If the urea nitrogen in blood is >14.2 mmol/L, it is called azotemia; if it is >21.4 mmol/L, it is called uremia. The normal value of blood creatinine is 44-97 umol/L. When creatinine and urea nitrogen are elevated in various chronic kidney diseases, the effective kidney function is often 60-70% impaired. Therefore, blood creatinine and urea nitrogen tests are not a sensitive indicator of kidney function. When normal values are measured, it does not exclude impaired kidney function. However, this test is important for the diagnosis and prognosis of uremia. The reason is that elevated blood creatinine and urea nitrogen are directly proportional to the severity of the disease.
So, does elevated blood urea nitrogen and creatinine necessarily mean that a patient is suffering from renal impairment? From our clinical experience, we are not sure. A comprehensive analysis must be made in conjunction with other clinical data, and a hasty diagnosis cannot be made on the basis of a single laboratory test.
How does glomerulonephritis occur?
A: Glomerulonephritis is an autoimmune reactive disease. Specifically, it can be caused by a variety of etiologies (including bacteria, viruses, parasites, drugs, etc.). After these pathogenic substances invade the body as antigens, the body’s defense mechanism produces substances that resist these pathogens, called antibodies. In the process of antibodies against antigens, two situations occur: one is that the pathogens that invade the body are defeated and the disease is cured; the other is that when antibodies fight against antigens, they also destroy their own tissues and cause disease, which is an abnormal immune response and is called autoimmune reactive disease. Glomerulonephritis occurs when kidney damage is caused through an immune response.
What is acute nephritis? What are the causes and clinical manifestations of each of them?
A: Acute nephritis is a group of common diseases. Its etiology consists of a variety of causes, with acute nephritis following streptococcal infection being the most common. Most cases belong to immune complex nephritis. It can have the following characteristics in clinical injury: (1) hematuria (2) proteinuria (3) edema (4) hypertension (5) oliguria and transient azotemia (6) some systemic manifestations, such as: fatigue, anorexia, nausea, vomiting, drowsiness, dizziness, headache, blurred vision and dull pain in the back, etc.
What is chronic nephritis? How is it classified?
A: Chronic nephritis is not a single disease, but a group of diseases with multiple etiologies and pathological types originating from the glomerulus. It has a long course and can be asymptomatic for a period of time with a slowly progressive course. Proteinuria, hematuria, edema, and hypertension can occur, as well as renal insufficiency, and the disease can last up to a year or even decades. Some patients eventually develop uremia. The clinical manifestations of patients with chronic nephritis are very diverse. To facilitate diagnosis and treatment, clinicians classify patients into the following four types according to their clinical manifestations: (1) General: moderate proteinuria and mild microscopic hematuria, mild to moderate edema, hypertension or with renal impairment. (2) Nephrotic type: clinical presentation with massive proteinuria (≥3.5g/d), hypoproteinemia (<30g/1) with or without edema, hyperlipidemia and hematuria. (3) Hypertension: In addition to the common type of manifestations, elevated blood pressure is more prominent and often accompanied by fundus changes of chronic nephritis. Fundus examination shows narrowing and thinning of retinal arteries, enhanced reflection, and arterial and venous cross-pressure phenomenon or flocculent exudate. (4) Acute exacerbation type: The disease is aggravated by infection, exertion or improper treatment during the course of the disease, when the patient develops a large amount of proteinuria, or even carnal hematuria, increased tubularity, marked edema and hypertension, and even a sharp deterioration of renal function.
What makes nephrotic syndrome?
A: Nephrotic syndrome is not an independent disease, various glomerular diseases (such as chronic nephritis, acute nephritis, acute nephritis and various secondary glomerular diseases) can appear the manifestation of nephrotic syndrome. Their common clinical features are the typical clinical manifestations of “three highs and one low”, i.e. (1) high proteinuria (urine protein >3.5g/24h), (2) high edema, (3) hyperlipidemia, and (4) hypoproteinemia (plasma albumin below 30g/L).
What is pyelonephritis?
A: Pyelonephritis is an infectious kidney disease caused by bacteria that inflame the mucous membrane of the renal pelvis, calyces and renal parenchyma. Based on clinical symptoms and history of onset, there are two types of pyelonephritis: acute and chronic.
In normal people, a small amount of bacteria is often present in the urethra and does not normally cause disease. If the body’s resistance decreases, the germs can take advantage of the situation and travel up the urethra to the bladder and then through the ureter into the kidney tissue to develop the disease. The following factors are also involved in the development of this disease, such as urinary tract obstruction, urinary tract device use, sexual intercourse, pregnancy, urinary tract malformation and urinary retention. Acute pyelonephritis mostly consists of more severe clinical manifestations such as sudden onset of fever, chills, nausea, vomiting, urinary urgency, urinary frequency, urinary pain, and lumbago. If it is not thoroughly treated at this time, it may turn into pyelonephritis. This disease accounts for the majority of women, with a female to male ratio of 10:1.
Chronic pyelonephritis has a history of acute pyelonephritis, some of which is chronic and recurrent, and some of which is asymptomatic until renal failure. The incidence of chronic pyelonephritis developing into chronic renal failure is 18.6-37.5%, accounting for 20% of all cases of chronic renal failure, so the disease should not be taken lightly.
What is polycystic kidney? How does it develop? What are the clinical manifestations?
A: Polycystic kidney refers to cystic occupying lesions in the kidney parenchyma, which is a hereditary disease. According to its genetic characteristics, it can be divided into two categories: infantile type and adult type. Adult polycystic kidney is the third cause of chronic renal failure accounting for 5-10% of hospitalized patients.
As the disease progresses, the cyst grows larger and larger, causing the normal kidney tissue to be crushed and destroyed. And a series of symptoms of renal insufficiency appear. The clinical manifestations are: (1) enlarged kidney, which can be 5-6 times larger than normal, and there can be obvious differences between the two sides; (2) local discomfort and hidden dull pain in the waist and abdomen; (3) microscopic or carnal hematuria, often episodic, mainly due to the rupture of the blood vessels of the cyst wall, when the back pain is often increased; (4) proteinuria and leukocyturia; (5) hypertension.
What is secondary nephropathy?
A: The so-called secondary kidney disease is due to the occurrence of other diseases in the body, which in turn affects the kidneys, causing damage to the kidneys and lesions. For example, hypertension, because it is not well controlled, resulting in kidney damage, becoming hypertensive nephropathy; another example is diabetes, because it is not well treated, long-term high blood sugar, so that the kidneys are damaged to become diabetic nephropathy; other lupus nephritis, allergic purpura nephritis. Pregnancy toxic nephropathy and so on, and many, many more. These types of nephropathy are secondary nephropathy, so that other diseases occur first and kidney damage comes later, other diseases are the cause and kidney lesions are the effect.
What is diabetic nephropathy? What is the cause of the disease? What are the clinical manifestations?
A: Diabetic nephropathy is a kidney damage disease secondary to diabetes. The pathological changes in the kidney are glomerulosclerosis with tubular hyaline vacuolar degeneration and sclerosis of the small arteries in the inlet and outlet of the kidney.
In addition to the original clinical manifestations of diabetes mellitus, the disease may present with edema, hypertension, dizziness and headache due to hypertension, increased foam in the urine due to large amounts of urine protein, and in severe cases, nausea, vomiting, anemia and hypocalcemia. This disease is a more common secondary kidney disease with a rapid progression and a poor prognosis. It is the first of the secondary kidney diseases in Western countries.
What is hypertensive nephropathy and what are the causes? What are the clinical manifestations?
A: Hypertensive disease as the cause, directly causing damage to the kidney, is called hypertensive nephropathy. Its pathogenesis is mainly due to long-term hypertension leading to arteriosclerosis, resulting in glomerular ischemia, tubular atrophy and interstitial fibrosis, which eventually impairs kidney function.
The clinical manifestations are in addition to the complications of other organs caused by hypertension. For example, cardiac complications: left ventricular hypertrophy, heart failure and coronary heart disease; cerebrovascular lesions: cerebral hemorrhage, cerebral infarction and retinal arteriosclerosis, etc. In addition, renal damage can appear abnormal urine volume, increased foam in urine due to increased urine protein, nausea, vomiting, anemia and edema.
What is allergic purpura nephritis? How does it develop? What are the clinical manifestations?
A: Allergic purpura nephritis is a kind of kidney damage secondary to allergic purpura. It is an immune complex disease in which the vast majority of intrarenal capillaries are involved in allergic purpura, but only 20-60% of glomeruli have symptoms of damage. This
6 is then called allergic purpura nephritis. It is common in children and adolescents.
The cause of the disease is unknown and may be related to the allergic state of the body itself. Allergens may be bacteria, drugs (e.g. tetracycline, quinidine, aspirin, etc.), foods containing foreign proteins, insect bites, toxins or prophylactic injections, but the vast majority have no obvious allergens.
Clinically, half of the patients have a history of upper respiratory tract infection 1-3 weeks prior to the onset of the disease. The climate presents with fever, purpura on the distal extensor surfaces of the limbs, buttocks and lower abdomen, mostly symmetrically distributed; there may be arthralgia, abdominal pain, nausea, blood in the stool and vomiting. Renal symptoms may include hematuria, proteinuria, edema, and hypertension.
What is lupus nephritis? How does it develop? What are the clinical manifestations?
A: Systemic lupus erythematosus is a systemic connective tissue disease with lesions involving multiple systems and organs. Lupus nephritis is the most common and serious visceral damage of SLE, which is secondary to nephritis. According to pathological examination, renal involvement accounts for about 90% of cases, and almost all SLE patients have varying degrees of renal damage according to electron microscopy and inter-immunofluorescence examination. Lupus nephritis is an immune injury caused by the deposition of immune complexes in the glomeruli. The main damage is in the glomeruli, and tubular and interstitial renal involvement is also present.
The clinical manifestations of the disease are diverse and can be of the mild kidney damage type, the nephrotic type, or the clinical manifestations of the acute form of nephritis.
What is hyperuric acid kidney damage? How does it develop? What are the clinical manifestations?
A: A lesion caused by high uric acid in the blood from various causes, which triggers kidney damage, is called hyperuric acid kidney damage, also called gouty nephropathy.
It is due to the deposition of crystals of uric acid salt, which is surrounded by inflammatory cells infiltration, resulting in glomerular base membrane thickening, glomerular fibrosis, tubular atrophy and deformation, and interstitial vascular hypertrophy. Pathologically, it belongs to chronic interstitial nephritis, which can also form kidney stones and cause intra- or extra-renal line obstruction.
In addition to the original gout manifestations, such as the formation of gout stones, joint and soft tissue damage and restricted joint movement, the kidney manifestations are mostly colic, hematuria, proteinuria and hypertension, edema and other manifestations of renal insufficiency caused by stone obstruction of the kidney and urinary tract.
Why does blood pressure rise when you have kidney disease?
A: Hypertension is one of the main clinical manifestations of kidney disease, and this type of hypertension is called nephrogenic hypertension. It accounts for more than 10% of all causes of hypertensive diseases. It is a secondary hypertension and is the first of all secondary hypertensive disorders.
The mechanism of renal hypertension is more complex, but there are two main causes.
1, increased blood volume: due to reduced glomerular filtration rate, resulting in water and sodium retention in the body, expansion of plasma and extracellular fluid volume, increased circulating blood volume, increased cardiac output, followed by increased peripheral resistance.
2, excessive renin secretion: due to renal lesions, renal tissue ischemia, stimulating the glomerular entry artery of the parabolic cells secretion of renin increased, renin activity increased. The action of renin on the peripheral blood vessels leads to their contraction and enhanced peripheral resistance, resulting in an increase in blood pressure.
In addition to the above two factors, there are also intrarenal antihypertensive substances and a variety of vasoactive factors, sodium pump inhibitors, etc. all play a role in the mechanism of hypertension.
Which commonly used drugs are damaging to the kidney?
A: (1) Antibiotics: dicloxacillin B, vanguardycin I, II, neomycin, kanamycin, gentamicin, polymyxin, vancomycin, neopenicillins, ampicillin, methicillin, benzoylpenicillin, tetracyclines, sulfonamides, rifampicin, etc. (2) Non-steroidal anti-inflammatory analgesics: anti-inflammatory painkillers, pautazone, ibuprofen, inflammatory painkillers, finasteride, paracetamol, antipyrine, aspirin, compound aspirin, etc. (3) Narcotics: ether, methoxyflurane, etc. (4) Anti-epileptic drugs: trimethoprim, phenytoin sodium, etc. (5) Tumor chemotherapy drugs: cisplatin, amethopterin, methylene urine, mitomycin, mitomycin C, 5-fluorouracil, etc. (6) Metals and complexing agents: etanercept, penicillamine, etc. (7) Various types of angiographic agents (8) Others: cyclosporine A, metacycline, allopurinol, mercurial, etc.
What are the side effects of hormone therapy for kidney disease?
A: Serious side effects may occur in the process of acute treatment of kidney disease. The common side effects are as follows: (1) infection; (2) potassium retention; (3) acute hyperalgesia; (4) bleeding and gastric perforation; (5) hypercoagulable state and embolism; (6) hyperalgesia and increased blood pressure. Due to the serious side effects of hormone therapy, combined with our experience in clinical practice, patients are advised to If hormone therapy is applied at the early stage of the occurrence of kidney disease, Chinese herbal medicine therapy must be intervened as soon as possible until it eventually replaces hormone therapy in order to reduce or avoid its side effects.
What complications are likely to occur in chronic renal failure?
A: Kidney failure, the impact on the human body is multifaceted, and a variety of complications ensues. The main ones are: hypertension, uremic heart disease, heart failure, uremic pneumonia, pleurisy, anemia, digestive system lesions, neurological lesions, mental disorders, and growth retardation in pediatric patients.
What are the clinical stages of renal insufficiency? How to stage?
A: The development process of chronic renal insufficiency can be divided into the following four stages: ① renal storage capacity decline – GFR (glomerular filtration rate) reduced to about 50%-80% of normal, the blood creatinine is normal, the patient is asymptomatic; ② azotemia stage – is the early stage of renal failure. GFR decreases to 25%-50% of normal, azotemia, blood creatinine is higher than normal, but <450mmol/L, usually no obvious symptoms, may have mild anemia, polyuria and nocturia; (3) renal failure stage - GFR decreases to about 10%-25% of normal, blood creatinine is significantly elevated (about 450-707umol/L). 707umol/L), anemia is more obvious, nocturia and water-electrolyte imbalance, and there may be mild gastrointestinal, cardiovascular and central nervous system symptoms; ④ Uremia stage - is the advanced stage of renal failure, GFR is reduced to less than 10% of normal, blood creatinine >707 umol/L, the clinical manifestations of renal failure and blood biochemical The clinical manifestations of renal failure and blood biochemistry abnormalities are already very significant.
What is uremia?
A: Uremia, not an independent disease name, is a syndrome of various kidney diseases to the end stage of development, the kidney function is extremely reduced, a large accumulation of metabolites (harmful substances) in the body, the body systems are severely damaged, the clinical performance of a series of symptoms and signs. At this time, the glomerular filtration rate (GFR) is less than 10ml/min, and the blood creatinine (Cr) is more than 707umol/L.
How does TCM recognize uremia?
A: Chinese medicine believes that uremia is the late manifestation of many kinds of kidney diseases, clinical symptoms include: fatigue, weakness, lumbar and knee weakness, edema, anemia, itchy skin, nausea, vomiting, elevated blood creatinine, urea nitrogen, later involving the five organs and six internal organs, and even pericardial effusion, pleural effusion leading to heart, lung and kidney failure.
During uremia, the key to the disease is the blockage of the kidney loop, the deficiency of both spleen and kidney, and the retention of turbid dampness and water toxicity. This can lead to various critical symptoms.
What is hemodialysis?
A: Hemodialysis uses the principle of semi-permeable membrane to introduce the patient’s blood and dialysis fluid into the dialyzer (artificial kidney) at the same time. With the help of solute gradient, osmotic gradient and water pressure gradient on both sides of the dialysis membrane, toxins are removed by diffusion and convection adsorption; excess water retained in the body is removed by ultrafiltration and osmosis; at the same time, needed substances can be replenished and electrolyte and acid-base balance disorders can be corrected. Hemodialysis therapy replaces part of the excretory function of the normal kidney (but not the endocrine and metabolic functions of the normal kidney). It prolongs the life of patients and is one of the effective measures to rescue acute and chronic renal failure.
What is peritoneal dialysis?
A: The peritoneum has the properties of a natural semi-permeable membrane with an area approximately equivalent to the surface area of human skin, which is larger than the total area of glomerular capillary filtration. The principle of peritoneal dialysis, like hemodialysis, is to use the diffusion, osmosis and ultrafiltration produced by the difference in solute concentration and osmotic pressure between the two sides of the semipermeable membrane to remove metabolic toxins from the body and regulate physiological functions for therapeutic purposes. There is no absolute contraindication to peritoneal dialysis, but infections and tumor-induced extensive peritonitis, peritoneal adhesions, and extensive burns on the abdominal wall are not suitable for peritoneal dialysis.
What should patients with kidney disease pay attention to in their life?
A: Kidney disease is a chronic disease, so attention in life is also long-term or even lifelong. 1. eat a low sodium, low potassium, low protein diet. 2. add or remove clothes according to the climate change, to prevent from getting cold. The patient’s resistance to the disease is low and will be further reduced by the cold. 3. If infection occurs in any part of the body, take timely and effective anti-infection treatment. 4. avoid overwork and stress. 5. avoid going to crowded public places to avoid infection. 6. avoid using drugs harmful to the kidneys. 7. male patients should pay attention to sexual life and female patients should be cautious about fertility. 8. 8, face life frankly, optimistic about life.
What are the advantages of Chinese medicine in treating kidney disease?
A: Chinese medicine treatment of kidney disease has very answer advantages: one, emphasizing a holistic view. Chinese medicine believes that although the lesion site in the kidney, but with the other five organs and six dysfunction is closely related, but also with the year dry season and climate change. Therefore, in the treatment of medicine both to the internal organs of the body yin and yang table heat and cold deficiency changes in the case, but also to take into account the year dry season and the influence of the climate and the selection of prescriptions and drugs. It is completely different from the mechanical and isolated way of understanding and treating diseases in Western medicine. Secondly, it emphasizes dynamic observation and evidence-based treatment. Chinese medicine recognizes that the same disease has different pathological and pathological characteristics at different stages of the disease, and the treatment method and medicine are also different, so the prescription and medicine are always consistent with the disease. Third, the drugs used are purely natural and green, with very few of the toxic side effects of Western medicine.
Why should the treatment of kidney disease pay attention to consolidation and persistence?
A: Kidney disease has two characteristics: one is the long course of the disease. The course of acute nephritis can be as long as 1 year, not to mention chronic nephritis? Secondly, it is easy to repeat. The actual fact is that you can find a lot of people who have been in a position to get a good deal of time and money. In view of the above factors, so the treatment of kidney disease should pay attention to consolidation and persistence, and in some cases, even a year or more of treatment. This is because the treatment, prescriptions and methods of taking medication are different in the active and stable stages. If paralysis, the condition is slightly stable to stop treatment without attention to consolidation and conditioning is very easy to repeat; if because of the need for longer treatment and heavy burden of thought, or impatient, or pessimistic and disappointed, is also not conducive to physical recovery.
Why should chronic kidney disease patients be followed up for a long time?
A: Chronic kidney disease can be affected by a variety of factors. Such as: various infections, external wind and cold, fatigue, improper diet or other tissue and organ diseases, etc. Sometimes these factors are difficult to prevent, thus resulting in a long and recurrent course of chronic kidney disease. Therefore, when patients are hospitalized and improve or clinically cured, they usually need regular or irregular follow-up examinations. As a doctor is responsible for your disease, we should follow up regularly or irregularly according to your condition. Through follow-up visits can understand the changes or development of the patient’s condition, so that timely and targeted prevention and treatment guidance, so that patients can better consolidate the effectiveness of treatment, stabilize the condition and prevent the recurrence of chronic kidney disease, this work has an important role in the recovery of patients, I hope that patients and their families can understand and support and cooperate with this work.
Why do patients with kidney disease need to limit sodium in food?
A: Na+ is the main cation in the extracellular fluid and is the main component in maintaining the body’s water and electrolyte balance, osmotic pressure and muscle excitability. Once the regulatory mechanism of water and sodium balance in the body is disrupted, excessive water and sodium retention or loss can occur.
The kidney is the main organ that regulates sodium balance. In healthy people, the kidneys regulate sodium by “eating more and excreting more, eating less and not excreting less”. The kidney maintains a dynamic balance of sodium levels by maintaining the stability of sodium in the body through the filtration and reabsorption of sodium, which is an important mechanism for maintaining body fluid levels.
Patients with kidney disease are prone to disorders of sodium balance. For example, patients with acute renal failure can develop dilutional hyponatremia due to oliguric edema, which further causes intracellular edema and manifests as symptoms of malignant cerebral edema. Clinical weakness, drowsiness, nausea, vomiting, and even confusion and hypotonic coma may occur. In contrast, patients with interstitial renal damage and damaged collecting ducts may have massive renal sodium loss. More often than not, of course, with impaired renal function, the ability of the kidneys to excrete sodium is reduced, resulting in sodium retention in the body, which can often cause hypertension, edema and congestive heart failure.
For normal people, dietary sodium chloride intake has little effect on blood pressure. Patients with renal failure, especially those with primary glomerular disease, often have hypertension. As the glomerular filtration rate decreases, the sensitivity of blood pressure to sodium chloride (the main component of salt) increases, and in addition, excessive sodium intake can exacerbate the deterioration of renal function through non-blood pressure-dependent mechanisms.
Restricting sodium in the diet does not mean simply reducing sodium intake, but rather limiting it to appropriate levels depending on the condition.
What are the criter