Since the 21st century, chronic kidney disease (CKD) has become one of the public enemies of people’s health all over the world. The International Society of Nephrology (ISN) and the International Federation of Kidney Funds (IFKF) jointly proposed to designate the second Thursday of March as World Kidney Day. This year, March 13 is the third World Kidney Day, and the theme is “The Amazing Kidney”.
Case 1.
Li, a student of a famous university in Sichuan, was assigned to work in a well-known organization right after graduation. After graduation, Li was found to be anemic during a voluntary blood donation. Since people thought anemia was normal, it did not attract much attention. The unit leader just told him to go home and rest for two months. Li’s mother was the chief physician of a hospital, but did not know much about the disease. It was thought that Li might have a problem with the bone marrow, but several bone punctures were done without finding the cause. Later, Li developed nausea and vomiting, and again suspected that there was a problem with his stomach. However, after a stomach spasm examination, it was found that no cause of anemia could be found, except for some problems in the mucosa. Finally, a doctor in the hospital reminded that it might be a kidney problem. Once the urine was checked, it was found that Li had uremia. Due to the time delay, Li died soon after.
Expert: The clinical manifestations of kidney disease are diverse and may include generalized itching, anemia, lesions of bones and joints, etc. People should go to the hospital regularly for routine urine examination, which is a mirror of kidney disease and should be incorporated in general health checkups.
Case 2.
There was a nationally renowned medical doctor who got diabetes in his 30s, but, until his death in more than 60 years, his kidney function was intact without any complications due to his optimistic attitude towards life, good living habits and rigorous medical follow-up measures. This is a relatively rare occurrence in the international arena. Diabetic nephropathy, as the first cause of end-stage renal failure in the United States and currently the second or third in China, often takes only 10 to 30 years from onset to kidney damage if poorly controlled.
Experts: If the problem is detected early and controllable factors are controlled, together with the usual attention to dietary adjustments, the progression of kidney failure can be significantly slowed down.
What are the “miraculous functions” of the kidneys?
First of all, the kidney is the excretory organ of the body and has the function of detoxification. After entering the body, many things (such as nutrients) are first transformed and metabolized by the liver, and then secreted and excreted by the kidneys. Secondly, it is also involved in endocrine regulation. For example, it promotes the production of red blood cells, blood pressure regulation, etc. Thirdly, the kidney is inseparable from the systemic system. It is equivalent to a general valve, and when it becomes impaired, it will move the whole body.
What is the current status of the prevalence of kidney disease?
There is currently a talk in the academic nephrology community that kidney is a non-communicable epidemic. For chronic kidney disease, the data published in the United States in 2006, the prevalence of chronic kidney disease reached 11.3%, although the available information and data in China is incomplete, but the results of Beijing, Shanghai, Guangzhou, a sample of some areas show that patients with chronic kidney disease also reached more than 10% of the total population. China’s 1.3 billion people, it accounts for more than 100 million. Data from the National Kidney Disease Database in the United States for the past seven years show that 45-50% of patients entering the middle and late stages of renal failure are triggered by diabetes and about 27% are caused by hypertension. And the incidence of these two diseases is gradually increasing in China. Currently, there are more than 200 million people with hypertension and more than 30-50 million people with diabetes in China. Nowadays, many people are not aware of the possible kidney damage caused by diabetes and hypertension and the damage caused by kidney failure.
What are the “clues” to detect kidney disease early?
For ordinary people, the easiest way is to observe whether there is any change in color of urine, blistering, hematuria, etc. Increased nocturia is often an early sign of kidney damage; whether there is swelling of eyelids or lower limbs; whether there is back pain and other symptoms. Of course, it is best to go to the hospital regularly for routine urine examination. If there are some high-risk factors, such as high blood pressure, diabetes and some other diseases, it is more important to have regular urine examination.
Once detected, how to prevent it?
Early detection, early treatment, and must be seen by a specialist, do not blindly go to believe in advertising goods, many advertising goods are deceptive, some drugs may also have nephrotoxicity.
The kidney is one of the main organs damaged by high blood pressure, and at the same time is an important organ for regulating blood pressure. So how much blood pressure is appropriate to keep?
The academic consensus is that 1 gram of urine protein in urine is the cut-off, and the more the protein content, the more the damage. For urine protein content of 1 gram or more, blood pressure should be kept at 125/75 mmHg; for less than 1 gram, blood pressure should be below 130/80 mmHg. The higher the blood pressure, the more urine protein is leaked, and the more kidney damage is done.
What is the incidence of each age group?
There is a difference in the incidence of kidney disease depending on gender and disease type. It is found at all ages, with the youngest being over 1 year old. Most of the kidney diseases are not inherited, but there is a disorder of the immune system later in life. For example, adolescents suffer more from acute nephritis and microscopic lesion nephropathy; while in women of childbearing age, the prevalence of lupus erythematosus is higher, and the ratio of women to men is 10:1; middle-aged and elderly people suffer mostly from kidney disease caused by hypertension and diabetes.
Can obesity also cause kidney damage?
Yes! Obesity is also a risk factor for kidney damage, and this condition belongs to metabolic kidney disease. Because of hyperlipidemia in obese people, it can also cause kidney damage, called obesity-related nephropathy. This is something that many people can easily ignore.
What are the suggestions for people’s dietary treatment?
There is a difference for different types and stages of kidney disease. Patients with early kidney disease should pay attention to a lighter diet, don’t make up for large fish and meat, don’t eat spicy food, and salt is usually controlled below 3 grams per day; for patients with metabolic kidney disease such as high sugar, high fat and high uric acid, greasy things, seafood, animal offal and other purine containing should be eaten less; for patients with chronic kidney disease, life should be regular and more rest. Be sure to find a specialist for consultation.
What are the characteristics of Huaxi Hospital in the treatment of kidney disease?
In the treatment of kidney disease, West China Hospital is at the advanced level in China. The treatment for patients with renal insufficiency is mainly divided into three steps. Firstly, oral medication control; if not, they will be transferred to standardized dialysis treatment; if the patient is young, with good family conditions, and in case of donor kidney, kidney transplantation can be performed. However, even after kidney transplantation, it is necessary to fight immune rejection through drugs, and this process will be accompanied by a lifetime.