Patient: I am a male, 42 years old, who had nephritis 20 years ago. 124 creatinine in November 2008; 115 creatinine in April 2009; 120 creatinine in February 26, 2010; 110 creatinine in March 17, 2010 (standard upper line value of 97). The last physical examination was for one + sign. In addition, I have been suffering from hypertension since 1999, and I take 2 tablets of Enaline (5mg) once a day to keep my blood pressure stable. What should I do now? I would like to see your hospital, can I make an appointment? I am currently taking Ennalin (5MG) twice a day, 2 tablets each time, Bailing capsules three times a day, 8 capsules each time, and Radix Polygonatum multi-glucoside tablets three times a day, 2 tablets each time. I would like to make an appointment to see the doctor and hope to provide a suitable time Laboratory and examination results: Last seen at: Huanghe Hospital, Sanmenxia City, Henan Province
smxxyh2002:Hello! Sun Jifeng, Department of Nephrology, Tangdu Hospital, Fourth Military Medical University
Thank you for your trust and consultation!
From the medical history and examination you described, it can be diagnosed as chronic nephritis, chronic renal insufficiency compensatory stage
According to the diagnostic criteria of chronic nephritis: 1. long history (20 years); 2. continuous or intermittent urinary abnormalities (proteinuria or hematuria); 3. varying degrees of renal impairment (referring to high blood creatinine); 4. often accompanied by hypertension (is taking antihypertensive drugs); 5. often accompanied by small arteriosclerosis (you have not yet checked the fundus, it is estimated that there is small arteriosclerosis, because if nephritis is accompanied by hypertension, it can exacerbate small arteriosclerosis)
You can look at the 5 criteria yourself probably one is not less.
For your current treatment, due to time constraints and my typing speed is too slow, I can only talk about the principles, please forgive me!
The purpose is: to protect the surviving kidney units and slow down the deterioration of renal insufficiency
1. control blood pressure well 130-125/80-75, preferably below 125/75
2. reduce proteinuria
3. If blood lipids are high, lower blood lipids
4. Anticoagulation and thrombolysis
5. Vascular expansion to improve microcirculation
6. Antioxidant
7. Chinese herbal medicine
8. Avoid several taboos in life (cold, diarrhea, major trauma, surgery, bleeding, nephrotoxic drugs including herbal medicines, heavy sweating – sauna, overwork, high-intensity physical exercise and other sweaty items), these will accelerate the deterioration of kidney function, we are called “slow plus urgent” in medicine (that is, the original kidney function is not good) But still stable, if encounter the above-mentioned triggering factors, kidney function may occur as acute renal failure as the deterioration)
Finally, I am a specialist clinic every Monday, Tel: 02984777424
Yours sincerely
Salutations