If we compare the kidney to a “boiler”, the “cinders” (metabolites) produced by the body after combustion must be eliminated through the boiler. Once there is a problem with the boiler and the waste is not discharged, not only will the “boiler” be damaged, but the whole system will also collapse. Western medicine believes that the kidney is an important organ of the human body. If the physiological dysfunction of the kidneys is not functioning properly in the body, a lot of problems will occur, and will affect the functioning of other organs, and even loss of life. Kidney is an excretory organ that ensures the balance of water and electrolytes in the body. All of us have heard of renal failure, also known as uremia, which is a disease caused by abnormal excretory function of kidney. Kidney also has a very important feature, it is an endocrine organ, secretes many hormones, these hormones can adjust the body’s blood pressure, but also can regulate the normal bone development. Therefore, the kidney has a very important position in the physiological functions of the human body. The kidney in the theory of Chinese medicine and the kidney in the theory of western medicine are not two identical concepts. Western medical theory of the kidney, is an anatomical organ of substance, is the organ that produces urine, is a human body sewage factory, wastewater treatment station, the human body in the process of metabolism produces a variety of metabolic products, mainly through the kidneys in the form of urine out of the body. About a quarter of the blood circulating in the body every day is filtered through the kidneys. In other words, every second, the heart pumps out a quarter of the blood volume to the kidneys to circulate, the kidneys will be left after the circulation of metabolic products, toxic substances excreted. The kidney in the theory of Chinese medicine sometimes refers to an organ, but more often it is a functional concept, equivalent to the generalization of the function of the urinary and reproductive systems in Western medicine, and is closely related to the whole life process of human birth, growth, strength, old age, and has been. These are two different sets of medical theories, two different sets of interpretation systems, and should not be confused. Therefore, today I will be from the Chinese and Western medicine two medical systems from different perspectives, the physiology of the kidney, pathology, prevention and health care and other aspects of a comprehensive introduction, I hope to be able to support the future of the kidney, kidney some guidance and help, so that we can take care of their own kidneys correctly, can live a longer, more quality of life. First, the morphology and structure of the kidneys Kidneys, commonly known as the waist of the people. Under normal circumstances, the human body has two kidneys, shaped like a large kidney bean. Adult kidneys are 9-12 cm long, 5-6 cm wide, 3-4 cm thick and weigh 120-150 grams. The shape, size and weight of the two kidneys are roughly similar, with the left kidney being slightly larger than the right kidney. The right kidney was thicker and shorter in appearance, while the left kidney was thinner and longer. The surface of the kidneys was smooth and could be divided into upper and lower ends, anterior and posterior surfaces, and medial and lateral margins. The front (lateral edge) is more convex, the back is more flat; the outer edge is curved, and the inner edge is concave in the middle to form the renal hilum, which is the gateway for the renal pelvis, renal arteries, renal veins, nerves, lymphatics, and ureters to enter and exit the kidneys. These structures, wrapped in connective tissue, are collectively known as the renal hilum, which is arranged with the renal vein in the front, the renal artery in the center, and the ureter in the back and bottom. The right renal hilum is shorter, making right-sided nephrectomy more difficult. From the renal hilum to the kidney, there is a large cavity called the renal sinus. The renal sinus is surrounded by renal parenchyma and contains renal arteries, renal veins, lymphatic vessels, renal calyces, renal calyces, renal pelvis, and adipose tissue. The kidneys are located on either side of the lumbar spine and behind the posterior peritoneum of the upper abdomen, immediately behind the posterior abdominal wall. It is backed by the very strong psoas major muscle and fronted by the abdominal organs, so it is relatively hidden compared to other organs, such as the liver and intestines. The kidneys are dark red colored substantial organs and are the main organs of excretion. Due to the space occupied by the liver, a substantial organ, on the right side, the right kidney is positioned 1 to 2 cm lower than the left kidney in most people. If we look at it with a microscope, we can see that each kidney is mainly composed of about 1 million renal units with the same structure and function and a small amount of connective tissue, with a large number of blood vessels and nerve fibers in between. The renal unit consists of two parts: the renal corpuscle and the renal tubule. The interior of the kidney can be divided into two parts: the renal parenchyma and the renal pelvis. In the longitudinal section of the kidney, it can be seen that the renal parenchyma is divided into two layers: the outer layer is the cortex and the inner layer is the medulla. The renal cortex is reddish brown when fresh. It is composed of glomeruli and convoluted tubules. The renal medulla is reddish when fresh and consists of 10-20 cones. Second, the physiology and pathology of the kidney The physiological functions of the normal kidney can be roughly summarized in the following aspects. (A) excretion of body metabolism end-products of human metabolism, will produce some metabolic wastes, such as urea, uric acid, creatinine, etc., the kidneys through the glomerular filtration and renal tubular secretion, the body metabolism end-products of the urinary excretion from the body, so as to maintain the normal physiological function. (B) to maintain the body water, electrolytes and acid-base balance blood flow through the glomerulus, the volume of large components such as red blood cells, white blood cells, etc. remain in the blood vessels to continue to circulate, the volume of small components such as water, sodium, sugar, etc. through the glomerular filtration flow into the tubules to form “primary urine”. Primary urine flows through the renal tubules, almost all of the nutrients and 99% of the water is reabsorbed by the renal tubules back into the body, the rest of the body’s metabolic wastes and very little water is the formation of urine through the ureter, the bladder and out of the body. Therefore, when there is too much or not enough water in the body, the kidneys are responsible for the regulation of urine output to maintain the water balance in the body. At the same time, the kidneys, through glomerular filtration, tubular reabsorption and secretion, not only excrete excess water in the body, but also regulate electrolyte and acid-base balance to maintain the stability of the internal environment. (iii) Regulating blood pressure The kidneys regulate blood pressure through the secretion of vasoactive substances such as renin, angiotensin and prostaglandins, so as to keep the blood pressure relatively stable. (iv) Promoting bone marrow hematopoiesis The kidneys promote bone marrow hematopoiesis and production of red blood cells by secreting erythropoietin. (v) Maintaining the normal structure and function of bones The kidneys also regulate calcium and phosphorus metabolism in the body in order to maintain the normal structure and function of bones and participate in the regulation of immune function. If renal function is impaired, the excretory and regulatory effects of the kidney will be reduced, thus causing a variety of diseases. Such as renal secretion of various active substances dysfunction, will cause elevated blood pressure, anemia, bone lesions; filtration and reabsorption dysfunction, will cause the body of water, electrolyte and acid-base balance disorders; renal function is seriously impaired, excretory dysfunction, urea, uric acid, creatinine and other metabolic end-waste can not be discharged from the body and retention in the body, uremia and endangered life will occur. Third, common kidney diseases and their hazards The latest epidemiological surveys show that chronic kidney disease has become one of the major threat to the public health of the world’s disease spectrum, and its prevalence is even higher than some common cancers. “About 6.5%-13.1% of the general population in developed countries suffer from different degrees of kidney diseases, of which the number of kidney diseases in the United States has exceeded 20 million, and hospitals admit and treat up to more than 1 million kidney patients every year.” Internationally renowned nephrologist and former president of the American Society of Nephrology, Prof. William Mitch, told Life Times that people who have kidney disease and do not go to the doctor are much more than the patients admitted to the hospital. (A) the reasons for the high incidence of kidney disease 1, poor lifestyle such as certain nutrients (carbohydrates, fat, salt, etc.) eating too much, too little physical activity, often stay up too late sleep deprivation and smoking, alcoholism and other factors, will kidney disease prompted by the occurrence. Or due to poor lifestyle caused by diabetes, hypertension, hyperlipidemia, high uric acid, obesity and other metabolic diseases, on the basis of which secondary kidney disease. 2, the cause of infection Some infections such as hepatitis, tuberculosis, AIDS, schistosomiasis, etc. can also cause kidney disease. 3.Misuse of drugs or irregular use of drugs, such as the application of nephrotoxic painkillers, aristolochic drugs. (ii) Common kidney diseases and their hazards Kidney diseases usually show a chronic process. Chronic kidney diseases include glomerulonephritis, tubulointerstitial diseases, renal vascular diseases, metabolic diseases, connective tissue diseases, infectious kidney damage, as well as congenital and hereditary renal diseases, tumors, stones and other renal diseases, and in China, primary glomerulonephritis and renal calculi are the most common diseases, followed by hypertensive arteriosclerosis, diabetic nephropathy, lupus nephritis, chronic pyelonephritis and polycystic kidney disease. Pyelonephritis and polycystic kidney. In order to facilitate clinical diagnosis and treatment, we can simply categorize renal diseases into two main groups, one is called nephrological diseases and the other is called nephrosurgical diseases. There are two major categories of renal medical diseases. The first type of medical disease is most commonly known as nephritis, which is also known as glomerulonephritis. The kidneys are full of tiny microstructures inside the kidneys, consisting of glomeruli, through which urine is formed by glomerular filtration. When these tiny ultramicrostructures have problems and the filtration function is impaired, it will lead to a series of very serious lesions. First of all, high blood pressure will appear, at the same time, because of the body’s large amount of protein loss, the body will appear edema, such as eyelids, lower limbs will appear swelling, which is a manifestation of nephritis and the danger of nephritis. There is another common nephrological disease called diabetic nephropathy. Diabetes mellitus is very common, long-term diabetes mellitus causes changes in blood vessels, nerves, leading to this kind of fine ultrastructural changes inside the glomeruli, it also leads to the occurrence of nephrology nephropathy. There are also two main categories of surgical renal disease. The very common one is kidney stones. Kidney stones fall into the ureter as a result of changes in body position, and when a 1cm stone falls into the ureter, the ureter undergoes violent spasms. If the ureter is blocked for a long time, it will cause hydronephrosis, and if it is not dealt with for a long time, the hydronephrosis will compress the kidney, and the whole function of the kidney will disappear. Another disease is the tumor of the kidney. Kidney tumors are divided into two types, benign and malignant, the benign ones are called benign tumors of the kidney, and the malignant ones are commonly known as kidney cancer. Tumor is benign and cancer is malignant. Early kidney cancer does not have any clinical symptoms. What are the manifestations of kidney tumor? Patients with advanced kidney tumor often have hematuria, pink urine, or tea color, such as not accompanied by infection, hematuria will not produce pain; secondly, sometimes patients, especially thin patients, touch the abdomen, often in the abdomen to touch the mass; thirdly, patients often feel lumbar pain, which is often seen in the late tumor. Therefore, don’t wait until the so-called “kidney cancer triad” occurs, then go to the hospital for consultation, then the effect will not be very good. Whether it is nephrological diseases or renal surgical diseases, if they are untreated or mistreated, they will cause renal failure, which is commonly known as uremia. (C) How to detect kidney disease at an early stage Chronic kidney disease can be completely asymptomatic or symptomatic at an early stage, which seldom causes us to pay enough attention to it without being detected at an early stage. To know whether your kidneys are healthy and how to detect kidney disease early? The way is very simple. First, go to the hospital for regular medical checkups, second, observe yourself carefully, and third, go to the hospital in time when you feel unwell. When you go to the hospital for physical examination, you must have kidney function test and urine routine examination, more so for those who suffer from high blood pressure and diabetes. Self-observation, mainly to pay attention to their own urine, blood pressure and other changes and the body eyelids or lower limbs with or without swelling and so on. Once you find abnormalities in urination and blood pressure, or swelling of the body, or pain in the lower back, you should consult a doctor promptly. For example, how to detect glomerulonephritis at an early stage? The method is very simple. When urinating, pay attention to whether there is foamy urine, or see whether there is swelling of the eyelids and lower limbs of the body, and whether the blood pressure is high. If these phenomena occur, you should go to the hospital to do a routine urine test to see if there is protein and red blood cells in the urine, if there are, you should consider that you have glomerulonephritis. Again, when the pain in the waist or painless hematuria occurs, you should go to the hospital in time to have a look, do an ultrasound and take a film. To see if there is any surgical disease inside the kidney, any stone in the kidney, any tumor in the kidney, so that the disease can be detected early and treated early. Kidney tumors can be detected by ultrasound as long as they are over 1cm. Stones can also be detected by ultrasound as long as they are over 0.5cm. People with diabetes, hypertension, cardiovascular diseases, people with metabolic diseases such as obesity, high blood fat, high uric acid, people with autoimmune diseases such as lupus erythematosus, people with long-term use of nephrotoxic drugs such as non-steroidal anti-inflammatory drugs, antimicrobials, people with family history of kidney disease, as well as people suffering from chronic urinary tract infections, urinary tract obstruction, hypercoagulable state and high-protein diets, smoking, excessive alcohol consumption, low out-of-normal Weight, age 65 years old and above people, often is the high risk of chronic kidney disease, more should be highly vigilant, be sure to regular or irregular on the renal function and urine routine examination. Kidney and kidney disease health care (a) Kidney health care for the general population (prevention before disease) People who do not have kidney disease should not think that kidney disease is far away from them, or think that they will not get kidney disease, thus neglecting the health care for the kidneys. Kidney is an important organ of human body with very important physiological functions, once the disease occurs, it will bring a lot of trouble to our life, survival and life. Therefore, the correct concept is to prevent the disease before it occurs, to prevent the disease before it occurs, from the following aspects of the maintenance of the kidneys, to prevent the occurrence of kidney disease. 1. Drinking water should not be too little If you drink too little water, the amount of urine excreted will be reduced accordingly, and some metabolic wastes and toxins will stay in the body. If you drink enough water, you can dilute the urine, expel toxins and maintain a fresh body. 2, the diet should not be too salty World Health Organization recommended salt “safety line” is 6 grams per day. If the human body’s daily intake of salt greatly exceeds this standard, will lead to an increase in the body’s sodium content, the formation of sodium and water retention, sodium balance imbalance will lead to kidney disease. For people with heavy tastes, they should eat more fruits and vegetables, and exercise appropriately. 3, should not overeat Modern people’s standard of living, dietary intake in excess, the intake of food will eventually produce waste – uric acid and urea nitrogen and so on. Most of these wastes are discharged through the kidneys, dietary excess will undoubtedly increase the burden on the kidneys. 4, should not hold urine Some people are busy at work and hold urine for a long time or have the urge to urinate also endure not urinate. If this is the case, the urine is retained in the bladder for too long, it is very easy to reproduce bacteria, and bacteria will be retrograde through the ureter to the kidney, resulting in urinary tract infections and pyelonephritis. 5, should not drink more carbonated beverages The pH of the human body is 7.2, carbonated beverages after drinking the body pH changed significantly. Kidneys are the main organ to regulate the pH level in the body, long-term excessive intake of carbonated beverages will aggravate the burden on the kidneys and increase the probability of kidney injury. 6, should not abuse analgesic drugs Long-term use or large doses of some anti-inflammatory analgesic drugs, such as painkillers, anti-inflammatory pain, paracetamol, aspirin, etc., easy to cause kidney damage. 7, should not abuse nephrotoxic herbs Nephrotoxic herbs are: Lei Gongteng, Guanmutong, Petunia, Cangdongzi, poppy husk, raw grass, make the gentleman, green woodruff, Guangpengzhi and so on. Among them, Lei Gongteng causes the most kidney damage; followed by Guanmutong, which injures the kidneys because it contains the nephrotoxic substance aristolochic acid. When these drugs are applied, attention must be paid to the indications and the dosage of the drug. (B) Kidney health care for high-risk groups (prevention and cure) As mentioned earlier, people suffering from diabetes mellitus, hypertension, cardiovascular disease, obesity, hyperlipidemia, high uric acid, lupus erythematosus, chronic urinary tract infections, urinary tract obstruction, hypercoagulable state and other diseases, long-term use of non-steroidal anti-inflammatory drugs, antimicrobials and other nephrotoxic drugs, a family history of renal disease, as well as a long-term high-protein diet, smoking, excessive alcohol consumption and low body weight out of normal. Those who have a family history of kidney disease, as well as those with long-term high protein diet, smoking, excessive alcohol consumption and low body weight out of the normal standard, and those who are over 65 years old, are often the high-risk group of chronic kidney disease, and they should pay attention to kidney health care from the following aspects in order to prevent and prevent the disease. 1, should actively control the risk factors (hypertension, diabetes mellitus, high uric acid, obesity, high blood fat, etc.), under the guidance of specialists adhere to drug therapy; 2, reasonable diet, adhere to the corresponding low salt, low sugar, low purine, low fat diet; 3, close observation of their own blood pressure, blood glucose, blood lipids, blood uric acid and other indicators, strictly controlled within the normal range; 4, at least every six months a test of routine urination, urine microalbumin and renal function. Microalbumin and kidney function, in order to find early kidney damage. (C) Health care for people with early-stage kidney disease (prevention of both diseases and changes) Once early-stage kidney disease is detected, we should pay great attention to kidney health care and prevention of both diseases and changes, that is to say, we should pay attention to kidney health care in the following aspects to slow down the process of kidney disease as much as possible and avoid aggravation of the condition or complication of other diseases. 1.Actively treat primary kidney disease and control proteinuria level. The more protein in urine, the more damage to kidney. Daily excretion of urinary protein should be maintained at less than 0.5g, or urinary protein/urinary creatinine <30mg/g.Cr. 2, low-protein diet: low-protein diet has the effect of protecting renal function, reducing proteinuria and so on. Usually 0.6-0.8g of protein per kilogram of body weight can be consumed daily. 3.Actively treat the complications caused by renal impairment, such as correcting renal anemia, correcting metabolic abnormalities such as water and electrolyte disorders (e.g., hyperkalemia, hyperphosphate, hypocalcemia) and acidosis. 4, try to avoid the use or less use of nephrotoxic drugs: if continue to use or overuse painkillers, anti-inflammatory pain, paracetamol, aspirin and other western drugs or nephrotoxic herbs, often aggravate the condition. 5, adhere to the treatment and follow-up: in the maintenance period of drug treatment should pay attention to observe the blood and urine indicators. In fact, the abnormality of human body feeling is months to years later than the change of urine and blood index. Therefore, every patient with kidney disease, no matter how the condition is, should have regular review and long-term follow-up.