It is very difficult for patients with chronic kidney disease to have this disease and be under a lot of pressure. We have been talking about how patients with chronic kidney disease can go about good self-management, and there are several aspects of this.
1, the patient needs to manage their disease. We need to manage it, we need to use the right drugs, we need the right diet and exercise, and we need to go to the hospital often to get some guidance from the health care professionals to manage the disease. Chronic kidney disease is a lifelong disease and the goal of treatment is not cure but recovery. So our patients have to take the responsibility as a husband at home, and as parents have to take the responsibility as parents, so they have to manage their daily life and manage their role in this society and family, which is not easy for patients. 2, the patient has a variety of symptoms, some are not necessarily the disease physiologically caused by the disease, but the disease brings psychological pressure, the patient feels particularly fatigued, to manage these symptoms, manage these mental stress. Patients with chronic kidney disease in China are not fully reimbursed by the state, we have to spend a lot of money every month to treat this disease, the economic burden is a big piece of chronic kidney disease patients, they also have to bear the economic burden, so they have to manage themselves. Self-management of chronic kidney disease is really not easy. 3, as for how to manage the diet? In fact, this piece has always been confusing for us, both from the point of view of health care professionals and from the point of view of patients. We are clear in theory, chronic kidney disease patients how to rational diet, but these rational diet often medical staff although theoretically know, but tell the patients we patients actually poor operability, for example, we clinically encounter poor kidney function, to control the diet, how much protein intake per kilogram of body weight per day, which is equivalent to a few eggs a few pieces of meat our doctors and patients do not This is why clinically told the patient low protein diet, either the patient does not eat protein malnutrition, or else the patient does not know how much protein is, the clinical operability is relatively poor. China’s hospital nutrition in this area of kidney disease nutrition has long been neglected, and now should make up for it. We found that the progression of kidney disease is significantly slower, and we are about half the rate of control of hypertension compared to the West, and the rate of control of diabetic patients in our diabetic nephropathy is also much better than in the West. The fundamental reason for this is that our patients really participate in the treatment of this disease, to control its lifestyle, once the control you will find that the disease is relatively easy to control. Let’s say that we now have nearly 200 million hypertensive patients in China, our hypertension control rate of about 6%, hypertension with a lot of good antihypertensive drugs, often three or four antihypertensive drugs in combination, but the blood pressure did not come down, why? These patients often eat in restaurants, eat a lot of salt, life is not controlled, salt is not well controlled, blood pressure is difficult to come down. Blood sugar is also the same, if you use insulin with very good hypoglycemic drugs, but end up eating a lot of carbohydrates, it is impossible to control blood sugar. Traditional medicine always emphasizes the use of drugs to control these diseases is not a simple disease can be controlled by drugs, chronic kidney disease is exactly the same reason. Let the patient grasp the appropriate knowledge, how this disease is how to develop how to control it, these knowledge should be taught to the patient, our health care workers are no longer like the previous simple patient to give him a prescription, our own positioning, we are the patient’s professional above the tutor, the patient has a problem to find us, more often than not, they are managing themselves, we teach him knowledge. Teach him knowledge is not enough, why we say to the patient to send some books to send some information, to the patient to do some lectures is far from enough, and finally no effect. It is very important to know what skills the patient should have to fight against the disease in its development. In the past, we talked about diet and salt control. Patients said that I have to control salt and I have a bad appetite, but how can we have the skills to control salt and make the food taste good so that patients can stick to it? We spend a lot of effort on the skills of coping with the disease, such skills include some general knowledge of life, and how to have a good mentality, in the skills of patient training. In addition, we use different methods to encourage patients to adopt a good lifestyle, because it is not easy to change the lifestyle, and the patient may not be able to change again in a few days, so it is necessary to use some continuous knowledge. In our team, the management of our patients is a lifelong follow-up, we are always with the patient. Kidney disease is divided into five stages, and the focus of our management method is different for each stage. But the core concept remains the same, it is always the patient’s self-management. No matter how far the patient’s disease progresses, we will never give up and never abandon. Even if the patient finally reaches the point of dialysis, many patients will have various comorbidities after dialysis, we will try to do prevention after dialysis, so that the patient can do a good job of self-management and prevent various comorbidities, so that the patient can have a good survival. Therefore, we never give up. Chronic kidney disease is very common and patients with chronic kidney disease are not alone, more importantly, the occurrence and development of chronic kidney disease can be prevented, and the core of prevention lies in the patient’s good self-management of the disease, and this self-management patients need knowledge and skills, and need to be motivated. Patients and health care professionals in the path of chronic kidney disease, the role of health care professionals is different from traditional diseases, the role of patients is different from the role of traditional diseases, patients should be more active in the disease process, disease control is more in their own hands. Our medical treatment has not solved all the problems, there are some kidney disease patients will progress, even if the progress, we still will not give up will not abandon, even if it goes to uremia, through dialysis and other methods can let patients live like normal people. Kidney disease is not terrible, it can be prevented, we need to take our health into our own hands.