5 questions and 5 answers, nephrologists teach you the correct use of urine-lowering egg drugs to reduce the risk of renal failure

Whether the urinary protein can be maintained at a low level is related to the overall prognosis of renal disease. Therefore, in the early stage of chronic kidney disease, the control of urinary protein level is very important. The basic bottom line is 1g. If it continues to exceed 1g, the damage to the glomerulus is more obvious, and the progress of renal function will be significantly accelerated. The earlier it is controlled below 1g, it will help to delay the deterioration of renal function and reduce the risk of uremia.

Therefore, rational and standardized medication is very important in the process of reducing urinary protein, which directly affects the stability of the disease. In some patients, when the disease was mild in the early stage, the urinary protein was not well controlled, and the primary factor was that the drug management was not in place.

< span>There are several kinds of drugs to inhibit kidney inflammation and reduce urinary protein, but the most commonly used drugs are glucocorticoids and immune preparations. Today, I will help you solve and correct a series of questions or problems that occur when you usually take hormones and other protein-lowering drugs.

1. Do all kidney diseases require hormones to reduce protein?

Immune system dysregulation is the main cause of kidney disease. The severe immune inflammatory control response in the kidney is the main reason for the loss of urinary protein. The role of hormones and immunosuppressants is to fight inflammation, regulate the metabolism of their own hormones and immune conditions. For patients with immune abnormalities in the early and middle stages, the combination of hormones and immunosuppressants is very bright.

Nephropathy is constantly changing and developing. It is mainly divided into three stages. The early stage is the inflammatory response dominated by immune inflammation. The middle stage is the non-immune inflammation-dominated fibrosis stage, with further deterioration of renal function, decreased filtration rate, and decreased detoxification function, and finally to the scarring stage, with bilateral kidney atrophy, with no room for reversal, and high risk of complications.

Hormone is often suitable for patients who are still in the early stage of renal disease, without severe renal function, but with relatively high urinary protein Treatment of severe kidney disease. For example, iga nephropathy, minimal change disease, membranous nephropathy, membranous proliferative glomerulonephritis, etc., these types of nephropathy are often not serious in the early stage, and most of them are sensitive to hormones, and the effect of reducing protein is often better. If there is hormone resistance combined with immunosuppressive agents, the stability of urinary protein can generally be controlled.

Patients in the middle and late stages of renal disease, the immune factors recede, and the main reasons for accelerating renal failure are complications and self- In this case, you will generally not choose to continue using hormones at this time.

Therefore, hormones are not necessary for all kidney diseases, and must be considered in combination with pathology, conditions and the patient’s own factors.

< span>2. When is the best time to take hormones?

Our own hormone secretion time is regular, usually “morning peak and evening trough” “. The endocrine hormones in the body are disturbed after kidney damage. In order to adjust to the normal rhythm, the best time to take hormones is generally 7-8 am in the morning. If there are other special circumstances, the medication time needs to be adjusted individually.

According to the efficacy of the drug, some drugs can be taken before meals to avoid affecting the efficacy of the drug. There are also some drug side effects that can cause gastrointestinal discomfort such as nausea, etc., can be taken after meals to relieve gastrointestinal symptoms. However, it should be noted that no matter which time period you take it, the dosage should not be wrong.

3. Can the side effects caused by long-term use of hormones be recovered? Will there be sequelae?

Due to the abnormal metabolism of the patient’s own hormones, a certain absorption process is required after taking exogenous hormones , causing some side effects, such as hormone face, hirsutism, buffalo back, etc., after some patients get used to hormones, the side effects of accelerated absorption will not be obvious. However, there are also some patients with intolerance who have obvious side effects on the disease after taking it, but in fact it is not a big problem.Side effects usually subside after stopping the drug.

But it should be noted that some irreversible damage, such as infertility caused by the impact on the reproductive organs, femoral head necrosis, etc. In fact, these situations can be avoided, but the doctor needs to strictly control the dosage, and kidney friends need to follow the principles of medication accurately.

< span>4. Taking hormones for 1 year or even longer, what should I pay attention to?

Some patients’ urine protein is sensitive to hormones and needs to take hormones for long-term maintenance. 2 years, the long ones take years. In the process of taking hormones, the damage to the body is minimized and the effect is maximized.

Kidney friends need to pay attention to three points, one is to supplement calcium. Hormone drugs will affect the absorption of calcium in some patients, causing calcium loss and increasing the risk of osteoporosis. It is recommended to take calcium tablets appropriately after checking blood calcium, usually get more sunlight, and eat foods high in calcium, which can help prevent . After taking hormones, there will be changes in mood, more anxiety or even depression, whether the mood is good or bad, pay attention to self-regulation so as not to affect the treatment of the disease. The third is to strictly control the dosage. Although the doctor will have a doctor’s order, some patients will increase or decrease the dosage in private, which is not conducive to the control of urinary protein. If there is any problem during taking the medicine, it must be communicated with the doctor before proceeding, so as to avoid detours.

< span>5. Do hormones need to be taken for life?

The last question is also the most concerned by most kidney patients. We talked about the mechanism of action of hormones, side effects, and which conditions can be used. Obviously, the answer to this question is not necessary. Considering the safety issues of hormones, other safer protein-lowering drugs with fewer side effects are often replaced in the middle and late stages of the disease. Don’t worry too much about this.

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