CKD awareness rate is less than 20%, and 60% of CKD patients die from cardiovascular disease

Text/Yangcheng Evening News All Media Reporter Zhang Hua

Photo/Yangcheng Evening News Data Map

Chronic kidney disease is poorly controlled and eventually develops into uremia, requiring dialysis or a kidney transplant to replace kidney function. However, what is surprising is that 60% of the deaths in patients with renal failure are due to cardiovascular disease.

Recently, Professor Chen Wei, director of the Department of Nephrology of the First Affiliated Hospital of Sun Yat-sen University, pointed out in an interview with reporters that data show that at least one out of every three chronic kidney disease patients in my country suffers from cardiovascular disease 60% of the final cause of death in patients with renal failure is cardiovascular disease. Therefore, patients with chronic kidney disease should be reminded to control the risk factors of cardiovascular disease as soon as possible.

uremic patients requiring dialysis or kidney transplantation to replace kidney function

Chronic kidney disease patient died of cardiovascular disease without waiting for dialysis

Currently, there are 132 million chronic kidney disease patients in our country. Chen Wei said, “The nationwide epidemiological survey data shows that the prevalence of chronic kidney disease in my country is 10.8%. However, the public’s awareness rate of chronic kidney disease is very low. A few years ago, a team from Zhongshan First Hospital conducted a The results of an epidemiological survey in South China showed that the awareness rate of patients with chronic kidney disease was less than 20% in both urban and rural areas. That is to say, during the epidemiological survey, the diagnosis of chronic kidney disease was confirmed by urine test and renal function test. However, less than 20% of patients knew that they had chronic kidney disease before. The prevalence of chronic kidney disease is high, the awareness rate is low, and the medical cost of the disease is high. This chronic disease is very harmful. “< /p>

The danger is that the awareness rate is not high. If the patient cannot be identified early and given early intervention and treatment, the disease will continue to progress, and the renal function will progressively deteriorate, which will lead to end-stage renal disease. stage, requiring dialysis or a kidney transplant to replace kidney function.

Professor Chen Wei said that another fact that our doctors also regretted is that many patients with chronic kidney disease died of acute myocardial infarction, heart failure and other causes before they received dialysis. According to statistics, among the comorbidities of patients with chronic kidney disease, cardiovascular disease ranks first. Cardiovascular disease is the cause of death in 60% of patients with chronic kidney disease.

Annual urine test + kidney function

Early detection of kidney disease

Different from the incidence of chronic kidney disease in Europe and America, the proportion of chronic kidney disease in my country is higher in the early stage, so there is still a large “window period” for treatment. If early patients can be screened and actively intervened, then these patients can have a good survival period.

So, how can kidney disease be detected early?

Professor Li Guisen, member of the Standing Committee of the Nephrology Branch of the Chinese Medical Association and director of the Department of Nephrology of Sichuan Provincial People’s Hospital, pointed out that the early symptoms of chronic kidney disease are not obvious, and the diagnosis rate is very low. Only 1 in 8 patients Patients knew they had kidney disease. In the early stage of chronic kidney disease, only a small number of people will have symptoms such as edema, changes in urine output, gross hematuria, anemia, and elevated blood pressure. Therefore, it is recommended to routinely measure urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) at annual adult physical examination. Especially in high-risk groups of chronic kidney disease, in order to better prevent the occurrence of chronic kidney disease, UACR and eGFR should be tested at least once or twice a year.

It is worth noting that, in clinical practice, young people in their twenties are also encountered because of obvious chest tightness and shortness of breath after exertion or exercise, and their renal function is only found in the emergency room of the hospital. It’s time for uremia. This shows that these children have developed chronic kidney disease without knowing it and have been combined with cardiovascular disease. “This kind of situation is not uncommon now.” Professor Chen Wei said.

Chronic kidney disease patients need early cardiovascular attention

The initial diagnosis of chronic kidney disease, such as nephritis without complications and comorbidities, should be taken seriously when it is not associated with cardiovascular disease or diabetes, and it should be reported to a specialist as soon as possible. Standardized treatment; and if there are signs of cardiovascular disease in the process of diagnosis and treatment, it is even more necessary to coordinate multidisciplinary treatment and give effective intervention as soon as possible.

According to reports, more than one-third of chronic kidney disease patients currently have cardiovascular disease, and chronic kidney disease and diabetes are also inseparable. With the rapid improvement of social and economic level and changes in people’s lifestyles, the prevalence of adult diabetes in my country has increased significantly. Diabetes has also become one of the most important causes of chronic kidney disease in hospitalized patients in my country, and it should be highly concerned by the public.

Therefore, Prof. Wei Chen pointed out that in clinical practice, it is very common for the three major diseases of diabetes, cardiovascular disease and chronic kidney disease to coexist. Patients should be conscious and not only focus on one aspect; for medical workers, they will also pay special attention to the impact of chronic diseases on various important target organs in the whole body in the process of diagnosis and treatment. To treat sexual injury, aiming at the overall health outcomes of patients, we will carry out multi-disciplinary collaborations such as nephrology, cardiology, and endocrinology to jointly improve the outcome of diabetes, heart and kidney disease comorbidity, and develop individualized, whole-course management plans for patients. In short, the prevention and control of chronic diseases requires both doctors and patients to have a holistic view and awareness of comprehensive prevention and control.

Notes on daily life for patients with chronic kidney disease

1. The core of the dietary care program for patients with chronic kidney disease lies in “three highs and four lows”, namely high calorie, high protein, high calcium and low phosphorus, low salt, low potassium, and low fat. Eat more fresh vegetables and fruits, supplement the necessary vitamins and folic acid. Professor Li Guisen pointed out that patients with chronic kidney disease should eat a low-salt diet first, and control their salt intake within 5 grams per day. At present, the general population in my country generally consumes too much salt. We can measure salt intake through 24-hour urine tests. The second is a low-fat diet to reduce the risk of cardiovascular events; the third is to limit protein intake. The so-called high protein refers to high-quality protein, but the total amount of protein needs to be limited. Because when renal function declines, a large amount of protein intake will increase the burden on the kidneys and accelerate the deterioration of renal function. The specific protein intake needs to be comprehensively considered according to the patient’s renal function, serum albumin level, and the patient’s weight. The fourth is a low-potassium diet, eat less mango, coconut, bananas and other foods high in potassium. The specific nutritional management plan needs to be formulated by professional physicians according to the specific situation of each patient.

2. Drinking water scientifically and reasonably for chronic kidney disease, drinking a lot of water in a short period of time is also a burden on the kidneys, and it is also prone to water intoxication;