Have you ever paid attention to your kidneys? On November 19, Chai Limin, deputy chief physician of the Department of Internal Medicine of Beijing Dongzhimen Hospital, shared a case on his social media account:
While visiting the outpatient clinic I met a 32-year-old patient who started to feel tired almost a year ago and woke up more times at night. He thought it was because he was tired from work and didn’t pay attention. He didn’t expect to be diagnosed with stage 4 chronic kidney disease. He said to me, “Doctor, please help me, my daughter is still young, I want to spend more time with her.” ①
The kidney is an unknown It is rare to feel pain, discomfort, etc. in the organs of the body. But in fact, from no symptoms to uremia, it gave you 5 chances.
From no symptoms to uremia,
From no symptoms to uremia,
The kidneys gave you 5 chances!
According to the degree of kidney damage, Chronic kidney disease can be divided into stages 1-5, and stage 5 is also called end-stage renal disease, which is also known as uremia.
According to the 2002 Kidney Disease Quality of Life Guidelines (K/DOQI), these 5 stages use serum creatinine to calculate glomerular filtration rate (GFR) formula. With the decline of glomerular filtration function, the symptoms are more and more obvious. ②
《Old Age Epidemiological Research Progress of Chronic Kidney Disease in the Population” Figure
The first chance: no obvious symptoms, normal renal function, but Abnormal urine. Blood or protein in the urine.
Second Chances: Mild Chronic Kidney Disease. There are no obvious symptoms yet, and there may be positive protein in urine, positive urine occult blood, or urine pH value greater than 8.
Third Chance: Moderate Chronic Kidney Disease. Some people began to experience fatigue, swelling, waist discomfort, foamy urine, hematuria, anemia, etc.
Fourth Chance: Severe Chronic Kidney Disease. Severe renal insufficiency, swollen hands and feet, less urine output, fatigue, poor appetite, abnormal electrolytes such as calcium, phosphorus and potassium, high blood pressure, anemia, etc.
Fifth Chance: Uremia (End Stage Renal Disease). Life-threatening complications such as metabolic acidosis, hyperkalemia, and cardiac insufficiency may occur.
Qin Yan, deputy director of Nephrology Department, Peking Union Medical College Hospital, in 2019 In an interview with the Health Times, one of the characteristics of chronic kidney disease is its insidious onset. The early clinical symptoms are not obvious and lack of characteristics. You still don’t feel uncomfortable even in the symptomatic stage, so kidney disease is sometimes called the “silent killer”, which is related to the structure of the kidney itself and its powerful compensatory function. ③
The human body has two kidneys, and each kidney is composed of 1 million nephrons. Under normal circumstances, the two kidneys “do half the work” to meet the metabolic needs of the organs of the whole body, but when encountering strenuous exercise, pregnancy, surgery and disease, the kidneys show more “responsibility”. Therefore, in the initial stage of renal function decline, there is often no obvious discomfort. ③
“Advances in Epidemiological Research on Chronic Kidney Disease in the Elderly Population” pointed out that if the stage 1-2 kidney disease can be treated by changing diet The progression of kidney disease can be slowed, stopped, or even reversed, along with lifestyle changes and treatment of the disease. ②
Attention! Kidney damage will have these signs
China Professor Hou Fanfan, academician of the Academy of Sciences and director of Nephrology Department of Nanfang Hospital of Southern Medical University, published an article in Health Times in 2021. The function of the kidneys is very powerful. The main function is to filter the excess “garbage” in the blood and then excrete it in the form of urine. Therefore, when the kidney function declines, the excess water and waste in the body cannot be discharged, which will cause problems such as oliguria, edema, and increased creatinine. ④
Tang Wen, Chief Physician of Nephrology Department of Peking University Third Hospital, published an article on the hospital’s official account in August 2022, stating that when the kidneys are damaged , there will be abnormalities in some indicators. ⑤
1. Abnormal urine components, such as increased trace albumin in urine, proteinuria or hematuria in urine, etc.
2. Imaging examinations will also find abnormalities, For example, B-ultrasound examination found abnormalities.
3. Histological examination of the kidney, observed through a microscope If pathological abnormalities are found in the kidney tissue, these all suggest that the kidney has been damaged.
It is worth noting that early kidney disease may not have any Performance, can be painless, not itchy. If the following symptoms appear, you need to seek medical treatment in time:
1. Swelling
For example, edema, including leg edema and facial edema.
2. Urine discoloration
Urine color changes, especially dark brown and red urine; dysuria, frequent urination, etc.
3. Powerless< /strong>
Severe kidney disease will cause weakness, fatigue, nausea, vomiting, not wanting to eat, etc. If the heart is affected, it will also cause breathing difficulties.
Early detection of kidney disease,
One indicator is key
Since kidney disease may not manifest in the early stage, how can it be early What about kidney disease? Dr. Tang Wen said that regular physical examination is very important, and regular physical examination is an important means of discovering kidney disease.
1. Urine routine:First of all, you need to pay attention to the results of the urine test, that is, the results of the urine routine test. If the results of the urine routine test are abnormal, you must seek medical treatment in time.
2. Blood routine:Secondly, one indicator is very important—serum creatinine, if there is an abnormal increase, you need to seek medical treatment in time, even if it is within the normal range, if there is a dynamic and continuous increase, you also need to pay attention.
3. Kidney B-ultrasound:Also pay attention to the results of renal B-ultrasound.
It should be noted that if the results are abnormal , To seek medical treatment in time, the doctor judges the condition and formulates a treatment plan. ⑤
These 10 types of people need to Check kidney function
Silent because of kidney disease , When the symptoms appear, often the renal function has been damaged. Therefore, the attending physician of the Nephrology Department of the First Affiliated Hospital of the Naval Military Medical University (Changhai Hospital) published an article in the People’s Daily Health Issue in September 2022 to remind, especially for the following 10 high-risk groups of chronic kidney disease, that it is very important to have a kidney examination every year.
1. Persistent proteinuria
2. Diabetes
3, high blood pressure
4, 60
5. Family history of kidney disease
6. People with gout
7. Kidney stones
8. Obese people
9. People who take medicine indiscriminately for a long time
10. People who smoke and drink heavily⑥
This article is synthesized from: ① 2022-11-19 Baijiahao “Chinese Medicine Internal Medicine Chai Limin “”A patient with advanced renal disease calls for help, but his reasons keep me silent” ② Liu Xiaoyan, Mei Feng. Epidemiological research progress of chronic kidney disease in the elderly population [J]. World Latest Medical Information Abstracts, 2019(61): 3 .③ 2019-04-02 Health Times “Why is Kidney Disease a Silent Killer?” “④ 2021-03-12 Health Times “Not all kidney diseases will be “swollen”” ⑤ 2022-08-25 Peking University Third Hospital “Early kidney disease is neither painful nor itchy, this index abnormality in physical examination should be paid attention to! “⑥ 2022-09-25 People’s Daily Health Account “Dr. Chen Zhou” “These 10 types of people, kidney disease loves to come to the door most! “
Source: Health Times