Some people with kidney function still have stable kidney function and return to normal life, while others are on the road to kidney failure. Chronic kidney disease includes a variety of types of kidney disease. Different pathological types are in different stages, and the difficulty of treatment and the degree of recovery are also different. Nephropathy treatment emphasizes individualized treatment plans, but there are also commonalities in treatment.
No matter what type of kidney disease it is, these three indicators need to be well controlled, and none of them are indispensable. Kidney friends should check themselves to see if these indicators meet the requirements ?
Erbai: 24-hour urine protein quantification and plasma albumin
The development of proteinuria affects renal filtration function , thus affecting the final development of renal disease. Protein-lowering therapy is also a key step in delaying renal function. At present, the main treatment for reducing proteinuria levels is hormone therapy combined with immunosuppressive therapy, which is effective for 80% of patients with renal disease. However, some patients are too sensitive to hormones, and can also be taken in combination with other protein-lowering drugs, such as antihypertensive drugs sartan, prilin drugs (disabled for patients with renal insufficiency), statins lipid-lowering drugs, leflunomide anti-inflammatory drugs, etc. .
In order to strengthen the effect of hormones and other drugs, kidney friends should also cooperate with the management of diet and reduce infection.
There is another proteinuria indicator, which is not of high concern for quantitative proteinuria, but cannot be ignored—plasma albumin. Plasma albumin is one of the causes of renal edema, cardiopulmonary edema, and thrombosis, and it also affects the patient’s immunity. When reducing the level of proteinuria, don’t forget to manage this indicator. Quantitative proteinuria is generally maintained below 1g to help avoid uremia. Adult plasma albumin is normal between 35 and 50 g/L.
Two kidneys: glomerular filtration rate, kidney volume
We usually talk about various functions of the kidney, including Detoxification, filtration, adjustment of water, electrolytes, acid-base balance, etc., seem to be invisible and intangible, only by imagination. In fact, there is an indicator that can directly reflect the status of kidney function, that is, the glomerular filtration rate. This indicator mainly depends on the amount of plasma filtered by the glomeruli per unit time. Simply put, it means how much work the glomeruli can do in a certain period of time. If the filtering capacity is insufficient, it means that the glomerulus is damaged, and the entire There were also problems with kidney function. Generally, the glomerular filtration rate is greater than or equal to 60ml/min/1.73 m2, indicating that the renal function is still good. Once it is lower than 60ml/min/1.73 m2, it means that renal insufficiency occurs, and it is necessary to actively protect the kidney.
The kidney will shrink after fibrosis and sclerosis, and the size of the kidney will also become smaller. The size of both kidneys can be observed by renal B-ultrasound. In addition to proteinuria, these two indicators are also one of the indicators that should be paid special attention during the treatment process.
Three highs: hypertension, hyperlipidemia, and hyperuric acid
renal hypertension and hyperlipidemia are associated with renal After the function is damaged, it will lead to abnormal blood circulation, resulting in vascular diseases, and some kidney friends themselves have high blood pressure and high blood lipids, so attention should be paid to treatment.
Excessive blood pressure and blood lipids will continue to destroy kidney cells, glomeruli and other kidney tissues, which will then lead to structural lesions and aggravate the inflammatory response in the kidneys, thereby increasing the Toxin levels, accelerate kidney failure, creating a vicious cycle.
High uric acid is a manifestation of renal endotoxin levels. Generally, patients with renal insufficiency will have elevated serum creatinine and uric acid, mainly due to poor renal metabolism and detoxification capabilities. caused. However, at the same time, uric acid will crystallize and deposit on the kidneys, causing damage to the renal tubules, which will not only affect the reabsorption function of the kidneys, but may also cause kidney atrophy, causing more renal cells to lose their ability to work.
Therefore, in addition to the indicators of “two whites and two kidneys”, the treatment of “three highs” indicators cannot be ignored.