To avoid uremia in the future, patients with kidney disease have another chance (maybe the last chance)

Zhou Xun, Chief Physician of Nephrology

Patients with chronic nephritis, before the age of 30, the glomerular filtration rate has been reduced Drop below 50ml/min, avoid uremia before the age of 70-80, is there still a chance?

Patients with diabetic nephropathy are in stage 4 of diabetic nephropathy before the age of 40, and they are 70-80 years old Is there still a chance to avoid uremia before?

Patients with polycystic kidney disease are already in the stage of chronic renal insufficiency before the age of 50, 70-80 Is there still a chance to avoid uremia before the age of one?

Patients with various nephritis are already in stage 4 of chronic kidney disease before the age of 60, and 70- Is there still a chance to avoid uremia before the age of 80?

And so on, in the above situations, it is difficult for patients to say that there is still a chance to avoid uremia in the future, or there is basically no There is a chance, maybe even the last chance is gone. In other words, at “this time”, the patient must have missed many treatment opportunities before.

For various chronic kidney diseases Generally speaking, in order to avoid future uremia, the patient missed at least the following three opportunities.

1. In the “early stage” of real kidney disease, the best chance is basically Can prevent future uremia are in the early stages of chronic kidney disease. Kidney is the first to understand that many chronic kidney diseases are already in the middle stage when they are discovered, and even uremia in the late stage of chronic kidney disease is discovered as soon as they are discovered. In other words, once kidney disease is discovered, there is basically no chance or no chance to avoid uremia. That is to say, we must find ways to discover that we are suffering from the disease at the beginning of kidney disease. This is the real “early stage” of chronic kidney disease, also known as stage 1 or stage 2 of chronic kidney disease. Usually, kidney disease can be detected early through physical examination or related manifestations, and kidney disease can also be detected early because of other diseases. Symptoms related to kidney disease include increased urine foam, edema of the face and lower extremities, gross hematuria, high blood pressure, and skin petechiae, etc. Further examination may also reveal that you have early kidney disease. This is also the best opportunity. If you pay attention to it and treat it actively, you can basically avoid future uremia.

2. The “situation” just started to appear, good chance, most of them can avoid uremia in the future

At the beginning of kidney disease, generally speaking, most patients will not have “conditions”. Except for a very small number of patients with symptoms such as gross hematuria and edema, the condition of most other patients is often “unknown “, not to mention what “situation” will appear. When the decline in glomerular filtration rate is more obvious or the serum creatinine has begun to rise, patients are prone to various “conditions”. However, these “conditions” are not particularly obvious or easy to be ignored, such as urine foam More and more, sometimes no edema and more repeated, multiple attacks of gross blood pressure, more and more frequent attacks of gout, blood pressure that was originally not high but has a rising trend, hemoglobin is normal or basically normal but has a downward trend; etc. The emergence of these “conditions” requires patients to go to the hospital as soon as possible to seek active treatment from a nephrology specialist. This is also a good opportunity, and most patients can also avoid future uremia.

3. Although the “conditions” continue, there is still a chance that many patients can avoid uremia

Kidney is the first to be discovered. Some patients have been in constant “conditions”, but they still don’t take their illness seriously, thus missing an opportunity to return home. If we can seize this opportunity, many patients with kidney disease can avoid uremia in the future. These “conditions” include that the serum creatinine has begun to rise and has been rising, and the glomerular filtration rate has decreased significantly and has been fallingDecline, the blood pressure caused by chronic kidney disease has reached the high blood pressure level, the hemoglobin drop caused by chronic kidney disease can be diagnosed as anemia, etc. There may be other situations that also belong to the “condition” and will not be listed here. up. Among chronic kidney disease patients with various “conditions”, middle-aged and elderly patients with chronic kidney disease stage 3a (chronic kidney disease with a glomerular filtration rate between 45-60ml/min) can be said to be the last a chance. Although the patient has reached the stage of chronic renal insufficiency, there is still a chance to avoid future uremia. If you miss it again, it is impossible to have another chance.

Got it? Generally speaking, it takes a long time for chronic kidney disease (CKD) to progress from the initial stage 1 to CKD stage 3 of chronic renal insufficiency, but more patients with CKD stage 1 will not develop or hardly develop Or develop very slowly. From CKD stage 1 to CKD stage 3, standard treatment is carried out for this stage, and the three treatment opportunities including the last chance are also in this stage. If you miss it, it will be difficult to avoid uremia in the future.

Simultaneously published with the WeChat public account of the same name “Kidney First”, the article is original by Zhou Xun and cannot be reproduced without authorization.