What are the “visible” signs of kidney disease when it occurs, recurs, or worsens? Many of the patients who came to the Nephrology Department saw edema, hematuria, and foamy urine—the three main complaints of kidney friends and typical manifestations of glomerular disease.
Whether you have kidney disease or not, you may want to learn how to self-examine your kidneys.
1. Is there any edema?
Eedema can be caused by increased urinary protein leakage.
The protein in the body has the function of “absorbing water” like a sponge. If the protein leaks out, there is not enough protein in the blood to absorb water, and the water will seep outside the blood vessels. tissue, causing edema. Water flows to low places, so it is common to see lower extremity edema, and a small concave pit will appear when you press your finger on the leg (finger pit edema):
This is also called “Nephrotic edema”, more common in patients with nephrotic syndrome.
If it is in the morning and sleep all night, the water flows down to the back, so the edema of the lower limbs is not obvious at this time, and it is not obvious until the afternoon and evening, so we It is often said that nephrotic edema is “light in the morning and heavy in the evening”.
There is also a type of renal edema, called “nephrotic edema”, which is usually swollen on the face, especially the eyelids, that is, edema of the eyelids. This kind of edema is caused by the imbalance of the renal bulb. The tedious mechanism is not introduced much. The simple understanding is that the kidneys cannot drain the water. Where will the water be held in the body? Wherever the skin is soft, hold it there, yes, the face, especially the eyelids.
Hypertension is more common in patients with nephritic syndrome, while nephrotic syndrome rarely has hypertension.
Edema is a “form”, a “marker”, not a “basic”. Relieving edema is not the core of treating kidney disease. However, if the edema is severe, it will affect the efficacy of the drug, and it can also cause pleural effusion, and even endanger the heart and lung function. Therefore, if the edema is obvious, it is necessary to use diuretic and detumescence drugs to control it in time.
2. Is there any foamy urine?
What is foamy urine?
In a broad sense, any object is a foam. In a building, there are many rooms, each room can be regarded as a vacuole, and objects that seem dense are also full of vacuoles from a microscopic perspective. It’s just that the solid foam is very firm and doesn’t dissipate as easily as urine foam.
Solids are very strong because strong intermolecular forces are firmly attracted. As for the liquid, its intermolecular force is also called tension, and the force is relatively small. Such as water and normal urine, only a small, short-term foam can be formed.
But the intermolecular force of urine protein is relatively large, which will increase the tension of urine and form a large number of foams that do not dissipate for a long time.
If there is foamy urine that does not dissipate for a long time, such as dozens of minutes, then proteinuria is one of the key suspects.
Increased urinary protein is an independent risk factor for the progression of nephropathy. It is closer to the “root of the disease” than edema and must be controlled. Patients with nephrotic syndrome need to be controlled within 0.3g. Syndrome patients need to be controlled within 0.5g. If left unchecked, varying degrees of proteinuria can progress to uremia over a period of years to decades.
3. Is there any hematuria?
People with kidney disease sometimes urinate red urine because there are a lot of blood cells in the urine.
Why do I have blood in urine?
It is usually because the walls of the capillaries in the kidneys have ruptured.
Due to heredity, gene mutation and other congenital reasons, coupled with acquired infection, it will lead to the abnormality of the immune system, resulting in the production of pathogenic substances – immune complexes. The mesangial cells of the kidney are very dedicated and will actively phagocytose immune complexes, but they did not expect that they would not be able to digest them, resulting in abnormal proliferation and squeezing of capillaries. After the capillaries are crushed, the red blood cells in the blood will escape and leak into the urine, forming hematuria, which is called renal hematuria.
When the number of red blood cells exceeding the standard is relatively small (more than 5 in the high-power field, but not too much), the red blood cells can only be seen with a microscope, which is called microscopic hematuria.
When the hematuria is severe, the microscope is full of red blood cells, and the urine can be seen red with the naked eye, which is called gross hematuria.
The gross hematuria indicates that the inflammation of the kidney is more serious, and it usually requires timely medication to control the disease.
In addition to the above three symptoms, nephropathy can also present polyuria, oliguria, and increased nocturia, which are manifestations of renal tubule and/or renal dysfunction, which may Accompanied by elevated serum creatinine.