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Zhou Qi
Nephrology
About me
An associate chief physician in the Nephrology Department of the People's Hospital of Ma'anshan City, with a Master's degree from a key medical university. Participated or led multiple projects funded by the Natural Science Foundation, and published nearly ten papers in Chinese and core journals.
Proficient in diseases
Glomerular diseases, diabetic nephropathy, lupus nephritis, blood purification.
Voices
How is acute pyelonephritis treated?
Acute pyelonephritis is a problem caused by an infection, also known as an upper urinary tract infection. Therefore, the treatment plan for this disease should be based on the pathogen. The vast majority of acute pyelonephritis is caused by bacterial inflammation, so antibiotics are often required. It is generally recommended that patients should receive intravenous antibiotic treatment to kill the bacteria, choosing the antibiotics sensitive to the results of urine culture. After 10 to 14 days of treatment, the condition of acute pyelonephritis can usually be controlled in most cases. The patient's body temperature will gradually decrease, symptoms of back pain will ease, and the white blood cells in the urine will also disappear. Only a very few cases of acute pyelonephritis are difficult to treat because such patients may have predisposing factors to urinary tract infection such as diabetes and urinary system stones. (Specific medication use should be conducted under the guidance of a doctor.)
Does kidney cancer cause fever?
Kidney cancer itself generally does not cause fever. Kidney cancer is a malignant tumor, and the most common clinical manifestation in patients is hematuria. As this malignant tumor grows larger, it may eventually rupture and bleed, leading patients to notice the formation of blood in the urine. Some patients may also be able to feel a mass in the abdomen. In severe cases of kidney cancer, it may lead to reduced urine output due to kidney failure. These symptoms are common manifestations of kidney cancer. Kidney cancer itself is unlikely to cause a fever, but due to the presence of kidney cancer, changes in the tissue structure of the kidney can occur, making infections more likely. When an infection occurs, it may also cause a fever, but this fever is not directly caused by the kidney cancer itself.
Does uremia cause blood in urine?
Patients with uremia may experience hematuria, but not all patients will do so. Uremia refers to a condition where over 90% of the patient's kidney tissue has been damaged. Due to the destruction of kidney tissue, when blood passes through the kidneys, it is indeed possible that red blood cells will leak from the glomeruli into the urine. Therefore, patients with uremia may exhibit signs of hematuria, especially those caused by primary chronic glomerulonephritis. If the uremia is caused by tumors or kidney stones leading to urinary obstruction, this situation can cause bleeding in the ureters or bladder, also resulting in hematuria. However, most patients with uremia have a very low chance of experiencing hematuria because the vast majority of their kidney tissue has been destroyed, even up to 100%, leaving no urine production, and thus no blood in the urine. If an anuric patient exhibits hematuria, the possibility of stones, tumors, or urinary tract infections should be considered.
Is acute nephritis prone to "excessive internal heat"?
Acute nephritis indeed tends to cause "fire-up," which refers to the viral infection in patients. Typically, the appearance of herpes on the upper lip is colloquially known as "fire-up," but in reality, this is an active manifestation of the herpes virus when the body's immune capacity is low. The human body often carries this virus, and symptoms appear when immunity is low. In the state of acute nephritis, it is easy to result in reduced immunity in patients, thus activating the dormant virus in the body, causing herpes in corresponding areas including the upper lip and corners of the mouth.
Can diabetic nephropathy patients eat kelp?
Patients with diabetic nephropathy should avoid eating seafood, including various types of sea fish, shellfish, as well as seaweed, kelp, and so on. This is because these seafood products contain a certain amount of purines, and some foods have a high purine content. When purines enter the human body, they are metabolized and eventually converted into uric acid, which needs to be excreted by the kidneys. Patients with kidney disease have decreased ability to excrete uric acid, and the accumulation of uric acid may cause further damage to the kidneys and also affect the cardiovascular and cerebrovascular systems. Therefore, generally speaking, it is advised that patients with diabetic nephropathy should avoid eating kelp. However, if the patient’s condition is in the early stages and kidney function is still normal, consuming some kelp in moderation generally should not be a problem, but it should not be consumed in large amounts.
What department should I go to for hydronephrosis?
Hydronephrosis refers to the accumulation of urine in parts such as the renal pelvis and calyces due to some reason causing the urinary system to not smoothly excrete urine. After the kidneys produce urine, it cannot be excreted smoothly, leading to the accumulation called hydronephrosis. Generally, it is necessary to visit the urology department, as the most common causes of hydronephrosis are stones or tumors in the urinary system and prostatic hyperplasia, among other issues, all of which require urological treatment. In most cases, surgery may be necessary to relieve the obstruction and resolve the hydronephrosis. However, there are also a small number of patients who may have hydronephrosis due to other reasons, such as cervical cancer or colorectal cancer patients, where enlarged tumors may compress the ureter leading to hydronephrosis. Patients with cervical cancer need to undergo surgical treatment in gynecology, while those with colorectal cancer may need treatment in general surgery.
Does acute nephritis cause fever?
Acute nephritis is actually a sterile inflammation, with significant proliferation of cells within the glomeruli, primarily related to immune dysfunction. Therefore, from this perspective, acute nephritis does not show symptoms of fever. However, due to the inflammatory response within the glomeruli causing acute nephritis, patients may experience renal failure. In the state of renal failure, the patient's immune capability further decreases, which could lead to complications from infections, with respiratory infections being the most common, including pneumonia, bronchitis, and acute tonsillitis. These inflammations may cause fever, but this fever is not a direct result of the acute nephritis itself.
What is the blood pressure in chronic renal failure?
High blood pressure is a common complication of chronic renal failure, with about 70 to 80 percent of patients experiencing elevated blood pressure. Controlling blood pressure is also an important aspect of the treatment of chronic renal failure. Generally, it is best for such patients to keep their blood pressure below 130/80 mmHg, with systolic pressure below 130 mmHg and diastolic pressure below 80 mmHg. If a patient’s 24-hour urinary protein quantification exceeds 1 gram, the blood pressure control requirements are even more stringent, ideally below 125/75 mmHg. Adequately controlling blood pressure also helps to slow the progression of chronic renal failure.
Late-stage symptoms of diabetic nephropathy
When patients with diabetic nephropathy reach the advanced stage, they actually already have severe renal failure. Prior to this, patients generally exhibit noticeable proteinuria. Continued progression of the disease will lead to the destruction of most of the renal tissues, causing renal failure. This condition is quite serious; patients often experience significant edema, even severe generalized edema. The accumulation of a large amount of fluid in the body leads to an increase in blood volume, and both the preload and afterload on the heart increase, often accompanied by symptoms of heart failure. When patients experience heart failure, they may find it impossible to lie flat and may experience chest tightness, shortness of breath, and difficulty breathing after activity, potentially endangering their lives.
Nephrotic syndrome urine output
Patients with nephrotic syndrome vary in the amount of urine they produce. Some patients have normal urine output and may not exhibit obvious symptoms of edema, but others may have reduced urine output, which can even lead to acute renal failure. Nephrotic syndrome emphasizes that the glomerular filtration barrier is damaged, resulting in a large amount of urinary protein, with a 24-hour urinary protein quantitative exceeding 3.5 grams. This situation highlights the decreased ability of the filtration barrier to retain proteins in the blood, meaning the integrity of the filtration barrier is compromised. However, the kidney's ability to excrete water and metabolic waste is not indicated by the term "nephrotic syndrome" itself, thus the patient's urine output can vary.