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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
Is Stage 2 Chronic Kidney Failure serious?
In clinical practice, chronic renal failure is not divided into stages 1, 2, 3, 4, and 5, but chronic kidney disease does have a stage 2. Stage 2 chronic kidney disease refers to a glomerular filtration rate (GFR) between 60 to 90 milliliters per minute. This stage indicates that the patient's kidney function has already been somewhat impacted since the normal GFR is approximately 100-120 milliliters per minute. Patients in stage 2 of chronic kidney disease may experience certain complications such as hypertension, proteinuria, and electrolyte imbalances, and the condition is considered relatively serious. The azotemic phase of chronic renal failure may correspond to stage 2 of chronic kidney disease, and the condition can be serious, requiring regular follow-ups. Although this stage may not involve severe complications requiring dialysis, it is crucial for patients to pay close attention, undergo regular check-ups and monitoring, address the primary disease, and slow the progression of renal failure.
What should I do about vomiting in nephrotic syndrome?
Patients with nephrotic syndrome experience significant urinary protein, which actually indicates glomerular lesions. If the patient does not have severe renal failure, such symptoms often do not lead to vomiting. If vomiting occurs, it is necessary to identify the cause, whether there is widespread edema, including gastrointestinal edema leading to vomiting, or if there is severe renal failure, even acute renal failure. In these cases, the patient's vomiting may be related to the nephrotic condition. Additionally, some medications used to treat nephrotic syndrome might cause vomiting and should be discontinued. If the vomiting is related to renal conditions, it is crucial to actively treat the primary disease and control nephrotic syndrome. However, if none of the above reasons are applicable, there might be an issue with the gastrointestinal tract itself, requiring consultation in gastroenterology, possibly needing a gastroscopy, and the use of medications to suppress stomach acid and promote gastrointestinal motility. (Please use medications under the guidance of a doctor.)
Can people with chronic renal failure eat mutton?
Patients with chronic kidney failure can eat mutton. Although these patients have reduced ability to excrete metabolic waste due to kidney failure, and the body's metabolic wastes are mainly due to the products of protein metabolism, in reality, patients with chronic kidney failure need to control their protein intake in their diet to avoid excessive protein intake leading to the overproduction of metabolic wastes. This would increase the excretory burden on the kidneys, and protein can also increase the excretion of urinary protein in patients. The daily protein intake for these patients should be controlled at less than 80% of that for normal people, with animal proteins making up more than 50% of this intake. Since mutton is an animal protein, patients with chronic kidney failure can eat mutton, but they should not eat too much.
Where to apply moxibustion for pyelonephritis
Pyelonephritis is an upper urinary tract infection caused by bacteria invading parts such as the renal pelvis and calyces, leading to inflammation. Moxibustion has no therapeutic value for patients with this disease. Pyelonephritis often occurs when bacteria ascend from the urethral opening into the urinary system, causing inflammation. Therefore, treatment generally involves the use of antibiotics to kill the bacteria. It is important to choose antibiotics that are sensitive to the infecting bacteria and preferably those that can form a high concentration within the urinary system. Typically, taking medication for 10-14 days can control the condition for the vast majority of patients. Using moxibustion or massage as physical therapy has little value, but patients can benefit from drinking more water and urinating frequently to help control the condition.
Can a color ultrasound detect renal cancer?
Color ultrasound is a diagnostic imaging method, and renal cancer is a malignant kidney tumor, which also has several stages with varying degrees of severity. For early-stage renal cancer, the cancerous characteristics are not pronounced, and at this time, performing a color ultrasound only serves as an indication and cannot confirm a diagnosis. In late-stage renal cancer, a color ultrasound might show more obvious signs or evidence indicative of a tumor, but it still cannot provide a definitive diagnosis. To confirm a diagnosis of renal cancer, a kidney biopsy or surgery is generally required. During surgery, a rapid frozen section biopsy can confirm the diagnosis. Preoperatively, to more accurately determine if the condition is renal cancer, an MRI or an enhanced CT scan might also be performed, as these tests provide more precise information than a color ultrasound.
Chronic renal failure anemia type
Based on indicators such as the size of red blood cells and the concentration of hemoglobin they contain, anemia is generally classified into microcytic hypochromic anemia, normocytic normochromic anemia, or macrocytic anemia. The type of anemia mainly associated with chronic renal failure is normocytic normochromic anemia. This is because the anemia caused by chronic renal failure is primarily due to a decrease in the secretion of erythropoietin by the kidneys, which is a hormone that promotes bone marrow hematopoiesis. When renal failure occurs, the secretion of this hormone decreases, leading to insufficient bone marrow hematopoiesis, resulting in normocytic normochromic anemia in patients. However, a small portion of patients may also have concurrent anemia, exhibiting features of microcytic hypochromic anemia as well.
Do you need to be hospitalized for hydronephrosis?
In most cases, hospitalization is required for the treatment of hydronephrosis, especially when it is first discovered. Hospitalization is primarily for assessing the severity of the patient's condition, identifying the cause of the condition, and determining the treatment plan. These are the main purposes of hospitalization. If the patient needs the aforementioned objectives to be met, it often requires surgery or hospital treatment. Therefore, patients with hydronephrosis need to identify the cause, which is often related to issues in the urinary system such as stones, tumors, or prostate enlargement. More complex examinations may be needed, and surgical treatment may be necessary, all of which need to be completed under hospitalization conditions. However, if the patient only has prostate enlargement and does not require surgery, placing a urinary catheter can resolve the issue, and such minor cases might also be handled on an outpatient basis.
Factors that exacerbate chronic renal failure
Patients with chronic kidney failure should pay close attention to potential triggers that could worsen kidney failure. Avoiding or managing these triggers is crucial for slowing the progression of chronic kidney failure. Common causes include various factors that lead to renal ischemia and hypoxia, such as diarrhea, vomiting, and heat stroke in the summer. These factors can cause dehydration, leading to ischemia and hypoxia in the kidneys, which is a common scenario for the acute exacerbation of chronic kidney failure. Secondly, obstructions in the urinary system can also contribute to the progression of chronic kidney failure. For example, urinary system stones and benign prostatic hyperplasia in males can cause urinary obstruction, leading to further deterioration of kidney function. Finally, infections, heart failure, and hypercalcemia are also factors that can potentially worsen chronic kidney failure.
How many days does the high fever last in pyelonephritis?
Pyelonephritis, also known as an upper urinary tract infection, indeed tends to cause fever in patients. Generally, this type of fever can rise sharply in a short period of time, potentially exceeding 39°C. The duration of the fever mainly depends on the patient's own resistance and the effectiveness of the medication. If sensitive antibiotics are used and the patient has strong immune capabilities, the bacteria can be killed or mostly eliminated in a short period of time. In such cases, the patient's high fever may gradually subside within three to five days. However, if the medication is ineffective, the fever may persist for an extended period, possibly lasting up to half a month or even a month. (The use of medications should be carried out under the guidance of a professional doctor.)
Can diabetic nephropathy be controlled?
The treatment of diabetic nephropathy is indeed a medical challenge currently. This disease is related to metabolic disorder, with factors such as high blood sugar state advanced glycation end products and oxidative stress contributing to the damage of the glomerular capillaries. Presently, there is no cure for this disease, nor is there a specific effective treatment. However, many patients have used certain treatments that can effectively delay the progression of the disease. Clinically, common measures include controlling blood sugar, blood pressure, and blood lipids. Additionally, combining the use of ACE inhibitors or angiotensin receptor blockers with sodium-glucose cotransporter 2 inhibitors can reduce the pressure within the renal corpuscles and lower urine protein levels.