Subscribe
170
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
Will hydronephrosis cause facial swelling?
In cases of hydronephrosis, it is not certain whether facial swelling will occur. Since the human body has two kidneys, the kidneys have strong compensatory capabilities. Even if one kidney is completely damaged, if the other kidney remains healthy, the remaining kidney can still perform the function of two kidneys. It can ensure sufficient excretion of water and metabolic waste. When water is sufficiently excreted, swelling should not occur. However, if both kidneys are affected by hydronephrosis, or if the opposite kidney also has problems, then the ability of the kidneys to excrete water may decrease. With both kidneys having issues, it can lead to poor and insufficient water excretion, consequently causing swelling, such as bilateral eyelids, facial areas, and both ankles.
Can IgA nephropathy patients eat watermelon?
IgA nephropathy is a chronic glomerulonephritis with varying degrees of severity and diverse clinical manifestations. Whether patients can eat watermelon depends on their kidney function and the presence of edema symptoms. If patients have kidney failure and noticeable edema, it is advised that they avoid eating watermelon, as it contains a significant amount of potassium ions. Consuming watermelon may lead to hyperkalemia due to the intake of large amounts of potassium ions. The main component of watermelon is water, and if patients have noticeable symptoms of edema, eating watermelon may exacerbate these symptoms and even cause issues like hypertension. If patients do not have noticeable edema and their kidney function is normal, eating small amounts of watermelon should not be a major concern.
Does chronic renal failure require dialysis?
Not all cases of chronic renal failure require dialysis. It is only considered when chronic renal failure progresses to an advanced stage, causing severe consequences, and the kidneys are unable to maintain normal body functions, leading to many complications. Generally, when chronic renal failure progresses to its final stage, i.e., uremia, the kidney function is left with about 10% capacity. The body then experiences a disruption in its internal environment, including the accumulation of a large amount of metabolic waste, serious electrolyte disorders, and severe metabolic acidosis. It is at this point that dialysis is considered. In the early stages of chronic renal failure, dialysis is not necessary.
What should I do about hydronephrosis?
Hydronephrosis is merely a consequence of urinary system diseases, indicating that the urine produced by the kidneys cannot be normally transported through the ureter to the bladder due to narrowing, adhesion, scarring, or obstruction somewhere. This causes the urine to accumulate in the renal pelvis and calyces. Therefore, the treatment of this disease requires identifying the cause, and then selecting a surgical treatment plan based on the situation. For instance, urinary system stones can cause hydronephrosis, and patients might need extracorporeal shock wave lithotripsy or open surgery for stone removal. Tumors in the urinary system can lead to hydronephrosis, and prostate hyperplasia can also cause similar symptoms, necessitating open surgery to resolve the obstruction. Some patients have congenital abnormalities, adhesions, or scars in the ureter, which might require surgical corrections of the ureter.
Can acute nephritis patients eat red dates?
In cases of acute nephritis, it is recommended that patients avoid eating red dates. During the acute phase of acute nephritis, there is severe inflammatory reaction in the glomeruli of the patient, and the extensive cellular proliferation may affect the filtration barrier of the glomeruli. If the glomeruli cannot filter blood, it leads to the accumulation of metabolic waste in the body, reduced urine output, and also affects the regulation of electrolytes and acid-base balance. Therefore, patients with acute nephritis may experience kidney failure and hyperkalemia, among other issues. Red dates contain a high amount of potassium ions, making them a high-potassium food, especially dried dates, which are even richer in potassium ions. Therefore, in cases of acute nephritis, especially if the patient has renal failure, it is advised to avoid eating red dates.
Symptoms of diabetic nephropathy anemia
Patients with diabetic nephropathy who exhibit anemia indicate that they are experiencing relatively severe renal failure. Such patients may show clear clinical symptoms, such as significant edema, excessive proteinuria, and renal failure. The impaired water excretion can lead to swelling in the lower limbs and facial area. The presence of anemia causes fatigue in patients, potentially leading to chronic ischemia and hypoxia in some organs. Symptoms such as listlessness and drowsiness may occur. In the state of anemia due to diabetic nephropathy, the accumulation of metabolic waste may also affect the patient's appetite, causing poor food intake. Additionally, diabetic damage to the retinal arteries can lead to a decline in vision, or even complete blindness.
How to reduce proteinuria in diabetic nephropathy
One major characteristic of patients with diabetic nephropathy is the increase in urine protein, and some patients may even have a large amount of urine protein. The treatment of this disease is indeed quite challenging, and there are not many effective treatments available clinically. In the early stages, when the patient's serum creatinine has not exceeded 256 µmol/L, clinicians often choose ACE inhibitors or angiotensin receptor blockers (ARBs) to reduce the pressure within the glomerulus and decrease urine protein. At the same time, it is recommended for patients to use insulin to control blood sugar. However, in recent years, there has been some progress in the treatment of diabetic nephropathy, such as the use of sodium-glucose cotransporter 2 inhibitors, which may help reduce urine protein. (Medication should be used under the guidance of a clinician, based on the specific condition of the patient.)
Can chronic renal failure be cured?
Chronic kidney failure is irreversible and incurable, with no possibility of kidney function recovery. There are many causes of chronic kidney failure, commonly including diabetic nephropathy, hypertensive nephropathy, chronic nephritis, polycystic kidney disease, etc. These causes affect the kidneys over the long term, resulting in extensive damage to kidney tissues. Since kidney tissues cannot regenerate, chronic kidney failure is incurable and irreversible. Patients with chronic kidney failure still require treatment to control the underlying causes leading to the condition, aiming to slow down the progression of the disease as much as possible, prolong the patient’s life, and ensure the quality of life. This is the primary goal of treatment.
Is nephrotic syndrome prone to recurrence?
Nephrotic syndrome is characterized by more than 3.5 grams of proteinuria in 24 hours and a serum albumin concentration lower than 30 grams per liter. Treatment of this disease should be aimed at the cause, with most patients suffering from primary nephrotic syndrome related to immune dysfunction, therefore often requiring treatment with steroids. Indeed, some patients easily experience relapses; after a period of steroid treatment, proteinuria may decrease or even turn negative. However, upon cessation of the medication or during occurrences like a cold, some patients may suffer from relapses. Not all patients respond this way, as some are dependent on steroids.
How should diabetic nephropathy patients drink water?
For any kidney disease, regardless of whether it is caused by diabetes or not, the patient's water intake needs to be carefully considered. Generally, a few key points should be adhered to: First, there should be no excess accumulation of water in the patient's body. The water intake should be excreted normally through the kidneys without accumulating too much water, as excessive accumulation can increase blood pressure and even lead to pulmonary edema or heart failure. Second, if the patient's urine output decreases, water intake should be limited but not excessively, to avoid affecting the blood supply to the kidneys. Ideally, urine output should be maintained between 1000 to 2500 milliliters. Water intake should depend on urine output; if urine output is high, the patient can drink more water, but if it is low, intake should be appropriately restricted. It's necessary to weigh oneself daily to monitor changes in weight; if a large amount of water accumulates, weight will gradually increase, and at this time, water intake should be restricted.