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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 pyelonephritis diagnosed?
Pyelonephritis is an upper urinary tract infection, with over 95% caused by bacterial infections in areas such as the renal pelvis and calyces, leading to inflammation. As a type of bacterial infection, if a patient's urine routine shows leukocytes and there is percussion pain in the renal area, along with fever, these symptoms combined with the urine examination can essentially lead to a diagnosis. However, a definitive diagnosis requires a culture of clean-catch midstream urine. If the bacteria in two consecutive urine cultures exceed 100,000 per milliliter and are the same type, the patient can be clearly diagnosed with pyelonephritis.
Pyelonephritis is an infection of the kidneys
In fact, pyelonephritis is not really nephritis; it is actually a type of bacterial inflammatory infection. Bacteria can infect many parts of the body. If the urinary system is infected and it reaches the renal pelvis and calyces, it is referred to as pyelonephritis. Over 95% of pyelonephritis cases are caused by bacterial infections, and 70% are due to Escherichia coli. Generally, this bacteria enters the urinary system from the urethral opening and ascends to the renal pelvis and calyces, where it proliferates and causes an inflammatory response. The main clinical symptoms of the patient are fever and back pain, and the patient may also experience gross hematuria (visible blood in urine).
What is the general blood pressure for hypertensive nephropathy?
Hypertension caused by kidney disease is called renal hypertension. The blood pressure of patients with renal hypertension is generally higher than that of those with primary hypertension. However, these patients can exhibit any range of blood pressure types. Their blood pressure might be in stage 1, meaning the systolic pressure is between 140 to 160 mmHg. It could also reach stage 3, where the systolic pressure exceeds 180 mmHg. In cases of heart failure, the patient's blood pressure might even reach 220 or 240 mmHg, though such extreme cases are relatively rare.
What should I do about uremia heart failure?
Patients with uremia often develop complications of heart failure, which is actually the leading cause of death in patients with uremia. This type of heart failure is mainly due to the decreased ability of the kidneys to excrete water, leading to an increase in blood volume and an increased burden on the heart. It is also related to many factors such as the patient often having hypertension, anemia, coronary heart disease, etc. For such diseases, it is first necessary to assess whether the patient has excess water in the body. If there is too much water, urgent dialysis ultrafiltration is needed to remove the water. After the water is removed, the symptoms of heart failure will be significantly relieved. Secondly, it is necessary to deal with some other complications related to heart failure. For example, in the case of anemia, temporary blood transfusions or the use of erythropoiesis-stimulating agents to promote hematopoiesis can be used. Hypertension requires the use of antihypertensive drugs to control blood pressure and other comprehensive treatment measures. (Please use medications under the guidance of a doctor)
Hydronephrosis should see which department?
Hydronephrosis should be treated at a formal hospital's department of urology. Hydronephrosis is due to some factor causing urinary tract obstruction, potentially seen in urological conditions such as stones, tumors, congenital abnormalities of the ureter, and other causes. These lead to the kidney producing urine that cannot be properly expelled. Dealing with this condition often requires intervention by the urology department, as hydronephrosis typically necessitates surgery. In early stages, patients may need to adopt corresponding methods to address the specific causes. For instance, patients with stones might need extracorporeal shock wave lithotripsy, and open surgery might also be necessary; deformities of the ureter might need corrective surgery. These surgical treatments need to be performed in the urology department.
Principles of Acute Nephritis Treatment
The treatment of acute nephritis mainly involves managing the complications of acute nephritis, because acute nephritis itself can potentially heal automatically. The inflammatory reaction in the glomeruli can naturally subside, and proteinuria can decrease, kidney function can recover. However, acute nephritis may cause some complications that could be life-threatening to the patient. Therefore, treatment should focus on these complications to help the patient overcome difficulties, and then wait for the acute nephritis to heal automatically. Common complications mainly include heart failure, high blood pressure, pulmonary infections, etc. Thus, if a patient experiences heart failure, diuretics or even dialysis may be needed, and if an infection occurs, a full course of antibiotics is necessary for anti-inflammatory treatment.
Does diabetic nephropathy hurt?
Diabetic nephropathy generally does not cause painful symptoms. Diabetic nephropathy refers to the kidney damage that results from long-term diabetes, caused by factors such as hyperglycemia, oxidative stress, and an increase in advanced glycation end products. In the early stages, patients may experience an increase in kidney size and an increased glomerular filtration rate. As the condition progresses, proteinuria may occur, and it could eventually lead to severe renal failure. Throughout this process, patients typically do not experience pain because the kidneys do not have nerve innervation and therefore do not feel pain. Thus, including diabetic nephropathy, various kidney diseases and nephritis generally do not manifest with pain.
Does hydronephrosis cause pain?
Patients with hydronephrosis do not all experience pain. In fact, only a minority of patients experience pain. Hydronephrosis is caused by some form of urinary obstruction, such as urinary system stones, tumors, or problems like prostate enlargement, which prevent urine from being excreted smoothly. In this case, the accumulation of fluid can be a long-term, gradual buildup. Patients often adapt to the progression of the condition and do not exhibit obvious symptoms, especially in the early stages. However, some patients may experience pain, such as those with urinary system stones, or pain may occur when a tumor ruptures.
Is pyelonephritis easy to treat?
Most cases of pyelonephritis start acutely, with patients abruptly experiencing bacterial infections in their urinary system, causing inflammation in areas such as the renal pelvis and calyces. This manifests clinically with symptoms such as fever and back pain. This acute onset type is called acute pyelonephritis, and it is relatively easy to treat because it involves a bacterial infection that requires antibacterial treatment. Hence, it is generally manageable. However, if a patient's condition becomes prolonged and turns into chronic pyelonephritis, treatment may be more challenging. The bacteria causing chronic pyelonephritis are often drug-resistant, and this condition might be associated with predisposing factors for urinary infections, such as urinary system stones, anatomical abnormalities of the urinary tract, or obstructions that can conceal bacteria or contribute to their resistance, making treatment more difficult.
Is pyelonephritis more serious or nephritis more serious?
Pyelonephritis is an upper urinary tract infection caused by a bacterial infection, leading to an inflammatory response in the urinary system. The severity of this condition can vary. Nephritis, on the other hand, refers to the sterile inflammation within the glomeruli of the kidney, which also varies in severity. Therefore, it is challenging to compare these two diseases in terms of their severity. In the case of pyelonephritis, most conditions are relatively more treatable, and using antibiotics can control acute pyelonephritis. However, a small number of patients may develop severe complications such as perinephric abscess, acute renal failure, renal papillary necrosis, and even death from septic shock. The severity of nephritis also varies, with symptoms ranging from significant proteinuria to mild hematuria. Therefore, a comparison should be based on the specific conditions of the patients. (The use of medications should be under the guidance of a doctor.)