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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
Early signs of diabetic nephropathy
Diabetic nephropathy is caused by long-term diabetes leading to damage in the small blood vessels. Generally, patients have a history of diabetes for over ten years. Diabetic nephropathy progresses through several stages. In the early stages, patients primarily exhibit microalbuminuria. Due to the presence of protein in the urine, patients may experience increased urine foam, especially noticeable with morning urination. Some patients may develop swelling in the lower limbs and around the eyelids. As the condition progresses, the amount of urine protein increases and the swelling becomes more pronounced, potentially reaching the level of nephrotic syndrome.
Is uremia contagious?
Strictly speaking, uremia is not an independent disease and it is not contagious. Uremia refers to the state where numerous causes chronically damage the kidneys over a long period, eventually leading to the destruction of most kidney tissue, resulting in the kidneys' inability to excrete metabolic waste. There are many causes of uremia, including chronic nephritis, diabetes hypertension, systemic lupus erythematosus, urinary system stones, and even prostate hyperplasia, among others, which damage the kidneys and lead to this condition. Generally, these causes are not contagious as they do not involve bacteria, viruses, or fungi. However, if uremia is caused by infectious diseases, such as hepatitis B virus or HIV, these infectious diseases can be contagious, but uremia itself is not contagious.
Which department should diabetic nephropathy patients see?
Diabetic nephropathy is damage to small blood vessels caused by diabetes, and the kidneys contain a large number of small blood vessels. Therefore, it generally takes more than ten years for diabetes to damage these small blood vessels, causing kidney lesions, proteinuria, renal failure, and other clinical manifestations. This disease can be treated in departments specializing in diabetes or endocrinology, as well as in nephrology. In the early stages of diabetic nephropathy, treatment primarily involves controlling blood sugar levels, and visiting departments like diabetes or endocrinology might be more specialized in this regard. These departments are proficient in adjusting medications for blood sugar control. When patients develop significant proteinuria, the condition progresses, and it is advisable to visit nephrology. At this point, the treatment focuses on the kidney lesions, as well as managing complications caused by diabetic nephropathy.
Does hydronephrosis hurt a lot?
Hydronephrosis does not necessarily cause severe pain. If the hydronephrosis develops suddenly over a short period, it might cause intense pain, most commonly due to urinary system stones blocking the ureter, leading to hydronephrosis. At this time, the ureter may experience spasms, causing severe pain. However, if the hydronephrosis develops gradually, the patient's pain symptoms might not be pronounced. For example, insufficient motility of the ureter or some type of narrowing could lead to the accumulation of fluid. If this condition develops slowly and persists for a long time, the patient might not feel particularly uncomfortable, despite the hydronephrosis, and it may only be discovered incidentally during a physical examination.
Is hydronephrosis with hematuria serious?
Whether hematuria in patients with hydronephrosis is serious cannot actually be determined by the amount of blood in the urine. It is important to identify the cause and assess kidney function, because hydronephrosis can lead to serious consequences, mainly kidney failure. If the hydronephrosis persists for a long time, it can compress the renal cortex and cause kidney shrinkage, leading to chronic kidney failure. The dangers of hematuria mainly include: first, it may cause significant bleeding, leading to anemia. Second, this type of hematuria could be caused by certain conditions, such as bleeding caused by a tumor in the urinary system, which is quite serious. Whereas bleeding caused by urinary tract infections or urinary system stones, in terms of the nature of the cause, is not considered very serious. However, significant bleeding can also lead to severe anemia and even shock, which would be more serious.
Can chronic renal failure be cured by dialysis?
Patients with chronic renal failure can undergo dialysis treatment to sustain life and improve quality of life. However, dialysis merely uses artificial means to excrete accumulated metabolic wastes and fluids in the body, regulate the internal environment, and simply substitutes for the function of the kidneys. Dialysis has no therapeutic value for renal failure itself. Therefore, patients with chronic renal failure should not expect dialysis to restore kidney function. Nonetheless, as a renal replacement therapy, dialysis can provide patients with a relatively good lifespan and quality of life. Dialysis treatment is necessary for patients with uremia.
How is uremia caused?
Uremia, also known as end-stage renal disease, is actually the late stage of chronic renal failure development, capable of causing long-term chronic damage to the kidneys. There are many reasons for this, and if these causes persist over a long period, continuously harming the kidneys without effective removal or control, it could eventually lead to severe renal failure, ultimately causing uremia. The causes that can chronically harm the kidneys mainly include diabetes, hypertension, chronic nephritis, polycystic kidney, urinary system stones, tumors, and other such conditions.
Sequelae of acute nephritis
Most cases of acute nephritis do not cause complications; generally speaking, acute nephritis is a self-healing disease that can recover on its own. Approximately three to four weeks later, the condition can gradually alleviate, with the patient’s urine protein and occult blood decreasing until they disappear and kidney function returns to normal, and the edema can also subside, so generally there won’t be any complications. However, there are a minority of patients whose conditions are prolonged and do not heal, and if the patient's condition persists for three months or even half a year without recovery, it might evolve into chronic nephritis. Also, some patients may experience severe kidney failure, heart failure, and pulmonary infections during acute nephritis, leading to severe consequences. The likelihood of these situations occurring is relatively low.
Is high creatinine uremia?
High creatinine levels do not necessarily indicate uremia. High creatinine often implies that the patient is experiencing renal failure, which can be classified into acute renal failure and chronic renal failure based on factors such as the patient's medical history and course of the disease. Uremia is the final state of chronic renal failure. Thus, even if high creatinine levels suggest the possibility of chronic renal failure, it does not necessarily mean that the patient has reached the final stage. Uremia, also known as end-stage renal disease, generally requires a patient's blood creatinine to exceed 707 µmol/L. Additionally, patients often simultaneously present with clinical manifestations such as renal anemia, disorders of calcium and phosphorus metabolism, and reduction in kidney size.
What is hydronephrosis?
The so-called hydronephrosis is a morphological description, referring to an obstruction in the urinary system caused by various reasons. After the kidneys produce urine, it cannot be normally delivered to the bladder. This leads to fluid accumulation in the renal pelvis and calyces, which can be detected through imaging as hydronephrosis. The causes of hydronephrosis are numerous. The most common cause is acquired obstruction, primarily due to urinary system stones, scarring from injuries, or tumors in the urinary system compressing the ureter, which often results in urinary tract obstruction. In addition, some congenital causes can also lead to urinary tract obstruction. Examples include segmental dysfunction of the ureter, intrinsic stenosis of the ureter, and twisting of the ureter. However, these congenital obstruction causes are relatively rare.