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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 acute nephritis easy to treat?
In most cases, acute nephritis is not difficult to treat because the disease itself is self-limiting, meaning that acute nephritis can heal naturally within about 3 to 4 weeks. However, acute nephritis can cause some complications, and in severe cases, it may lead to disability or death. Therefore, when patients with acute nephritis develop serious complications, treatment may be relatively difficult or complications such as pulmonary infections, heart failure, and acute renal failure may occur. But with appropriate treatment, most cases are hopeful to be controlled.
Principles of treatment for pyelonephritis
Pyelonephritis, also known as an upper urinary tract infection, is a bacterial inflammation, with over 95% being caused by bacterial infections, among which 70% are caused by Escherichia coli. Therefore, as a bacterial infection-induced inflammation, antibiotic treatment is of course necessary. Clinically, third-generation cephalosporins or fluoroquinolone antibiotics are often chosen for bactericidal treatment. For acute pyelonephritis, it is generally recommended that medication be administered for 14 days, alongside measures such as increased water intake and frequent urination. In cases of chronic pyelonephritis, a low-dose, long-course antibacterial treatment, such as using nitrofurantoin, may also be employed, with continuous medication for two months. (Please consult a clinical doctor for specific medication use; do not self-medicate.)
Is nephrotic syndrome hereditary?
Nephrotic syndrome is generally not hereditary. It refers to a group of clinical symptoms and manifestations. The fundamental issue in patients is the damage to the glomerular capillaries, which leads to significant proteinuria, subsequently causing edema, hyperlipidemia, and hypoalbuminemia in the plasma. The causes of this disease are classified into primary and secondary types. Primary nephrotic syndrome is related to immune system dysfunction and may involve multiple genes; therefore, the disease is not considered a clear hereditary disease, but the likelihood of offspring developing renal issues may be higher than in the general population. Secondary nephrotic syndrome is mostly related to factors such as hepatitis B infection, allergies, diabetes, etc., and these diseases are not hereditary either.
Does nephrotic syndrome easily lead to cerebral infarction?
Nephrotic syndrome is a high-risk factor for cerebral infarction, making patients prone to strokes. This is because patients with nephrotic syndrome excrete large amounts of protein in their urine, which reduces protein concentration in the plasma and disrupts the anticoagulant fibrinolysis system, leading to an increased tendency to form blood clots. These clots are prone to develop in the veins of the lower extremities and the renal veins, and cerebral arteries in the skull are also susceptible to occlusion. Therefore, in such patients, if the plasma albumin level is very low, such as below 20 grams per liter, there is a need for routine use of anticoagulant medications.
Is stage five chronic kidney failure serious?
Strictly speaking, there is no condition called "chronic renal failure stage five," but there is a term "chronic kidney disease stage five." Chronic kidney disease is divided into five stages based on the glomerular filtration rate (GFR). Stage five chronic kidney disease indicates that the patient's GFR is less than 15 milliliters per minute, which is about 15% of normal kidney function and is essentially equivalent to uremia. Therefore, chronic renal failure or chronic kidney disease stage five is very dangerous and can cause many complications. Moreover, this type of kidney failure is irreversible and incurable, and the patient may need to undergo dialysis or a kidney transplant.
Chronic kidney failure is not contagious.
Chronic kidney failure is not contagious. Strictly speaking, chronic kidney failure is not an independent disease; it is a state of disease. It refers to various causes that damage the kidneys, leading to the loss of kidney tissue, and ultimately, the kidneys lose their ability to perform excretory functions. This state is called chronic kidney failure. Chronic kidney failure itself is not contagious. Contagious diseases involve some type of pathogen, whereas the common causes of chronic kidney failure include chronic nephritis, diabetes, kidney diseases, hypertensive nephropathy, etc. None of these diseases are contagious, hence chronic kidney failure is also not contagious.
Acute nephritis has the following characteristics:
Acute nephritis has the following characteristics: First, patients with acute nephritis often have a history of a precursor upper respiratory tract infection. After catching a cold, patients may develop hematuria, proteinuria, or anuria. Second, patients with acute nephritis will experience a decrease in complement C3 in the blood. After recovery from acute nephritis, complement C3 can restore itself. Third, acute nephritis is self-limiting; generally, the patient's condition will gradually improve over three to four weeks, and recovery can be complete after eight weeks. However, a very small number of patients might experience prolonged illness, evolving into chronic nephritis. Fourth, the pathological characteristic of acute nephritis is diffuse proliferation of capillary endothelial cells, which is a manifestation of pathological damage to the glomeruli.
The characteristics of proteinuria in IgA nephropathy
IgA nephropathy is a pathological type of chronic glomerulonephritis, which can cause patients to exhibit symptoms such as proteinuria and hematuria. Regarding the characteristics of proteinuria, it is generally primarily glomerular proteinuria. In the classification of patients' proteinuria, glomerular proteinuria accounts for a large proportion. If IgA nephropathy presents as chronic nephritis or nephrotic syndrome, the patient's level of proteinuria will be quite severe, with significant amounts of proteinuria, where the 24-hour urinary protein quantification may exceed 1g or even reach more than 3.5g. However, not all patients with IgA nephropathy have such high levels of proteinuria; some may only have mild proteinuria.
Will acute nephritis cause facial swelling?
Acute nephritis can also cause facial swelling in patients. The pathological damage in patients with acute nephritis is the diffuse proliferation of glomerular cells, which reduces the glomeruli's ability to filter blood. As a result, patients may experience proteinuria and hematuria. Decreased kidney function in water excretion can lead to water accumulation in the body, causing edema in the lower limbs or facial area. The increase in urinary protein can also increase vascular permeability and decrease plasma osmotic pressure, leading to the movement of water outside the blood vessels. These factors can all cause edema. In the body, water tends to accumulate in areas where tissues are looser, such as the facial area. Thus, it is possible for patients with acute nephritis to experience facial swelling.
Acute Pyelonephritis Nursing Measures
Acute pyelonephritis, also known as an upper urinary tract infection, is a type of bacterial inflammation. In terms of care, patients should first focus on increasing their fluid intake. If the patient does not have urinary system stones, tumors, or other factors causing urinary obstruction—that is, if there is no kidney hydronephrosis—it is recommended that the patient's daily urine output be maintained at 2000-2500 milliliters. This means increasing fluid intake can help flush the urinary system, reducing bacterial growth and reproduction, which is beneficial for the treatment of pyelonephritis. Secondly, since the patient has acute inflammation, dietary considerations should include eating light, avoiding heavy and greasy foods as well as spicy and stimulating foods, and paying attention to perineal hygiene. Additionally, during episodes of fever, if the patient's body temperature is not very high, a warm water sponge bath can be given, especially focusing on the neck, armpits, and the root of the thighs, which can facilitate heat dissipation and is very beneficial for reducing body temperature.