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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
Can chronic kidney failure CKD5 be cured?
The so-called CKD refers to chronic kidney disease. According to the glomerular filtration rate, CKD is divided into 5 stages, where stage 5 means that the patient's glomerular filtration rate has fallen below 15 milliliters per minute, which is equivalent to uremia. Chronic renal failure is irreversible and cannot be recovered, so it is impossible for patients whose condition has progressed to later stages to recover. Therefore, for such conditions, the only option is to choose renal replacement therapy so that the patient can survive. Renal replacement therapy mainly includes hemodialysis, peritoneal dialysis, or kidney transplantation.
Manifestations of recovery from nephrotic syndrome
In principle, there is no concept of complete recovery for nephrotic syndrome. The condition of nephrotic syndrome can be alleviated and controlled to the greatest extent, but it cannot be completely cured. When the condition is alleviated, the patient's glomerular filtration barrier is repaired, resulting in a reduction in proteinuria and a decrease in urinary foam clinically. Once the patient's urinary protein decreases, the plasma protein concentration will gradually increase. Thus, water moves back from outside to inside the blood vessels, leading to a reduction in edema. These clinical signs all indicate an improvement in the condition of nephrotic syndrome. Of course, to assess the condition, it is still necessary to rely on the patient undergoing a 24-hour quantitative urine protein test.
Are kidney stones severe?
The severity of kidney stones depends on the size of the stones and their location. For example, stones within the kidney parenchyma, if not large and not moving, generally do not cause much trouble. However, if the stones block the area of the renal pelvis and calyces, or even move downward to block the ureter, causing the urine produced by the kidneys to not be excreted smoothly, it will cause the patient to experience renal colic. This type of pain is very intense, radiating to the back and causing abdominal pain, as well as pain in the perineal area. Patients often may also experience fever and other clinical symptoms. Prolonged obstruction of the urinary system can lead to renal failure, which is quite dangerous.
Is kidney cancer the same as uremia?
Kidney cancer and uremia are two completely different concepts. Kidney cancer refers to the presence of a malignant tumor, which is a malignant lesion in kidney-type tissues. Certain cells in the kidney are in a state of limitless proliferation, continuously replicating to form kidney-like masses, and may cause hematuria, or even squeeze kidney tissues affecting their function. Uremia, on the other hand, refers to long-term chronic damage to the kidneys from various diseases, leading to the destruction of over 90% of kidney tissue, rendering the kidneys unable to excrete metabolic waste. This results in azotemia, electrolyte disorders, and other complications, a state known as uremia. Patients with kidney cancer, if the damage to kidney tissues is not severe, may still have normal kidney function. However, if severe problems occur in both kidneys, kidney cancer could also lead to uremia, although this situation is relatively rare.
What tests are involved in checking for uremia?
Uremia refers to the final stage of chronic renal failure, also known as end-stage kidney disease. Therefore, the first step in examining a patient with uremia is to check renal function. The patient's blood creatinine level must reach a certain level to diagnose uremia. Secondly, it is necessary to examine the urinary system through color Doppler ultrasound, and to conduct blood tests for routine blood indicators, electrolytes, parathyroid hormone, etc. The color Doppler ultrasound shows a reduction in kidney size, which provides evidence for the diagnosis of uremia. Patients with uremia often also suffer from various complications, including anemia, electrolyte disorders, hyperparathyroidism, and so on. Therefore, such patients also need to undergo examinations for routine blood parameters, electrolytes, and parathyroid hormone levels, among other indicators.
Will people with hydronephrosis have edema?
Hydronephrosis can potentially cause patients to exhibit symptoms of edema. Urine is produced by the kidneys and is expelled from the body through the urinary system, including the ureters and bladder. If there is an obstructive issue in the urinary system, the urine produced by the kidneys cannot be excreted smoothly, leading to hydronephrosis. When a large amount of fluid cannot be excreted, it eventually causes edema in the body. However, if the patient has hydronephrosis on only one side and the other kidney is healthy, the healthy kidney can fully compensate for the entire kidney function and sufficiently excrete fluids. Therefore, patients with unilateral hydronephrosis often do not show obvious signs of edema. But if a patient has bilateral hydronephrosis, and urine produced by both kidneys cannot be excreted, the patient will exhibit signs of edema.
Does diabetic nephropathy cause back pain?
Diabetic nephropathy generally does not cause symptoms of back pain. Diabetic nephropathy refers to patients with long-term hyperglycemia, typically those whose blood sugar has been elevated for ten years or more, causing damage to the small blood vessels. The kidneys, being rich in small blood vessels, undergo glomerular sclerosis. Early in the disease, patients experience an increased glomerular filtration rate. As the condition progresses, proteinuria gradually increases. When proteinuria occurs, patients may exhibit noticeable edema, and in some cases, patients may develop severe edema due to substantial proteinuria, leading to serious complications like pulmonary edema and heart failure, which manifest as respiratory difficulties and chest tightness. However, these conditions do not cause back pain, even though there is glomerular sclerosis, as patients do not feel any pain associated with it.
post-acute nephritis sequelae
Acute nephritis is a self-limiting disease, and most patients can fully recover, so the vast majority of patients generally start to show improvement in routine urine tests three to four weeks after onset, with normal kidney function and resolution of edema, resulting in few, if any, sequelae. Of course, a small number of patients may experience prolonged unhealed conditions that can progress to chronic nephritis. These patients may then develop complications, including hypertension and renal anemia, which are long-term potential issues. However, the vast majority of patients with acute nephritis do not experience complications or sequelae.
The difference between hypertensive nephropathy and renal hypertension
Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.
Is hydronephrosis scary?
Hydronephrosis is rather alarming, as it harms the body in two main ways: First, it creates increased pressure inside the kidneys due to fluid accumulation in the urinary system. This pressure can compress kidney tissue, and if not resolved, may lead to irreversible kidney damage and renal failure. However, if hydronephrosis formed in the short term is quickly addressed by clearing the urinary system, it typically has minimal impact on kidney function. Another aspect relates to the causes of hydronephrosis, some of which are complicated issues, such as bladder cancer, rectal cancer, or cervical cancer in females. These cancers can press on the ureter, leading to hydronephrosis. Other causes, such as urolithiasis or benign prostatic hyperplasia, are relatively easier to manage.