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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 to deal with swollen feet in IgA nephropathy?
IgA nephropathy is a pathological type of chronic glomerulonephritis, and patients are prone to edema. The treatment of this edema is divided into two aspects: First, it is necessary to control the condition of IgA nephropathy itself. If there is a significant amount of proteinuria or a large formation of crescents in the glomeruli, the patient may need to use steroids and immunosuppressive agents to control the inflammatory response in the glomeruli. This is the fundamental approach to treating this disease. Second, symptomatic treatment is applied. For mild edema, no special treatment is generally required. However, for severe edema or even systemic edema, it may be appropriate to use diuretics to increase urine output, which can alleviate the patient's edema. However, this is not a solution to the root cause of the problem.
Is pyelonephritis easy to treat?
Pyelonephritis is generally not difficult to treat. Because the condition often appears quite aggressive, it is caused by bacteria entering the urinary system through the urethra, leading to an inflammatory response. Therefore, the primary treatment involves using antibiotics to kill the bacteria. Most of the bacteria causing pyelonephritis are Gram-negative rods, so antibiotics sensitive to Gram-negative rods are often chosen. After a treatment course of 10-14 days, the patient's condition is generally controllable and curable. However, there are also a few cases of chronic pyelonephritis, involving complex factors related to urinary tract infections, such as urinary tract malformations, urinary system stones, prostate hyperplasia, diabetes, etc., which make treatment more difficult. (Medication should be used under the guidance of a doctor.)
Is diabetic nephropathy dialysis painful?
Whether it is diabetes, nephritis, high blood pressure, or other causes leading to kidney failure, it may eventually progress to uremia. Patients with such conditions need dialysis or a kidney transplant to survive. Generally, patients undergoing any type of dialysis do not experience significant pain symptoms. Dialysis can be divided into hemodialysis and peritoneal dialysis, both of which use artificial methods to remove metabolic waste from the patient's body and maintain the stability of the internal environment. These methods generally do not involve significant traumatic procedures, so they mostly do not cause notable pain. However, patients undergoing hemodialysis may need temporary needling each time, which causes minimal trauma and typically does not result in severe pain or significant discomfort.
What should I do about tinnitus caused by uremia?
Tinnitus in uremia requires further consultation at the ENT department of a formal public hospital. Tinnitus is not a typical symptom of uremia and may not necessarily be related to kidney disease or caused by uremia. Some patients may experience tinnitus due to severe anemia, which leads to insufficient blood supply in the skull, or due to persistently high blood pressure caused by uremia, which can also potentially cause tinnitus. However, the probability of these scenarios is generally low, and it is still recommended that patients seek further consultation at an ENT department to clarify potential causes, such as infections or tumors in the inner ear system.
What are the characteristic manifestations of kidney cancer?
Kidney cancer is a type of malignant tumor. Patients with this disease may exhibit some clinical symptoms. Some patients experience dull pain in the lumbar and back area due to the large growth of the tumor, which compresses the renal capsule. As the tumor grows, it may rupture and bleed, causing the patient to have visible blood in the urine. This type of hematuria is often painless and consistent throughout; patients may also feel a mass in the abdomen. In the early stages of kidney cancer, many patients do not exhibit clinical manifestations or discomfort. Therefore, patients often only exhibit the aforementioned clinical symptoms in a more severe state, later in the progression of the disease.
Early symptoms of diabetic nephropathy
Diabetic nephropathy is divided into five stages. In the first and second stages, patients generally do not have significant proteinuria. At this time, the pressure inside the glomeruli increases, and the glomerular filtration rate actually increases, which may result in an increase in kidney size. During this period, patients generally do not have obvious symptoms, and it is difficult to detect without detailed examination. By the third stage, patients develop proteinuria, which increases as the disease progresses, and patients may notice an increase in urine foam. When diabetic nephropathy reaches the stage with proteinuria, a prominent clinical symptom is edema. This edema initially appears in the bilateral facial and lower limb areas. As the disease progresses, some patients may also experience generalized edema, and can develop effusion in the pericardium, thoracic cavity, and abdominal cavity. Symptoms such as chest tightness, shortness of breath, difficulty breathing, pulmonary edema, and heart failure may occur.
Symptoms of stage 2 diabetic nephropathy
Diabetic nephropathy is divided into five stages. Speaking in terms of the severity of the condition, in the second stage, the clinical manifestations are not very obvious, and the patient's kidney size may increase. Generally, at rest, the patient's urine protein is negative, but after activity, there might be traces of albumin in the urine. Due to the presence of a small amount of protein in the urine, there may be an increase in urine foam, and the patient may experience mild edema, although the symptoms of this edema are also not very noticeable. At this stage, the damage of diabetes to other organs of the body is not very evident, therefore, retinopathy is not severe, and the patient’s vision decline is not significant. The patient may also have concurrent issues like hypertension and hyperlipidemia.
How is hydronephrosis diagnosed?
Strictly speaking, hydronephrosis cannot be considered an independent disease; it is merely a descriptive term in imaging, and is the result of many causes and various etiologies. It occurs because urine produced by the kidneys cannot smoothly pass through the ureters and bladder to be excreted from the body, leading to fluid accumulation in the renal pelvis and calyces. This may be caused by prostate enlargement, tumors in the urinary system, urinary system stones, or chronic inflammation and scarring of the ureters. Generally, hydronephrosis can be detected through imaging techniques, including urinary system ultrasound or CT, which can confirm the diagnosis.
Can people with nephrotic syndrome eat strawberries?
Patients with nephrotic syndrome can eat strawberries in moderate amounts. Patients with nephrotic syndrome typically have urinary protein levels exceeding 3.5g in 24 hours, along with noticeable symptoms of edema. It is essential for these patients to control their intake of water, especially those with severe edema, as excessive water intake can further exacerbate the swelling. Additionally, patients should limit their intake of plant proteins, follow a low-salt diet, and avoid heavy consumption of oils and fatty foods. From the above perspectives, it is generally acceptable for patients with nephrotic syndrome to eat strawberries in moderation. Strawberries contain very little plant protein and will not increase urinary protein levels. Although strawberries do not contain much salt, patients with nephrotic syndrome still need to consume them in moderation due to their high water content.
Can chronic renal failure reproduce?
Patients with chronic renal failure, if they are male, can attempt to conceive under the guidance of a clinic doctor after discontinuing the use of medications that affect fertility; usually, there are no major issues for male patients. However, for female patients, attempting to get pregnant carries a significant risk because pregnancy increases the burden on all organs, including the kidneys, which can exacerbate kidney diseases, especially in cases like lupus nephritis. Nevertheless, not all patients with chronic renal failure are absolutely unable to conceive; some have successfully managed the risks associated with pregnancy. In such cases, it is necessary to weigh the pros and cons.