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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 contagious?
Acute nephritis is not contagious. Acute nephritis generally occurs after a patient has a bacterial inflammation of the respiratory tract, such as infections by streptococcus, staphylococcus, and other bacteria affecting the respiratory tract, urinary tract, digestive tract, or skin. This leads to a secondary inflammatory response. These inflammatory immune complexes travel through the bloodstream to the kidneys, causing an inflammatory reaction within the organ. It could also be due to the deposition of immune complexes within the glomeruli, leading to glomerular damage. This disease itself is not contagious. Although these bacteria exist as triggers, they typically do not have the capability to infect other patients. Moreover, even if they were to infect others, it would not necessarily lead to nephritis.
How to treat occult blood in IgA nephropathy
IGA disease is a pathological type of chronic glomerulonephritis. This type of glomerular lesion often leads to positive occult blood in urine, and in some cases, may even cause gross hematuria visible to the naked eye. However, the relationship between hematuria and the severity or prognosis of the patient's condition is not very clear, so clinically, hematuria is not considered as a treatment target. Generally, during the active phase of the disease, patients can be treated with corticosteroids and other medications, especially those with more than 1g of protein in a 24-hour urine collection. Otherwise, most patients choose ACE inhibitors or ARBs as antihypertensive drugs to reduce the pressure inside the glomerulus. Additionally, avoiding colds can also help reduce occult blood in urine. (Specific medications should be administered under the guidance of a physician)
What tea to drink for hydronephrosis
Before hydronephrosis is adequately treated and before the obstruction in the urinary system is resolved, in areas such as the renal pelvis and calyces where there is fluid accumulation, it is advised that patients should not drink tea and should try to reduce their fluid intake. This is because the fluids cannot be excreted through the kidneys, and drinking large amounts of water at this time could worsen the obstruction and may also lead to edema. Therefore, patients are advised not to drink tea until the hydronephrosis is resolved. Once the causes of urinary tract obstruction, such as urinary system stones or tumors, have been removed, patients can increase their water intake, but it is still recommended not to drink tea because tea contains considerable amounts of oxalate, which can lead to the recurrence of kidney stones.
How is nephrotic syndrome diagnosed?
Nephrotic syndrome is a general term for a group of clinical symptoms. Its primary diagnostic criteria include a 24-hour urine protein quantification of greater than or equal to 3.5 grams and plasma albumin less than or equal to 30 grams per liter; these two criteria are essential for the diagnosis of nephrotic syndrome. Meeting these criteria is sufficient for the diagnosis. There are also two additional supporting diagnostic criteria for nephrotic syndrome, which include possible symptoms of edema and hyperlipidemia. These four elements are the main clinical manifestations and diagnostic criteria of nephrotic syndrome.
Why does nephrotic syndrome cause sleepiness?
Excessive sleepiness is not a common clinical manifestation of nephrotic syndrome; generally, patients with nephrotic syndrome rarely exhibit excessive sleepiness. If a patient does display sleepiness, it is necessary to investigate the causes, such as a reduction in blood volume and decreased blood pressure caused by nephrotic syndrome, leading to insufficient cerebral blood supply. Furthermore, in cases of nephrotic syndrome, the patient’s immune capacity decreases, making them more susceptible to various infections, such as infections of the upper respiratory tract and lungs. When inflamed, patients are also likely to feel excessively sleepy. In some patients, there is a risk of cerebral infarction, which can also cause sleepiness.
Can diabetic nephropathy with swollen feet be treated?
Diabetic nephropathy in the middle and later stages can cause edema, especially in patients with significant proteinuria or renal failure. Many patients can even experience generalized edema. For such patients, swollen feet and swelling in other parts of the body can be considered for appropriate use of diuretics to increase urine output and eliminate edema. However, generally, the extensive use of diuretics is not actively advocated because excessive diuresis can also lead to significant protein loss and even cause insufficient blood volume, affecting the blood supply to the kidneys. Nevertheless, some patients with severe conditions that cause pulmonary edema and heart failure may not respond well to diuretics. In such cases, dialysis ultrafiltration may be required to remove water, alleviate edema, and reduce cardiac stress.
Kidney disease IgA means IgA nephropathy.
Kidney disease IgA, formally known as IgA nephropathy, is an immunological diagnostic term for chronic glomerulonephritis. It is characterized by the deposition of immune complexes, primarily IgA, in the mesangial areas of the glomeruli. IgA is a type of immunoglobulin, which upon deposition in the kidneys induces inflammatory responses, leading to proliferation of mesangial cells, accumulation of mesangial matrix, and widening of the mesangial area. This can cause damage to the glomerular filtration barrier, manifesting as proteinuria and hematuria. Some patients may also develop crescent formations in the glomeruli, leading to renal failure.
Can diabetic nephropathy undergo kidney transplantation?
Diabetic nephropathy has now become the leading cause of uremia in China, accounting for the largest proportion. In the 1980s and 1990s, chronic nephritis was the most common cause of uremia in China. Over the past decade, diabetic nephropathy has gradually surpassed chronic nephritis and become the leading condition. This condition requires dialysis or a kidney transplant when it progresses to uremia. Patients with diabetic nephropathy in a uremic state can undergo a kidney transplant. After the transplant, these patients still need to use medications to control their blood sugar and blood pressure, to prevent high blood sugar and high blood pressure from further damaging the new kidney. Of course, if conditions allow, performing a combined kidney and pancreas transplant might yield better results.
Can people with acute nephritis eat beef?
In the acute phase of nephritis, patients are generally required to have a light diet and minimize their protein intake, with their protein intake level being about 80% of that of a normal person. They should primarily consume animal-based proteins, which should account for more than 50% of their intake. This principle is called a high-quality, low-protein diet. Therefore, overall, patients with acute nephritis can eat beef, as it is considered a high-quality protein. However, the amount ingested needs to be limited. The intake of beef should be calculated based on the patient's body weight, with every 100 grams of beef containing 20 grams of protein. The total daily protein intake for patients should be 0.6 to 0.8 grams per kilogram of body weight, including both animal and plant proteins. Patients can use the aforementioned data to calculate how much beef they can eat.
What is the best treatment for hydronephrosis?
The so-called hydronephrosis often occurs due to some factor blocking the urinary system, causing urine to not be excreted normally. The most common cause is urinary system stones, but it can also be due to issues like tumors or benign prostatic hyperplasia. The treatment for stones depends on the size of the stone. Stones smaller than 5 millimeters in diameter can often pass naturally. If the stone is 7 to 15 millimeters in diameter, extracorporeal shock wave lithotripsy is typically used. If stones in the lower mid-ureter do not respond well to medication, retrograde removal under cystoscopy can also be performed. For some patients who have had a long-standing obstruction, renal function may already be impaired. If the obstruction cannot be relieved, surgeries such as creating a urinary diversion can be performed. This includes procedures like bladder fistulation, pyelostomy, or percutaneous ureterostomy, among others.