Subscribe
58
Li Liu Sheng
Nephrology
About me
Master, chief physician, deputy director of nephrology, master supervisor. Presided over and participated in 3 research projects, presided over a project that won the second prize of scientific and technological progress in Yichang City, won a third prize, published 26 papers in core journal magazines, and contributed to the compilation of a monograph "Urology". Member of the Hubei Biomedical Dialysis Engineering Society, youth member of the Hubei Nephrology Society, member of the Yichang Kidney Disease Quality Control Center.
Proficient in diseases
There is unique experience in the diagnosis and treatment of various chronic kidney diseases, including renal biopsy, central venous catheter placement, peritoneal dialysis, hemodialysis, etc.
Voices
How can vomiting be alleviated in chronic renal failure?
There are many reasons why patients with chronic kidney failure experience vomiting. To alleviate vomiting, it is first necessary to clarify the cause of vomiting. Generally, if vomiting is caused by an excess of toxins, dialysis treatment may be needed at this time. If it is due to chronic gastritis, drugs that protect the gastric mucosa are needed. Additionally, if it is due to electrolyte disorders, it is essential to correct the electrolyte disturbance to alleviate the symptoms of vomiting. Furthermore, if the vomiting is caused by an infection leading to gastroenteritis, anti-infection drugs are required. Also, some patients with chronic kidney failure may experience nausea and vomiting due to very high blood pressure, which can lead to increased intracranial pressure; in this case, it is necessary to control the blood pressure and reduce intracranial pressure.
Can IgA nephropathy affect menstruation?
IgA nephropathy is a very common glomerular disease in the department of nephrology and is often seen in adolescents, affecting both males and females. Generally, IgA nephropathy itself does not affect menstruation. However, if hormones or immunosuppressants are used during the treatment of IgA nephropathy, it may affect the menstrual cycle or the amount of menstrual flow. In other words, some patients with IgA nephropathy may experience delayed menstruation, reduced menstrual flow, or even increased menstrual flow while using these medications. Therefore, for patients with abnormal menstruation, it is important to report to the doctor in a timely manner and to actively undergo relevant examinations to rule out other causes. If there are no other factors, medication treatment can continue while regularly monitoring kidney function and changes in routine urine tests.
Symptoms of hydronephrosis
Hydronephrosis itself may not have any symptoms, but when hydronephrosis significantly increases, patients can feel soreness and discomfort in the lumbar region or upper abdomen. If the hydronephrosis is caused by urinary tract stones blocking the passage, patients often experience kidney pain and visible blood in the urine; if it is caused by congenital narrowing, it is prone to be complicated by urinary tract infections, with symptoms such as chills, fever, back pain, frequent urination, urgency, and painful urination. Sometimes, hydronephrosis occurs intermittently, with the patient experiencing abdominal pain, nausea, vomiting, and reduced urine output during an episode. The pain disappears after a few hours, followed by the excretion of a large amount of urine. This condition is often seen in ureteral obstruction. Of course, prolonged hydronephrosis can lead to renal failure, causing symptoms such as fatigue, poor spirit, anemia, and even swelling.
What should I do about the high fever caused by nephrotic syndrome?
Patients with nephrotic syndrome, due to long-term use of steroids, have particularly weak resistance and are prone to various infections. High fever is a common symptom in patients with nephrotic syndrome after an infection. Once a high fever due to infection occurs in nephrotic syndrome, it must be taken seriously because infections are often a significant trigger for the relapse or worsening of the condition. Once the condition worsens, patients often experience heavy proteinuria, hypoalbuminemia, edema, and declining kidney function. Therefore, it is crucial to go to the hospital in a timely manner after the onset of high fever for medical treatment, and to conduct routine blood and urine tests, kidney function tests, and chest X-rays to determine the cause of the patient's high fever, whether it is a viral or bacterial infection. Besides, it is important to drink plenty of water, urinate frequently, rest in bed, reduce outdoor activities, and avoid fatigue. If a viral infection causes the fever, antiviral medications that clear heat and detoxify should be used. If a bacterial infection causes the fever, sensitive antibiotics should be used for symptomatic treatment. (Medications should be used under the guidance of a doctor.)
Can IgA nephropathy hematuria heal itself?
Hematuria is the most common clinical manifestation of IgA nephropathy. As IgA nephropathy is a chronic disease and not self-healing, the hematuria associated with it does not resolve on its own and will repeatedly occur or exacerbate. Typically, patients with IgA nephropathy exhibit microscopic hematuria when the condition is stable. However, gross hematuria may appear during physical exertion or respiratory infections, such as pharyngitis. In addition, IgA nephropathy patients also show increased urinary protein and can experience elevated blood pressure. Back pain is also a common clinical manifestation in patients with IgA nephropathy, so there is no need to be overly concerned about the presence of blood in the urine.
What should I do about acute nephritis?
Once acute nephritis occurs, it should be actively treated. The measures for treatment are that during the acute phase, the patient should rest in bed. The bed rest period is generally 2-3 weeks, and continues until the patient's gross hematuria disappears, blood pressure returns to normal, and edema subsides. In addition to resting, it is also necessary to control salt intake in the diet, especially in cases with edema or high blood pressure, where daily salt intake should generally not exceed 3g. Protein should mainly come from lean meat, fish, eggs, and milk. Furthermore, strict management of water intake is crucial, especially in cases of oliguria, where water consumption should be minimized. Additionally, if there is an infection combined with these conditions, sensitive antibiotics should be used for treatment, usually advocating the use of penicillin-type antibiotics; if there is edema, diuretics can be appropriately used; if blood pressure is elevated, antihypertensive drugs can be used. Besides these, for severe acute nephritis patients who also suffer from acute renal failure, dialysis treatment might be necessary. (Medication use should be conducted under the guidance of a doctor.)
Is uremia serious in the early stages?
In the early stages of uremia, although the condition is not as severe as in full-blown uremia, the patient will still experience many uncomfortable symptoms. For example, after getting up in the morning, the patient may notice swelling in the eyelids on both sides, feel nauseous and have a significant decrease in appetite. They may also feel fatigued and tired after physical activity. Additionally, changes in the volume of urine occur, such as an increase in the frequency of nighttime urination to three to five times. Patients may also experience varying degrees of dizziness, headaches, and gradually increasing blood pressure that is difficult to control. Other symptoms include itchy skin and muscle soreness, among other clinical signs. Therefore, timely treatment in the early stages of uremia is necessary to slow the rapid progression of chronic kidney disease to the uremic stage.
Precursors of renal failure
The kidneys have a very strong compensatory ability. When kidney function is slightly impaired, many people do not have any uncomfortable symptoms and feel everything is normal. However, if one actively seeks out early signs, it is possible to detect precursors to kidney failure. At this time, if one can go to the hospital in time for routine blood tests, urine tests, and kidney function tests, it is possible to determine if there is kidney failure. The most obvious precursor symptom of kidney failure is usually general fatigue, which many people tend to overlook. This is because there are indeed many reasons that can cause fatigue, especially since many people attribute it to fatigue or stress factors. Additionally, many patients with precursors to kidney failure experience edema, particularly the kind that disappears after rest, so it is especially not taken seriously. Another symptom of kidney failure precursors is a significant increase in the frequency of urination at night, which is also often overlooked.
Acute nephritis etiology and pathogenesis
The primary cause of acute nephritis is related to antigen-antibody mediated immune damage. This means that when patients with acute nephritis are infected by streptococci, certain components within the streptococci can act as antigens and bind to corresponding antibodies produced in the body, forming immune complexes. These immune complexes circulate through the bloodstream and eventually deposit in the glomeruli. When the complement system is activated, inflammatory cells infiltrate, ultimately leading to the development of acute nephritis. Acute nephritis is a common group of primary glomerular diseases, characterized by a sudden onset, with hematuria, reduced urine output, proteinuria, edema, and hypertension as its most significant features. Once acute nephritis occurs, bed rest is usually required, along with active treatment. After treatment, most patients with acute nephritis can recover fully, with few recurrences.
Acute nephritis clinical manifestations
Acute nephritis is commonly seen in pediatric patients. One to three weeks before the onset of acute nephritis, infections often occur in the throat, upper respiratory tract, and skin. Once acute nephritis occurs, the typical clinical manifestations of the patient are hematuria, which can be gross hematuria or microscopic hematuria. There is also edema, especially noticeable swelling of the eyelids and face after getting up in the morning. Due to the edema and reduced urine output, the patient often experiences a significant increase in blood pressure. Of course, in addition to these clinical manifestations, the patient may also experience irritability, back pain, nausea, loss of appetite, and poor spirit. Patients with acute nephritis can also experience severe complications, such as hypertensive encephalopathy, acute heart failure, acute renal failure, etc. Therefore, acute nephritis must be given sufficient attention and actively treated.