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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.
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Causes of Uremia
Uremia is a syndrome caused by the progressive development of various chronic kidney diseases that ultimately leads to bilateral renal failure in patients, unable to timely remove excess water, electrolytes, and various toxins from the body. The causes of uremia are many and complex. Common causes include chronic nephritis, diabetic nephropathy, and hypertensive nephropathy. Other diseases such as chronic interstitial nephritis, chronic pyelonephritis, uric acid nephropathy, chronic obstructive nephropathy, renal vascular diseases, and hereditary nephritis can also lead to uremia. Once uremia occurs, patients often exhibit symptoms of general discomfort and may need to choose dialysis treatment, which can be either hemodialysis or peritoneal dialysis, depending on individual circumstances.
Does uremia cause fever in its early stages?
Fever is not an early clinical manifestation in patients with uremia; therefore, patients in the early stages of uremia do not exhibit fever. Typically, in the early stages of uremia, patients only show symptoms such as fatigue, poor spirit, lack of appetite, and easy fatigue, and may experience edema, such as swelling of the eyes and facial area after waking up in the morning, making it difficult for patients to open their eyes, and swelling of the lower limbs. In addition, patients also exhibit high blood pressure, such as increased systolic and diastolic pressures, which are difficult to control. Patients often exhibit clinical symptoms such as dizziness and headache. Patients also experience a significant increase in the frequency of urination at night and an increase in urine output, which are all early manifestations of uremia.
Is hydronephrosis of both kidneys serious?
Clinically, bilateral hydronephrosis is serious, as it can lead to expansion of the renal pelvis. Long-term bilateral hydronephrosis can compress the renal parenchyma, leading to the development of chronic obstructive nephropathy, and thus cause chronic renal failure. Additionally, because urine cannot be expelled from the body in a timely manner in bilateral hydronephrosis, it is easy to combine with bacterial infections, which can lead to acute pyelonephritis. Patients may experience chills, fever, and severe back pain, as well as hematuria and general fatigue. Therefore, it is essential to identify the cause of bilateral hydronephrosis and treat it based on the nature of the hydronephrosis. Usually, the causes of bilateral hydronephrosis are related to stones, but tumorous diseases, bladder stones, or urethral strictures are also common causes.
How is acute nephritis diagnosed?
The diagnosis of acute nephritis is actually not difficult, focusing on the following key points: 1. A history of upper respiratory or skin infections prior to the onset of the disease. 2. Typical manifestations of acute nephritis syndrome, including hematuria, proteinuria, reduced urine output, edema, and elevated blood pressure. Among these, hematuria is the most important basis for diagnosing acute nephritis, which can be gross hematuria or microscopic hematuria, and proteinuria can be mild or severe. 3. During the acute phase, there can be an increase in anti-O and a decrease in serum complement C3 concentration. 4. It commonly affects adolescents and children. 5. Most cases improve or even recover after four to eight weeks of treatment.
What are the symptoms of kidney cancer?
Kidney cancer is a common tumor in urological surgery, and a typical symptom in patients with kidney cancer is the appearance of hematuria. The characteristic of this hematuria is that it is painless visible hematuria throughout the course. Initially, the severity of the hematuria is relatively mild, occurring intermittently. However, over time, the hematuria gradually worsens, and the intervals shorten, even leading to significant bleeding. Another symptom of kidney cancer is back pain, which is caused by the increased size of the tumor pulling on the kidney, causing pain. When the tumor presses, it can also lead to severe back pain. A mass is another common symptom of kidney cancer; when a mass is felt on one side of the upper abdomen or back and moves up and down with respiration, it is generally indicative of the late stages of kidney cancer. Therefore, the typical symptoms of kidney cancer are hematuria, pain, and a mass.
How to reduce swelling in the feet caused by nephrotic syndrome?
Swelling of the feet is a common phenomenon in nephrotic syndrome. Once swelling occurs, patients feel uncomfortable symptoms and a sensation of heaviness in their feet, so corresponding de-swelling treatment is necessary. How to reduce swelling? Firstly, a low-salt diet is essential to control salt intake, with daily salt consumption around 2 to 3 grams. In addition to this, small doses of diuretics such as hydrochlorothiazide and spironolactone can be used. If the diuretic effect is not satisfactory, other more potent diuretics like furosemide may be added. Of course, the fundamental treatment for foot swelling in nephrotic syndrome involves the use of steroids and immunosuppressants. This treatment works by suppressing the permeability of the glomerular basement membrane and reducing protein leakage, thereby ultimately eliminating the foot swelling.
How long does acute nephritis require bed rest?
Acute nephritis is commonly seen in children. Once acute nephritis occurs, the main clinical manifestations in patients typically include hematuria, which can be visible or microscopic. It is also accompanied by varying degrees of edema, elevated blood pressure, and even transient renal failure. As for how long patients with acute nephritis need to stay in bed, current studies suggest a minimum of 2-3 weeks of bed rest. If the patient’s hematuria disappears, urinary protein decreases, and edema subsides, they can gradually start moving out of bed. If the condition remains stable, activities can shift from indoors to outdoors. However, if visible hematuria reoccurs, or if edema reappears after activity, it is necessary to continue bed rest for another 4-6 weeks. Therefore, students suffering from acute nephritis often need to take a leave of absence from school and should be closely monitored for changes in their condition under a doctor's guidance.
Can patients with IgA nephropathy eat beef?
Diet plays a very important role in the treatment of IgA nephropathy patients. For IgA nephropathy patients, the general dietary requirement is to eat a light diet, avoid spicy foods, and avoid fried foods. IgA nephropathy patients can eat beef. Beef contains animal protein, which is a high-quality protein with essential amino acids that are easily absorbed and utilized by the human body. Of course, if IgA nephropathy patients have normal kidney function, there aren't too many restrictions on their diet compared to healthy individuals. They should mainly consume fresh vegetables and fruits, and avoid pickles, salty vegetables, and fermented vegetables. If there is accompanying kidney dysfunction, it is advisable to minimize the intake of plant proteins and limit the consumption of plant-based proteins such as soy products.
How to treat acute nephritis?
Acute nephritis is commonly seen in children. The most typical clinical manifestations of acute nephritis include macroscopic or microscopic hematuria, increased urinary protein, and varying degrees of edema, particularly noticeable in the eyelids and facial areas. There may also be varying degrees of increased blood pressure, and even renal failure can occur. In terms of treatment, there are no specific drugs for acute nephritis; the main approach is symptomatic and supportive treatment. During the acute phase, patients should rest in bed and receive targeted treatment for their complications. If there is severe edema, diuretics may be used appropriately. If there is a significant increase in blood pressure, antihypertensive drugs should be used to control the pressure. In cases of severe heart failure, palpitations, chest tightness, and shortness of breath, diuretics should also be used to alleviate the cardiac load. If the patient experiences oliguria, hyperkalemia, or acute renal failure, temporary dialysis may be necessary. Furthermore, a low-salt, low-fat, and light diet should be maintained to prevent complications from excessive salt intake causing edema and high blood pressure. (Use of medications should be under the guidance of a doctor.)
IgA nephropathy stages 1, 2, 3 criteria
According to the standards of the World Health Organization, IgA nephropathy is classified into five stages pathologically. The first stage is where most glomeruli appear normal under light microscopy, with only minor mesangial proliferation or associated cellular proliferation, generally showing slight changes without damage to the tubules and interstitium; The second stage indicates mild lesions where over fifty percent of the glomeruli are normal, with only a small portion of the glomeruli showing mesangial cell proliferation, glomerular sclerosis adhesion, and other changes, without the formation of crescents; The third stage is focal segmental glomerulonephritis, characterized by diffuse proliferation of mesangial cells and widening of the mesangial areas, with the lesions exhibiting focal segmental changes and comparatively mild interstitial lesions.