Chronic kidney failure

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Written by Li Liu Sheng
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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What is the blood pressure in chronic renal failure?

High blood pressure is a common complication of chronic renal failure, with about 70 to 80 percent of patients experiencing elevated blood pressure. Controlling blood pressure is also an important aspect of the treatment of chronic renal failure. Generally, it is best for such patients to keep their blood pressure below 130/80 mmHg, with systolic pressure below 130 mmHg and diastolic pressure below 80 mmHg. If a patient’s 24-hour urinary protein quantification exceeds 1 gram, the blood pressure control requirements are even more stringent, ideally below 125/75 mmHg. Adequately controlling blood pressure also helps to slow the progression of chronic renal failure.

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Written by Niu Yan Lin
Nephrology
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Diet for Patients with Chronic Renal Failure

Patients with chronic kidney failure should first pay attention to a low-salt and low-fat diet, with daily salt intake less than six grams, and try to eat less salty food such as pickled vegetables and preserved products. Additionally, due to the impaired excretion of potassium and phosphorus in patients with chronic kidney failure, it is necessary to eat less high-phosphorus and high-potassium foods. Common high-phosphorus foods include various marinated meats and other processed foods, and common high-potassium foods include fruits such as bananas, peaches, mangoes, and vegetables like green vegetables and potatoes. At the same time, it is important to maintain a high-quality, low-protein diet. If dialysis treatment has not yet been started, protein intake should be controlled at 0.6 grams per kilogram of body weight per day. If dialysis treatment has already begun, the standards can be appropriately relaxed.

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Written by Zhou Qi
Nephrology
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Chronic Renal Failure Treatment Plan

The treatment of chronic renal failure primarily requires a clear understanding of the cause, and treatment targeting the cause is essential to slow the progression of chronic renal failure. The most common causes of chronic renal failure are diabetes, hypertension, and chronic nephritis. Therefore, for patients with chronic renal failure caused by diabetes, insulin is often needed to control blood sugar. For patients with hypertensive kidney disease, antihypertensive drugs are certainly necessary to control blood pressure. However, in the early stages of renal failure, ACE inhibitors or ARBs are the preferred choices. For patients with chronic nephritis in the early stages, corticosteroid medications are required for treatment. However, if the serum creatinine has already exceeded 256 micromoles per liter, treatment then focuses mainly on managing complications, and corticosteroids are no longer used. (Please use medications under the guidance of a doctor.)

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Written by Zhou Qi
Nephrology
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Can patients with chronic renal failure have sexual intercourse?

Patients with chronic renal failure can have sexual intercourse, but there are prerequisites. Since sexual activity is physically demanding and requires adequate cardiopulmonary function, patients can engage in sexual activity if they do not experience chest tightness or shortness of breath and their blood pressure is well controlled. If there are no obvious symptoms of fatigue, difficulty breathing, or chest tightness during sexual activity, there should be no significant problems. However, since the patients have chronic renal failure, it is advisable to avoid conception unless prepared for pregnancy. Pregnancy can further burden the kidneys in female patients and potentially exacerbate chronic renal failure. Male patients with chronic renal failure may be taking medications that could affect sperm quality. Therefore, contraception should be practiced unless preparations have been made.

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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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What are the symptoms of chronic kidney failure?

Chronic kidney failure generally may have some clinical symptoms, but many patients do not have any discomfort. Some common clinical symptoms mainly include increased urine foam and decreased urine output. Due to the decline in renal function for urine excretion, it can lead to edema, particularly in areas such as both ankles and the face. In the state of renal failure, patients may also experience hyperkalemia and metabolic acidosis. Due to metabolic acidosis, patients might exhibit deep and labored breathing. In the advanced stages of kidney failure, patients may suffer from renal anemia, leading to fatigue and potentially experiencing bone pain and susceptibility to fractures due to renal osteodystrophy.

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Written by Zhou Qi
Nephrology
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Can chronic renal failure become pregnant?

Although patients with renal failure are not absolutely unable to become pregnant, pregnancy is ultimately a burden on the kidneys. Pregnant patients with renal failure may experience further deterioration of kidney function and may face numerous complications during pregnancy, such as heart failure, severe anemia, etc., which may pose some risks. However, there are still very rare case reports, including successful pregnancies in patients on dialysis for uremia, but the probability of this is extremely small, and the risks involved are too great. Generally speaking, it is not recommended for female patients with chronic renal failure to become pregnant.

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Written by Zhou Qi
Nephrology
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Chronic Kidney Failure Various Indicators

In patients with chronic kidney failure, the primary indicator to observe is obviously kidney function. It is essential to regularly monitor the patient's blood creatinine and urea nitrogen levels, which are generally required to be tested every 1 to 3 months when chronic kidney failure is stable. Additionally, urine output should be monitored. If there is a decrease in urine output and swelling occurs, it may indicate that the patient's kidney function is continuously deteriorating. A complete blood count should also be checked to observe changes in the patient's anemia status. Chronic kidney failure often causes hypertension, so blood pressure monitoring is also necessary for these patients. Electrolyte monitoring is important as kidney failure can lead to disturbances in calcium and phosphorus metabolism and subsequent secondary hyperparathyroidism. Therefore, the levels of calcium, phosphorus, and parathyroid hormone also need to be tested.