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Chronic kidney failure
What should I do about coughing caused by chronic kidney failure?
Patients with chronic renal failure who experience coughing should first analyze whether it is caused by an infection. In such cases, routine blood tests and chest CT scans are needed to confirm whether there are any infectious lesions in the lungs. Additionally, it should be checked whether the patient has systemic lupus erythematosus, vasculitis, or other conditions, as these diseases can affect the lungs and cause pulmonary lesions leading to coughing. Therefore, treatment should be targeted based on the cause. If the cough is due to an infection, antibiotics are required, but the dosage must be adjusted according to the patient's kidney function. If the cough is due to pulmonary changes caused by a systemic disease, targeted treatment for the systemic disease is needed.
Principles of Treatment for Chronic Renal Failure
The principles of treatment for chronic renal failure include early-stage non-dialysis conservative treatment as well as end-stage renal replacement therapy. Non-dialysis conservative treatment includes delaying the progression of kidney damage, which requires treating the primary disease, implementing nutritional support, and controlling factors that accelerate kidney disease progression, such as controlling high blood pressure, proteinuria, and hyperlipidemia. Additionally, it is necessary to eliminate metabolic waste from the body, and maintain the body's water, electrolyte, and acid-base balance. Renal replacement therapy includes hemodialysis, peritoneal dialysis, and kidney transplant therapy.
Chronic renal failure inevitably has symptoms.
Patients with chronic kidney failure do not necessarily have symptoms, and the symptoms of each patient are not exactly the same. Chronic kidney failure refers to the damage to the kidneys by various chronic kidney diseases, eventually leading to the kidneys' inability to adequately excrete metabolic waste, causing the accumulation of water and metabolic waste in the body. This leads to disturbances in the patient's electrolytes and may also present clinical symptoms such as anemia and hypertension. However, not all patients feel discomfort, so chronic kidney failure is also known as the silent killer. If a patient undergoes a blood test, it will show an increase in blood creatinine and urea nitrogen, which is the only common feature among all patients with chronic kidney failure.
Symptoms of Chronic Kidney Failure
The clinical symptoms of chronic renal failure mainly include symptoms related to disturbances in electrolyte and acid-base balance, as well as symptoms of metabolic disorders of proteins, carbohydrates, fats, and vitamins. There are also manifestations in various organ systems, including the cardiovascular system, respiratory system, gastrointestinal tract, hematologic system, neuromuscular system, endocrine system, and bone lesions. Metabolic acidosis is common; patients may also exhibit water and sodium retention or hypovolemia and hyponatremia. Potassium metabolism disorders are often characterized by hyperkalemia, while disturbances in phosphorus and calcium metabolism are mainly manifested as hyperphosphatemia and calcium deficiency. Patients may also show cardiovascular manifestations, primarily hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms in patients may include loss of appetite, nausea, and vomiting. Additionally, renal anemia and a tendency to bleed are common, and skeletal changes are quite frequent, leading to malnutrition of bones, osteomalacia, and osteoporosis.
What medicine is used for chronic renal failure?
The treatment of chronic renal failure primarily requires identifying the cause and treating it accordingly. Chronic renal failure refers to the state in which various diseases damage the kidneys, leading to the destruction of kidney tissue and resulting in the kidneys' inability to adequately excrete metabolic waste, causing an accumulation of such wastes in the body. There are no medications that can directly affect the kidneys, regenerate kidney tissue, and restore kidney function. Currently, medicine cannot achieve this, and there are no specific drugs for the treatment. Therefore, the treatment of chronic renal failure focuses on treating the primary disease to slow the progression of renal failure. For example, chronic renal failure caused by diabetes necessitates the use of insulin to control blood sugar, while patients with hypertension need to use antihypertensive drugs.
What should I do about edema from chronic renal failure?
Chronic renal failure often leads to edema, which is a common symptom associated with the decreased ability of the kidneys to excrete water, resulting in significant water retention in the body. There are two treatment options for this disease. First, medication can be used, typically diuretics such as loop diuretics. After administration, the patient's urine output increases, which can help reduce edema. Second, for patients who do not respond well to medication, and in cases where edema leads to heart failure or pulmonary edema, dialysis treatment may be considered. Through dialysis ultrafiltration and dehydration, edema can also be alleviated.
Chronic Renal Failure Clinical Manifestations
Patients with chronic renal failure may exhibit fatigue, which is mainly due to anemia. Patients with stage three or higher chronic renal failure generally have anemia, which can lead to symptoms such as fatigue, palpitations, and pallor. Additionally, patients may experience nausea and vomiting, which are primarily caused by an increase in toxins. Furthermore, patients may also exhibit symptoms such as edema and shortness of breath, as individuals with chronic renal failure typically experience reduced urine output. A higher intake than output over time can lead to an increased circulating blood volume, resulting in heart failure.
Does chronic renal failure require dialysis?
Not all cases of chronic renal failure require dialysis. It is only considered when chronic renal failure progresses to an advanced stage, causing severe consequences, and the kidneys are unable to maintain normal body functions, leading to many complications. Generally, when chronic renal failure progresses to its final stage, i.e., uremia, the kidney function is left with about 10% capacity. The body then experiences a disruption in its internal environment, including the accumulation of a large amount of metabolic waste, serious electrolyte disorders, and severe metabolic acidosis. It is at this point that dialysis is considered. In the early stages of chronic renal failure, dialysis is not necessary.
Can chronic renal failure be cured?
Chronic kidney failure is irreversible and incurable, with no possibility of kidney function recovery. There are many causes of chronic kidney failure, commonly including diabetic nephropathy, hypertensive nephropathy, chronic nephritis, polycystic kidney disease, etc. These causes affect the kidneys over the long term, resulting in extensive damage to kidney tissues. Since kidney tissues cannot regenerate, chronic kidney failure is incurable and irreversible. Patients with chronic kidney failure still require treatment to control the underlying causes leading to the condition, aiming to slow down the progression of the disease as much as possible, prolong the patient’s life, and ensure the quality of life. This is the primary goal of treatment.
What is best to eat for chronic renal failure?
Patients with chronic renal failure are advised to adopt a low-salt, low-fat, and high-quality protein diet. For those not undergoing dialysis, protein intake should be strictly controlled to 0.6 to 0.8 grams per kilogram of body weight per day. Additionally, patients with stage 3 CKD or above often experience electrolyte disorders, such as hyperkalemia, which can lead to cardiac arrest and arrhythmias. Therefore, it is important to avoid foods high in potassium, such as bananas, oranges, dates, kiwis, and tomatoes. Due to the strict protein intake, hypoproteinemia may occur, and these patients are also prone to hyperphosphatemia. It is recommended to choose foods with a low phosphorus to protein ratio, generally those with a ratio below fifteen. After starting dialysis, the same principles apply, but protein intake can be slightly increased, as some protein is lost during both hemodialysis and peritoneal dialysis. The protein intake can be adjusted to 1.0 to 1.2 grams per kilogram of body weight per day, while still controlling phosphorus and potassium intake.