Indiscriminate use of drugs can cause acute renal failure

Speaker: Deputy Chief Physician, Department of Nephrology, Zhongda Hospital, Southeast University

Debilitating, nausea, itching, coma... These symptoms may be caused by acute kidney failure. Acute renal failure refers to a sudden or continuous decline in glomerular filtration rate, which causes retention of nitrogen waste, imbalance of water, electrolytes and acid-base balance, leading to clinical complications of various systemic complications. Acute kidney failure severely damages the kidney, which requires more attention and prevention. It is the first step to recognize its cause.

Three major causes of renal failure

The causes of acute renal failure are various and can be divided into three categories: prerenal, renal and post-renal. Prerenal acute renal failure refers to the reduction of effective circulating blood volume in the blood vessels caused by various prerenal factors, the sharp decrease of renal blood flow, the strong contraction of renal blood vessels, the insufficient perfusion of renal cortical blood vessels, and the decrease of glomerular filtration rate. The reasons are: low blood volume, loss of digestive tract fluid, such as vomiting, diarrhea leading to dehydration; large blood loss; severe burns, trauma and other fluid loss; cardiovascular disease; renal vascular obstruction; renal vascular dynamics self-regulation disorder.

The cause of post-renal acute renal failure is mainly acute urinary tract obstruction. Only the urinary tract can ensure the normal function of the urinary system. Acute urinary tract obstruction increases the pressure above the obstruction, affecting the secretion and excretion of urine, and even hydronephrosis. The renal parenchyma is pressed to cause a sharp decline in renal function and cause renal failure.
Renal acute renal failure refers to renal parenchymal injury, which is usually caused by renal ischemia or nephrotoxic substances, and renal tubular epithelial cells, including renal glomerular disease, renal vascular disease and interstitial lesions.

Five "culprits" in life

The above causes are very serious and seem to be far away from us, but many pathogenic factors are hidden in our daily lives. The following five "culprits" have to be prevented.

Improper medication. Many medicines can't be eaten or eaten often, otherwise it will cause a huge burden on the kidneys, and even lead to kidney damage and kidney failure. The first category is antibiotics. The most toxic is aminoglycosides, such as gentamicin, kanamycin, and neomycin, which have direct nephrotoxicity. Followed by β-lactams, such as cephalosporins and penicillins. There are also sulfonamides, which are easy to precipitate crystals in the renal tubules, causing symptoms such as hematuria, dysuria, and urinary closure. When taking sulfa drugs, it is necessary to add bicarbonate or citrate to alkalize the urine, while drinking plenty of water to increase the amount of urine, elderly and renal dysfunction should be used with caution.

The second category is antipyretic analgesics, which are over-the-counter medications and are generally available at pharmacies. Many people have headaches, joint pains, or rheumatoid arthritis, traumatic arthritis, and cervical spondylosis. People who have low-dose, short-term, and no kidney disease have little problem with analgesics, but those who have poor kidney function may have great damage to the kidneys after taking them.

The third category is contrast agent, which is mainly based on CT enhancement and coronary angiography. Contrast kidney disease is increasingly common. People with poor kidney function are high-risk groups. It is necessary to pay attention to assessing whether it is suitable for angiography, what kind of contrast agent is used, and avoiding continuous angiography or high-dose angiography.

Another thing to be reminded is that the general population uses safe drugs or drug doses within a safe range, and can also damage the kidneys when applied to children and the elderly. Therefore, when the elderly and children are ill, under the guidance of a doctor, try to choose a drug with low toxicity; be sure to follow the doctor's advice, do not blindly increase the dose or extend the medication time. If side effects or kidney damage occur, stop taking the medicine and seek medical attention.
Abuse of whitening cosmetics. The ingredients of cosmetics on the market are usually complicated. In order to achieve the effect of rapid whitening and rapid freckle, merchants will add lead, mercury and other toxic substances to cosmetics. Once inhaled, absorbed, and deposited in the kidneys, these harmful substances cannot be excreted and accumulated in the kidneys to cause damage. Once the glomeruli and renal tubules are destroyed, it is difficult to recover as ever.
Excessive exercise. Although the movement is good, you can't "use too much force." Especially in high-temperature weather, severe exercise, sweating, rain, can cause severe ischemia of the kidneys, can not maintain the balance of body fluid electrolytes and excretion of metabolites, causing hyperkalemia, metabolic acidosis and uremic syndrome.

Mistaken fish gall. Many people have symptoms of blistering in their mouths, squatting on their faces, etc. When they hear that fish broth can clear their eyes, they go to buy grass carp and take the fish to swallow. This directly leads to vomiting and diarrhea, chest tightness and palpitation, decreased urine output, severe liver and kidney indicators, electrolyte imbalance in the body, and severe acidosis, which are usually diagnosed as acute renal failure. From the perspective of Chinese medicine, fish bile does have the effect of clearing away heat and detoxifying, clearing the liver and clearing the eye, but it must be properly treated and taken with caution. If not eaten properly, the fish gall bladder is like arsenic, and its bile toxin hydrocyanic acid can cause poisoning, acute kidney damage and kidney failure.

Old sugar friend. The kidney function of human beings gradually declines after the age of 40. The kidneys of patients with diabetes and hypertension suffer damage every day, and the resistance of diabetic patients is prone to urinary tract infection. Under the combined effect of these several reasons, the elderly sugar friends Prone to acute renal failure.

Active treatment, strengthen nursing

Acute renal failure must first correct the cause of reversibility. For all kinds of severe trauma, heart failure, acute blood loss, etc. should be treated accordingly, including expansion, correction of blood volume deficiency.

Second, maintain the patient's water, electrolytes and acid-base balance. Strictly calculate the patient's 24-hour liquid intake and withdrawal, and follow the principle of “pay-as-you-go” when refilling.

Again, once signs of infection appear, active antibiotics should be actively used.
In addition, blood purification plays a key role in the treatment of acute renal failure, and has a good effect on correcting symptoms such as azotemia, heart failure, severe acidosis and encephalopathy.

Daily care plays an important role in the recovery of patients with acute renal failure. Patients in recovery period should be absolutely bed rest, keep quiet, reduce the burden on the kidneys; patients with lower extremity edema should raise the lower limbs; for patients with conscious disorders, extra bed guardrails; comatose should be routinely treated according to comatose patients; pay attention to personal hygiene To keep the skin clean and strengthen oral care; for bedridden and weak patients, it should be turned over regularly to prevent pressure sores and lung infections; when the amount of urine increases and the condition improves, the patient can gradually increase the amount of activity so as not to feel tired. .

Does carbonated beverages contain phosphate that can cause kidney failure?

Summer has arrived, and carbonated drinks have become an option for many people to quench their thirst. However, an article appeared in a circle of friends recently that carbonated drinks contain a lot of phosphate, which can cause kidney disease. If you drink too much, it will cause kidney failure. Is this true?

Does carbonated beverages contain phosphate that can cause kidney failure? fake!

In fact, phosphorus is also one of the essential elements of the human body.
According to the World Health Organization's assessment, the maximum daily tolerance of phosphorus to adults is 70 mg / kg body weight. The body's absorption of phosphorus is mainly derived from phosphorus brought by natural phosphorus foods and food additives. The assessment also specifically pointed out that under the premise of high calcium diet, the body's tolerance to phosphorus absorption will be higher.

According to the “Reference Intake of Dietary Nutrients of Chinese Residents” (2016 edition), the tolerance for daily intake of phosphorus in Chinese adults is 3500 mg/day. The standard states that this intake does not harm health for almost all individuals in the general population. The phosphorus content of a can of carbonated beverage is about 40 mg. According to the standard, if the intake of phosphorus exceeds the standard to damage the kidneys, then at least 85 cans of carbonated beverages should be consumed in one day.

The main problem of carbonated beverages is that the sugar content is high, the body's intake of sugar is too high, it is easy to cause obesity, leading to obesity-related nephropathy, and even more serious consequences. You should control the intake of carbonated drinks, drink as much water as possible, and be good for your health.

About the consumption tips of carbonated drinks

1. Scientific purchase of carbonated drinks

Carbonated beverages are divided into juice type, fruit type, cola type and other types. The national standard "carbonated drinks (soda)" (GB/T10792-2008) stipulates that the juice content of juice-type carbonated drinks must be greater than 2.5%. The carbon dioxide gas capacity (20 ° C) is not less than 1.5 times. Once the carbonated beverage is opened, carbon dioxide will escape and affect the taste of the beverage. Consumers should choose packaging products of different specifications according to their needs.

2, carbonated drinks can not be frozen

The solubility of carbon dioxide in the carbonated beverage after freezing in water is lowered, which causes a large amount of gas to be precipitated from the water, causing excessive pressure in the container. A closed container will first deform and may cause an explosion and danger.

3, carbonated drinks can not be over-drinked

Children and adolescents are one of the main consumer groups of carbonated beverages. Since carbonated beverages generally contain about 10% sugar, the calories are high, and it is easy to cause obesity when drinking frequently, which affects the growth and development of adolescents. Therefore, it is important not to over-optimize carbonated beverages, especially for adolescents at the development stage, to drink as little as possible.

Peritoneal dialysis patients, control water, salt and potassium

Professor Yang Hongtao mentioned that "while the patient is controlling the water and salt intake, it is also important to note that potassium intake is also the key. Do not forget to limit potassium in controlling water and salt."

Control salt from starting or not entering high-salt foods

Patients with peritoneal dialysis due to insufficient metabolism of the kidneys, excessive intake of salt or salty foods, easily lead to edema, so experts recommend that patients with peritoneal dialysis should try not to enter or reduce high-salt foods in daily life, for salt intake It is best to control between 3-6g per day. Patients can use vinegar, onions, garlic, pepper, mustard, etc. instead of salt. Some foods high in sodium, such as salt, monosodium glutamate, soy sauce, oyster sauce, soybean meal, etc., and all preserved processed foods (salted vegetables, canned food, ham, etc.) should be eaten or not eaten. Patients with peritoneal dialysis should note that all sauces are high-salt foods such as chili sauce, bean paste, salad dressing, and ketchup. For these sauces, patients with peritoneal dialysis should also avoid it.

Controlling salt is more than just salt, and limiting potassium is also key.

Professor Yang Hongtao mentioned that many patients with peritoneal dialysis are more cautious about the intake of edible salt, but many patients still choose salt instead of salt. For this practice, Professor Yang Hongtao made a negative opinion. The main component of the salt is potassium chloride, which is actually a potassium salt. The concept of salt limitation should not only stay in the aspect of salt, but should include components such as potassium salts that accumulate in the body and cause edema in patients with kidney disease. Therefore, the intake of potassium should also be controlled.

How to control the intake of potassium? Professor Yang Hongtao's answer is: patients with daily urine output of less than 1000ml and edema must limit potassium intake.

Potassium limit can be started from the following aspects:

1. Limit the consumption of fruits and juices, vegetables and vegetable juices;

2, to avoid raw vegetables or drink soup, vegetables should be cut into small pieces before the water and then fry;

3, high potassium content foods can be reduced by freezing, water soaking or discarding the soup;

4, no vegetable soup or broth bibimbap;

5, boiled vegetables for 3 minutes and then fry;

6. After the potato is sliced, the juice is poured off after 20 minutes of soaking;

7, do not use low potassium salt, thin salt soy sauce, salt;

8. Ultra-low temperature chilled foods contain 1/3 less potassium than fresh foods.

Foods high in potassium are:

Phosphorus, low potassium and high food: spinach, canola, bananas, oranges, moderate juice, potatoes, tomatoes, lentils, radishes.

High-phosphorus and high-potassium foods: soybeans (green beans, soybeans, black beans), lean meat. Miscellaneous beans, mushrooms, peanuts, and melon seeds.

Professor Yang Hongtao told us that controlling water and salt is of great benefit to patients with kidney disease. For patients with peritoneal dialysis, the control of water and salt, blood pressure is reduced, can reduce the use of oral antihypertensive drugs, saving medical expenses; on the other hand, control the water salt, reduce the capacity load, and maintain blood pressure at a normal level Better protects residual kidney function. Therefore, patients with peritoneal dialysis must not neglect to limit the intake of water and salt. Of course, don't forget that salt limitation is not only salt, but potassium is also very important.

Tips of Food Supplement for Kidneys - black food to help kidney?

The term “kidney health” is believed to encompass health issues that many friends are very concerned about. More and more friends have kidney deficiency, which has caused great impact and harm to the body. I believe everyone knows that "it is a three-point drug." Taking drugs for a long time will actually affect the kidneys.
In addition, recuperation is also critical for kidney deficiency. In life, we may wish to pay more attention to the small tricks of supplementing the kidney. In order to eliminate the inner small question mark, let's take a look at the method of supplementing the kidney.

Is there any tip to supplement your kidneys?

First, the diet is light, away from heavy taste

In the first place, we must pay attention to the lightness of the diet. Because in our life, if you want to effectively regulate and nourish, then you must try to avoid heavy foods. In addition, during the process of drinking soup, you are advised not to Drinking too thick soup, this situation will cause a certain burden on the kidneys.
Second, ginseng, kidney two treasures

The quickest way to tonify the kidneys is to use goji berries which can really play a good conditioning role, in addition to ginseng also has the same kidney function, but the choice of these two foods, it is recommended that you choose a reliable food source buy.

Third, black food, do not look at things

In addition, I believe that female friends know that black food is very comprehensive for tonifying kidney. It contains trace elements needed by the human body and can be quickly absorbed by the body. The most common ones are black beans, black rice and black sesame seeds.

Fourth, rich in protein, should regulate the body

In addition, everyone can eat some high-protein foods properly. It is recommended that you eat more soy products in your life. These foods can be quickly absorbed by the human body and will not cause overnutrition. The food is well digested, and naturally it will not cause a big burden on the kidneys.

Effective kidney, can not be separated from the nutritional balance. Excessive vegetarianism is not advisable, because excessive eating of vegetarian food may make the body malnourished, nutrition is not sufficient, and how to regulate the kidneys? In life, the combination of vegetarian diet is the right choice for eating. Eating a small amount of carbohydrates and meat is quite beneficial for conditioning kidney.

How to find diabetic nephropathy in time

Diabetic nephropathy is one of the microvascular complications of diabetic patients, and its incidence is slow. Because patients do not have any symptoms in the early stage, when they go to the hospital for examination, they often develop protein in the urine or serum creatinine has increased. Therefore, diabetic nephropathy should be discovered in time, and early diabetic nephropathy can only be detected early through regular monitoring. Currently, a more authoritative method for screening early diabetic nephropathy is to detect 24-hour urinary microalbumin quantification.

24-hour urine microalbumin quantitative standard for patients with diabetic nephropathy

Normal people's 24-hour urinary microalbumin quantitation is less than 30 mg. If the diabetic patient has a 24-hour urinary microalbumin quantification of 30 mg to 300 mg for 2 consecutive months, the urinary microalbumin should be detected in time. The reason is that if the patient is caused by other causes, it belongs to early diabetic nephropathy.

If the 24-hour urinary microalbumin is more than 300 mg, then enter the clinical diabetic nephropathy, where urine can show protein.

Method of taking 24-hour urine specimens

The method of taking 24-hour urine specimens is to urinate at 7:00 on the first day, and then urinate again at 7:00 the next morning to collect all the urine during the first day, and the urine at 7:00 on the first day is not recorded. The urine at 7 o'clock the next morning must be recorded. After mixing, take the total amount of urine and record it, then take a small cup of urine and send it to the hospital for testing.

What factors form diabetic nephropathy?

Everyone knows that diabetic nephropathy is one of the many complications of diabetes. The most important symptom is the presence of glomeruli in the kidneys, which are prone to deterioration. Once this symptom is discovered, it will be advanced. So what factors form diabetic nephropathy? Let us take a look at the factors that form diabetic nephropathy.

The factors that form diabetes are as follows:

First, genetic factors

Most patients with diabetes will eventually not have kidney disease, but some patients with good long-term glycemic control may also have diabetic nephropathy, mainly due to the formation of major glucose transporters on mesangial cells.

Second, high blood sugar factors

Most diabetic nephropathy is closely related to hyperglycemia. When the patient's blood sugar control is poor, hyperglycemia and glycosylation end product production increase, causing mesangial cell proliferation, extracellular matrix, mesangial expansion, The glomerular basement membrane is thickened, etc., thereby promoting the occurrence of diabetic nephropathy.

Third, the factors of hypertension

Although there is no direct relationship between hypertension and diabetic nephropathy, the increase in blood pressure during the microalbuminurial period of the original hypertension course can accelerate the deterioration of renal function in patients with diabetic nephropathy, thereby inducing diabetic nephropathy.

Fourth, renal hemodynamic abnormal factors

Renal blood flow factors play a very important role in the development of diabetic nephropathy, and may be a starting factor. The specific analysis is generally carried out from the following four situations:

1. When hyperglycemia, the capillary wall pressure increases, promotes the expansion of mesangial cells, the epithelial cell foot processes fuse and produce dense droplets, and the glomerular epithelial cells fall off the basement membrane, resulting in high perfusion in the glomerulus. High filtration state.

2, glomerular basement membrane type IV collagen messenger nucleic acid increased, to thicken the basement membrane, and finally form a diffuse, nodular lesion of the mesangium, resulting in glomerular sclerosis.

3. In the case of increased renal blood flow pressure, protein filtration increases, promotes matrix augmentation, forms mesangial area and glomerular basement membrane, leading to nodular glomerular sclerosis.

Internal and External Traditional Chinese medicine for kidney disease

Traditional Chinese medicine treatment: one person, individualized treatment
Traditional Chinese medicine believes that chronic renal failure involves the five internal organs in the location, mainly spleen and kidney. It is believed that the disease is caused by edema, lymphatic syndrome, low back pain and other diseases. It can be a deficient performance and should belong to Chinese medicine Guange,Shenlao, Nidu.

In clinical practice, nephropathy is usually divided into 7 syndrome types, namely spleen and kidney deficiency, wet turbidity and internal cessation syndrome, spleen and kidney yang deficiency syndrome, yin and yang deficiency syndrome, wet turbid syndrome, water and gas syndrome, blood stasis syndrome, and wind dynamometer . Clinically, the combination of Chinese and Western medicine is applied to the treatment, and the principles of tonifying the spleen and tonifying the kidney, reducing turbidity, benefiting the water, removing phlegm, and extinguishing the wind are adopted, and a variety of suitable prescriptions are formed for individualized treatment. One person, one party, Has achieved good results.
With the progress of pharmacology research of traditional Chinese medicine, traditional Chinese medicine has not adhered to syndrome differentiation treatment for chronic renal failure, but has combined treatment of disease differentiation, syndrome differentiation and modern Chinese medicine pharmacology. According to modern pharmacological research, the toxic effect of drugs is abandoned and targeted. The special prescriptions, such as the Chinese herbal medicine decoction “
Astragalus decoction for lowering turbid” in our hospital, have achieved remarkable curative effect in clinical application.

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External treatment of traditional Chinese medicine: multi-channel administration
The traditional Chinese medicine treatment has a long history and is widely used. In recent years, the external treatment of traditional Chinese medicine has been applied to the treatment of chronic renal failure, and various routes of administration have achieved remarkable effects.

Traditional Chinese medicine bath foot: Studies have shown that Chinese medicine bath foot therapy can promote blood circulation, increase renal blood flow, and regulate the function of organs. There are 3 series of 15 commonly used prescriptions in our hospital. They are selected according to different diseases, different syndromes and different seasons. They are personalized and individualized treatments, and have excellent curative effect in the treatment of chronic kidney diseases.

Chinese medicine colon perfusion dialysis: the use of large-capacity dialysate constant temperature introduction device for intestinal cleaning, colon dialysis, colonic administration, safe, non-invasive, low cost, affirmative effect. As a third dialysis treatment method after hemodialysis and peritoneal dialysis, traditional Chinese medicine colon perfusion dialysis plays an increasingly important clinical role in the treatment of chronic renal failure.

Acupoint ultrasound electrotherapy: Acupoint ultrasound electrotherapy stimulates the effective acupuncture points of the human body through special frequency electric waves, regulates the human nervous system, vascular system, endocrine system and human immune system, and promotes the repair of renal function. It can significantly reduce blood muscle liver and reduce by clinical verification. Urinary protein, markedly improve edema and other symptoms, have a good effect on urinary tract irritation (urinary frequency, urgency, urinary pain) in patients with repeated urinary tract infections.

Chinese medicine acupoint application: Chinese medicine acupoint sticking therapy for chronic renal failure, inspired by Li Shizhen's "Compendium of Materia Medica" acupoint sticking therapy. Our hospital has been used as a topical ointment with traditional Chinese medicine experience prescriptions, applied to the corresponding acupoints, used to treat various kidney diseases, and broadened the application range of Chinese medicine acupoint application, with good results.

Acupoint injection of traditional Chinese medicine: Acupoint injection therapy uses certain specific Chinese and Western medicine injections to inject the relevant acupoints of the human body, so that the double stimulation of acupuncture and drugs on the acupuncture points can be organically combined. The drug stays at the acupoints for a longer period of time, which can enhance the therapeutic effect. , to play its comprehensive effectiveness and improve efficacy.