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Zhang Hui
Nephrology
About me
Tianjin Hospital, Tianjin City, Department of Nephrology, attending physician, has been engaged in internal medicine clinical work for many years, with rich clinical experience in common and prevalent internal medicine diseases.
Proficient in diseases
Specializes in the diagnosis and treatment of various acute and chronic kidney diseases and complications.
Voices
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.
Kidney disease syndrome is classified as what disease?
Nephrotic syndrome is a clinical subtype of chronic kidney disease. It can be diagnosed when there is significant proteinuria, hypoalbuminemia, accompanied by edema and hyperlipidemia. This represents a severe stage in the progression of kidney diseases, generally requiring treatment with steroids and immunosuppressants. Nephrotic syndrome may have complications such as thrombosis, infections, hyperlipidemia, and acute renal failure.
Characteristics of Nephrotic Syndrome
The characteristics of nephrotic syndrome are defined by significant proteinuria, where significant proteinuria refers to urinary protein exceeding 3.5 grams in 24 hours; hypoproteinemia, which refers to blood albumin levels below 30 grams per liter; edema, which may present in facial and lower limbs, and even severe patients may exhibit generalized edema around both lower limbs; and hyperlipidemia, characterized by increased cholesterol and triglycerides in the blood. These patients may exhibit reduced urine output, edema, and noticeably increased foam in the urine.
What tests are conducted for nephrotic syndrome?
Patients with nephrotic syndrome need to complete routine urine tests, 24-hour urine protein quantification, liver and kidney function tests, routine blood tests, electrolyte panels, blood glucose tests, and lipid profiles. Additionally, it is important to determine the cause of nephrotic syndrome, excluding the possibility of nephrotic syndrome caused by immune system diseases, including tumors, vasculitis, lupus, and other diseases. These tests include rheumatoid immune panels, antinuclear antibody spectrum, anti-GBM antibodies, ANCA panel, and immunoglobulins. Moreover, these patients should undergo kidney ultrasound, tumor marker tests, and thyroid function tests.
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.
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.
Chronic renal failure anemia treatment
Patients with chronic renal failure generally have anemia combined with stage three or above of chronic kidney disease (CKD). When the hemoglobin falls below 100 grams per liter, it is necessary to start treatment to correct anemia. At this point, relevant lab tests should be conducted to check for abnormalities in folate, vitamin B12, ferritin, and serum iron levels, and specific treatments should be administered accordingly. Treatments generally include iron supplements, erythropoiesis-stimulating agents, folate, and vitamin B12 to help correct anemia.
How should you eat with nephrotic syndrome?
Nephrotic syndrome is characterized by urine protein greater than 3.5 grams, serum albumin less than 30, the presence of edema, and hyperlipidemia. Patients matching these criteria can be diagnosed with nephrotic syndrome. From its diagnosis, we can see that such patients have a high amount of urine protein and relatively low blood protein. For these patients, it is necessary to control their protein intake, generally suitable at 0.6-0.8 grams per kilogram of body weight per day. Due to hypoalbuminemia, as the liver synthesizes protein, it also leads to an increase in blood lipids. Therefore, patients with nephrotic syndrome need to follow a low-fat diet to avoid further elevation of blood lipids. Additionally, as patients with nephrotic syndrome generally have edema, it is necessary to restrict sodium intake to prevent sodium and water retention, further aggravating the edema.