Subscribe
165
Zhou Qi
Nephrology
About me
An associate chief physician in the Nephrology Department of the People's Hospital of Ma'anshan City, with a Master's degree from a key medical university. Participated or led multiple projects funded by the Natural Science Foundation, and published nearly ten papers in Chinese and core journals.
Proficient in diseases
Glomerular diseases, diabetic nephropathy, lupus nephritis, blood purification.
Voices
Can chronic renal failure be cured by dialysis?
Patients with chronic renal failure can undergo dialysis treatment to sustain life and improve quality of life. However, dialysis merely uses artificial means to excrete accumulated metabolic wastes and fluids in the body, regulate the internal environment, and simply substitutes for the function of the kidneys. Dialysis has no therapeutic value for renal failure itself. Therefore, patients with chronic renal failure should not expect dialysis to restore kidney function. Nonetheless, as a renal replacement therapy, dialysis can provide patients with a relatively good lifespan and quality of life. Dialysis treatment is necessary for patients with uremia.
How is uremia caused?
Uremia, also known as end-stage renal disease, is actually the late stage of chronic renal failure development, capable of causing long-term chronic damage to the kidneys. There are many reasons for this, and if these causes persist over a long period, continuously harming the kidneys without effective removal or control, it could eventually lead to severe renal failure, ultimately causing uremia. The causes that can chronically harm the kidneys mainly include diabetes, hypertension, chronic nephritis, polycystic kidney, urinary system stones, tumors, and other such conditions.
Sequelae of acute nephritis
Most cases of acute nephritis do not cause complications; generally speaking, acute nephritis is a self-healing disease that can recover on its own. Approximately three to four weeks later, the condition can gradually alleviate, with the patient’s urine protein and occult blood decreasing until they disappear and kidney function returns to normal, and the edema can also subside, so generally there won’t be any complications. However, there are a minority of patients whose conditions are prolonged and do not heal, and if the patient's condition persists for three months or even half a year without recovery, it might evolve into chronic nephritis. Also, some patients may experience severe kidney failure, heart failure, and pulmonary infections during acute nephritis, leading to severe consequences. The likelihood of these situations occurring is relatively low.
Is high creatinine uremia?
High creatinine levels do not necessarily indicate uremia. High creatinine often implies that the patient is experiencing renal failure, which can be classified into acute renal failure and chronic renal failure based on factors such as the patient's medical history and course of the disease. Uremia is the final state of chronic renal failure. Thus, even if high creatinine levels suggest the possibility of chronic renal failure, it does not necessarily mean that the patient has reached the final stage. Uremia, also known as end-stage renal disease, generally requires a patient's blood creatinine to exceed 707 µmol/L. Additionally, patients often simultaneously present with clinical manifestations such as renal anemia, disorders of calcium and phosphorus metabolism, and reduction in kidney size.
What is hydronephrosis?
The so-called hydronephrosis is a morphological description, referring to an obstruction in the urinary system caused by various reasons. After the kidneys produce urine, it cannot be normally delivered to the bladder. This leads to fluid accumulation in the renal pelvis and calyces, which can be detected through imaging as hydronephrosis. The causes of hydronephrosis are numerous. The most common cause is acquired obstruction, primarily due to urinary system stones, scarring from injuries, or tumors in the urinary system compressing the ureter, which often results in urinary tract obstruction. In addition, some congenital causes can also lead to urinary tract obstruction. Examples include segmental dysfunction of the ureter, intrinsic stenosis of the ureter, and twisting of the ureter. However, these congenital obstruction causes are relatively rare.
What department to see for hydronephrosis?
Patients with hydronephrosis should visit the urology department of a formal hospital, because the conditions causing hydronephrosis are often surgical in nature. The most common cause is urological stones, which block the ureter or the bladder opening, causing urine to accumulate within the urinary system and leading to hydronephrosis. Additionally, patients with benign prostatic hyperplasia may also experience this condition. Tumors in the urinary system may compress the ureter and cause hydronephrosis. Some patients have congenital deformities of the ureter, where changes in the anatomical structure can lead to hydronephrosis. In summary, these conditions often require surgical treatment, thus necessitating consultation at a formal hospital's urology department.
Can pyelonephritis be cured?
Whether pyelonephritis can be cured mainly depends on whether the patient has predisposing factors for urinary tract infections. These factors primarily include: Firstly, abnormalities in the anatomical structure of the urinary tract that may lead to obstruction of urine excretion, such as urological system stones, tumors, prolonged indwelling catheters, congenital abnormalities of the urinary system, and others. Additionally, there are some conditions that may lead to a decreased immune response, such as elderly individuals who are bedridden, those with diabetes, or patients using immunosuppressants. If the aforementioned factors are present, treatment of such cases of pyelonephritis might be challenging, with patients possibly experiencing recurrent episodes and potentially progressing to chronic pyelonephritis, eventually becoming difficult to cure completely. However, if none of these factors exist, the majority of cases with simple acute pyelonephritis can be cured and controlled by medication.
Can IgA nephropathy be cured?
IgA nephropathy cannot be completely cured. IgA nephropathy is a type of chronic glomerulonephritis and is a chronic disease. Currently, it is incurable in medical practice. However, many patients have only mild symptoms, such as mild hematuria, proteinuria, and minor kidney damage, and timely long-term management of the disease usually does not lead to severe consequences. Some patients, on the other hand, have relatively severe conditions and require treatment with steroid medications. Most of these patients can achieve relatively good treatment outcomes and ultimately avoid severe kidney failure. However, a very small number of patients may eventually experience significant proteinuria and even severe renal failure.
How to diagnose pyelonephritis?
For the diagnosis of pyelonephritis, it is first necessary to confirm the diagnosis. Generally, patients should first undergo routine urine tests. In these tests, the presence of white blood cells and positive nitrites, along with clinical symptoms such as back pain, blood in urine, and fever are common. A routine blood test often shows elevated white blood cells and C-reactive protein. These indicators together suggest the presence of pyelonephritis. Furthermore, a culture of a clean-catch midstream urine sample can be done. If the bacteria grow to a certain quantity, it can also help in confirming the diagnosis of pyelonephritis. Additionally, to assess complications associated with pyelonephritis, it is necessary to perform blood tests for kidney function and an ultrasound of the urinary system to rule out conditions such as acute renal failure, renal papillary necrosis, and perinephric abscess, among others.
How many years can a person with diabetic nephropathy live?
Diabetic nephropathy is divided into several stages, from mild to severe. In the early stage, patients only have an increased glomerular filtration rate and the proteinuria is not significant. As the disease progresses, the protein in the urine increases, eventually leading to renal failure and even developing into uremia. The entire process can last many years, with some patients experiencing it for up to ten years. In fact, when diabetic nephropathy progresses to its final stage, uremia, patients still have many treatment options, such as hemodialysis, peritoneal dialysis, or kidney transplantation, and even combined kidney and pancreas transplantation. Therefore, how long a patient can live depends on the patient's age, presence of cardiovascular and cerebrovascular diseases, and the choice of treatment methods, among other factors.