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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
The characteristics of proteinuria in IgA nephropathy
IgA nephropathy is a pathological type of chronic glomerulonephritis, which can cause patients to exhibit symptoms such as proteinuria and hematuria. Regarding the characteristics of proteinuria, it is generally primarily glomerular proteinuria. In the classification of patients' proteinuria, glomerular proteinuria accounts for a large proportion. If IgA nephropathy presents as chronic nephritis or nephrotic syndrome, the patient's level of proteinuria will be quite severe, with significant amounts of proteinuria, where the 24-hour urinary protein quantification may exceed 1g or even reach more than 3.5g. However, not all patients with IgA nephropathy have such high levels of proteinuria; some may only have mild proteinuria.
Will acute nephritis cause facial swelling?
Acute nephritis can also cause facial swelling in patients. The pathological damage in patients with acute nephritis is the diffuse proliferation of glomerular cells, which reduces the glomeruli's ability to filter blood. As a result, patients may experience proteinuria and hematuria. Decreased kidney function in water excretion can lead to water accumulation in the body, causing edema in the lower limbs or facial area. The increase in urinary protein can also increase vascular permeability and decrease plasma osmotic pressure, leading to the movement of water outside the blood vessels. These factors can all cause edema. In the body, water tends to accumulate in areas where tissues are looser, such as the facial area. Thus, it is possible for patients with acute nephritis to experience facial swelling.
Acute Pyelonephritis Nursing Measures
Acute pyelonephritis, also known as an upper urinary tract infection, is a type of bacterial inflammation. In terms of care, patients should first focus on increasing their fluid intake. If the patient does not have urinary system stones, tumors, or other factors causing urinary obstruction—that is, if there is no kidney hydronephrosis—it is recommended that the patient's daily urine output be maintained at 2000-2500 milliliters. This means increasing fluid intake can help flush the urinary system, reducing bacterial growth and reproduction, which is beneficial for the treatment of pyelonephritis. Secondly, since the patient has acute inflammation, dietary considerations should include eating light, avoiding heavy and greasy foods as well as spicy and stimulating foods, and paying attention to perineal hygiene. Additionally, during episodes of fever, if the patient's body temperature is not very high, a warm water sponge bath can be given, especially focusing on the neck, armpits, and the root of the thighs, which can facilitate heat dissipation and is very beneficial for reducing body temperature.
Does diabetic nephropathy require a biopsy?
Whether a patient with diabetic nephropathy needs a biopsy depends on the condition of the patient. Firstly, if the kidney disease is in the early stages and the blood creatinine level has not exceeded 256 micromoles per liter, a kidney biopsy can be considered. Otherwise, if the blood creatinine level exceeds 256 micromoles per liter, a biopsy is no longer meaningful since significant fibrosis and hardening of kidney tissue have already occurred. At this point, if it is unclear whether the proteinuria is caused by diabetes or another disease, a kidney biopsy can be considered to diagnose the cause and extent of glomerular damage, and to provide a basis for treatment.
Symptoms of recurring pyelonephritis
Pyelonephritis is an upper urinary tract infection. When the condition recurs, the initial symptoms are similar. Patients may also experience fever, and the temperature can rise quickly, even up to 40 degrees Celsius. There may also be a systemic inflammatory response, characterized by fatigue and loss of appetite, among other symptoms. Recurrence can also cause pain in the lumbar region, which may even radiate to the perineal area, and patients may also experience visible hematuria. In urinalysis, leukocytes or positive leukocyte esterase can be observed. These are the symptoms of recurring pyelonephritis.
Does nephrotic syndrome cause itchy skin?
Nephrotic syndrome generally does not cause itchy skin in patients. In patients with nephrotic syndrome, the glomerular filtration barrier is severely damaged, leading to a significant presence of urinary protein and edema, but itchy skin is a rare clinical symptom. If a patient experiences itchy skin, it is recommended to visit the dermatology department of a standard hospital. As such patients may have a disordered immune system, they are prone to various skin issues, such as allergic dermatitis and eczema, which might cause symptoms of itchy skin. However, these are not directly related to nephrotic syndrome.
Is IgA nephropathy sexually transmitted?
IgA nephropathy, a type of chronic glomerulonephritis, does not transmit through sexual intercourse. This condition involves a sterile inflammatory response within the glomeruli of the kidneys, not caused by pathogens such as bacteria, viruses, or fungi. Instead, it results from an immune dysfunction, causing inflammation in the glomeruli without any infectious agents. Therefore, IgA nephropathy is not contagious, and sexual intercourse does not pose a risk of transmitting the condition to a sexual partner. As such, patients with IgA nephropathy can engage in sexual activities if their physical condition permits.
Can patients with IgA nephropathy have sexual intercourse?
Patients with IgA nephropathy can engage in sexual intercourse, but there are certain prerequisites. Firstly, this disease is not contagious, and it will not be transmitted to the partner during intercourse. Secondly, there is not a significant relationship between renal function and sexual capability; patients with kidney diseases typically retain normal sexual and reproductive functions. However, since sexual activity requires a certain amount of physical strength, and in cases where the patient's condition is particularly severe, it might render the patient unable to engage in sexual activities. Therefore, if the patient does not have significant hypertension, severe edema, especially genital edema, pulmonary edema, or heart failure, they would be capable of engaging in sexual activities, and thus can have intercourse.
What are the symptoms of chronic kidney failure?
The symptoms of chronic kidney failure are related to the severity of the condition; the more severe the kidney failure, the more symptoms the patient will have. In the early stages, patients may not feel uncomfortable or show any symptoms. Some patients may experience swelling in the lower limbs and facial area. Others may display clinical signs such as elevated blood pressure and visible blood in the urine. As kidney failure progresses and blood creatinine levels exceed 442 umol/L, patients may experience fatigue, which is due to renal anemia. Some patients may also experience a loss of appetite, nausea, vomiting, and other gastrointestinal symptoms.
How many days does the fever last in acute nephritis?
Generally speaking, acute nephritis itself does not cause fever symptoms in patients. Acute nephritis can cause visible hematuria and an increase in foamy urine. Some patients may also experience a reduction in urine output, severe edema, kidney failure, and other clinical symptoms. However, fever is not a common symptom caused by acute nephritis itself. If such patients develop a fever, it may be due to lung or gastrointestinal infections caused by acute nephritis, as patients with acute nephritis have lowered immune capabilities and are often prone to bacterial infections in other parts of the body, such as coughing and sputum production. In such cases, the patient might have lung inflammation and would require antibiotic treatment to kill the bacteria. Generally, most patients' conditions can be controlled after 10 to 14 days.