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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
post-acute nephritis sequelae
Acute nephritis is a self-limiting disease, and most patients can fully recover, so the vast majority of patients generally start to show improvement in routine urine tests three to four weeks after onset, with normal kidney function and resolution of edema, resulting in few, if any, sequelae. Of course, a small number of patients may experience prolonged unhealed conditions that can progress to chronic nephritis. These patients may then develop complications, including hypertension and renal anemia, which are long-term potential issues. However, the vast majority of patients with acute nephritis do not experience complications or sequelae.
The difference between hypertensive nephropathy and renal hypertension
Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.
Is hydronephrosis scary?
Hydronephrosis is rather alarming, as it harms the body in two main ways: First, it creates increased pressure inside the kidneys due to fluid accumulation in the urinary system. This pressure can compress kidney tissue, and if not resolved, may lead to irreversible kidney damage and renal failure. However, if hydronephrosis formed in the short term is quickly addressed by clearing the urinary system, it typically has minimal impact on kidney function. Another aspect relates to the causes of hydronephrosis, some of which are complicated issues, such as bladder cancer, rectal cancer, or cervical cancer in females. These cancers can press on the ureter, leading to hydronephrosis. Other causes, such as urolithiasis or benign prostatic hyperplasia, are relatively easier to manage.
How to deal with swollen feet in IgA nephropathy?
IgA nephropathy is a pathological type of chronic glomerulonephritis, and patients are prone to edema. The treatment of this edema is divided into two aspects: First, it is necessary to control the condition of IgA nephropathy itself. If there is a significant amount of proteinuria or a large formation of crescents in the glomeruli, the patient may need to use steroids and immunosuppressive agents to control the inflammatory response in the glomeruli. This is the fundamental approach to treating this disease. Second, symptomatic treatment is applied. For mild edema, no special treatment is generally required. However, for severe edema or even systemic edema, it may be appropriate to use diuretics to increase urine output, which can alleviate the patient's edema. However, this is not a solution to the root cause of the problem.
Is pyelonephritis easy to treat?
Pyelonephritis is generally not difficult to treat. Because the condition often appears quite aggressive, it is caused by bacteria entering the urinary system through the urethra, leading to an inflammatory response. Therefore, the primary treatment involves using antibiotics to kill the bacteria. Most of the bacteria causing pyelonephritis are Gram-negative rods, so antibiotics sensitive to Gram-negative rods are often chosen. After a treatment course of 10-14 days, the patient's condition is generally controllable and curable. However, there are also a few cases of chronic pyelonephritis, involving complex factors related to urinary tract infections, such as urinary tract malformations, urinary system stones, prostate hyperplasia, diabetes, etc., which make treatment more difficult. (Medication should be used under the guidance of a doctor.)
Is diabetic nephropathy dialysis painful?
Whether it is diabetes, nephritis, high blood pressure, or other causes leading to kidney failure, it may eventually progress to uremia. Patients with such conditions need dialysis or a kidney transplant to survive. Generally, patients undergoing any type of dialysis do not experience significant pain symptoms. Dialysis can be divided into hemodialysis and peritoneal dialysis, both of which use artificial methods to remove metabolic waste from the patient's body and maintain the stability of the internal environment. These methods generally do not involve significant traumatic procedures, so they mostly do not cause notable pain. However, patients undergoing hemodialysis may need temporary needling each time, which causes minimal trauma and typically does not result in severe pain or significant discomfort.
What should I do about tinnitus caused by uremia?
Tinnitus in uremia requires further consultation at the ENT department of a formal public hospital. Tinnitus is not a typical symptom of uremia and may not necessarily be related to kidney disease or caused by uremia. Some patients may experience tinnitus due to severe anemia, which leads to insufficient blood supply in the skull, or due to persistently high blood pressure caused by uremia, which can also potentially cause tinnitus. However, the probability of these scenarios is generally low, and it is still recommended that patients seek further consultation at an ENT department to clarify potential causes, such as infections or tumors in the inner ear system.
What are the characteristic manifestations of kidney cancer?
Kidney cancer is a type of malignant tumor. Patients with this disease may exhibit some clinical symptoms. Some patients experience dull pain in the lumbar and back area due to the large growth of the tumor, which compresses the renal capsule. As the tumor grows, it may rupture and bleed, causing the patient to have visible blood in the urine. This type of hematuria is often painless and consistent throughout; patients may also feel a mass in the abdomen. In the early stages of kidney cancer, many patients do not exhibit clinical manifestations or discomfort. Therefore, patients often only exhibit the aforementioned clinical symptoms in a more severe state, later in the progression of the disease.
Early symptoms of diabetic nephropathy
Diabetic nephropathy is divided into five stages. In the first and second stages, patients generally do not have significant proteinuria. At this time, the pressure inside the glomeruli increases, and the glomerular filtration rate actually increases, which may result in an increase in kidney size. During this period, patients generally do not have obvious symptoms, and it is difficult to detect without detailed examination. By the third stage, patients develop proteinuria, which increases as the disease progresses, and patients may notice an increase in urine foam. When diabetic nephropathy reaches the stage with proteinuria, a prominent clinical symptom is edema. This edema initially appears in the bilateral facial and lower limb areas. As the disease progresses, some patients may also experience generalized edema, and can develop effusion in the pericardium, thoracic cavity, and abdominal cavity. Symptoms such as chest tightness, shortness of breath, difficulty breathing, pulmonary edema, and heart failure may occur.
Symptoms of stage 2 diabetic nephropathy
Diabetic nephropathy is divided into five stages. Speaking in terms of the severity of the condition, in the second stage, the clinical manifestations are not very obvious, and the patient's kidney size may increase. Generally, at rest, the patient's urine protein is negative, but after activity, there might be traces of albumin in the urine. Due to the presence of a small amount of protein in the urine, there may be an increase in urine foam, and the patient may experience mild edema, although the symptoms of this edema are also not very noticeable. At this stage, the damage of diabetes to other organs of the body is not very evident, therefore, retinopathy is not severe, and the patient’s vision decline is not significant. The patient may also have concurrent issues like hypertension and hyperlipidemia.