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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
Is uremia hereditary?
Uremia is not actually an independent disease, so it's difficult to say that uremia is hereditary. Uremia refers to a condition where the kidneys are 90% damaged. However, there are many reasons that can cause more than 90% of kidney tissue damage; among these, some are genetic diseases, but most are not hereditary. Common causes of hereditary uremia include diabetes, as well as primary chronic glomerulonephritis, hypertension, urinary system stones, and even prostate tumors, allergic purpura, etc., which can all cause kidney damage. These factors are generally not genetic diseases. However, there are very few causes of uremia that are genetic diseases, mainly including autosomal dominant polycystic kidney disease.
What should I do if I have hydronephrosis and atrophy?
Hydronephrosis leading to kidney shrinkage indicates that the condition has persisted for a long time. Long-term hydronephrosis places significant pressure on the kidneys, which in turn compresses the kidney tissues causing tissue shrinkage. The destruction and shrinkage of tissues result in the kidneys' inability to function properly, leading to azotemia. Patients will experience chronic kidney failure, a situation that is difficult to reverse. Even if surgery is performed to relieve the obstruction and allow urine to be excreted, the damaged kidney tissue cannot regenerate. Therefore, it is still necessary to relieve the obstruction as soon as possible to avoid further damage to the remaining kidney tissue. For patients who have progressed to uremia, it may be necessary to consider hemodialysis or peritoneal dialysis, or undertake a kidney transplant to sustain life.
Chronic renal failure inevitably has symptoms.
Patients with chronic kidney failure do not necessarily have symptoms, and the symptoms of each patient are not exactly the same. Chronic kidney failure refers to the damage to the kidneys by various chronic kidney diseases, eventually leading to the kidneys' inability to adequately excrete metabolic waste, causing the accumulation of water and metabolic waste in the body. This leads to disturbances in the patient's electrolytes and may also present clinical symptoms such as anemia and hypertension. However, not all patients feel discomfort, so chronic kidney failure is also known as the silent killer. If a patient undergoes a blood test, it will show an increase in blood creatinine and urea nitrogen, which is the only common feature among all patients with chronic kidney failure.
Is acute nephritis contagious?
Acute nephritis is not contagious. Acute nephritis generally occurs after a patient has a bacterial inflammation of the respiratory tract, such as infections by streptococcus, staphylococcus, and other bacteria affecting the respiratory tract, urinary tract, digestive tract, or skin. This leads to a secondary inflammatory response. These inflammatory immune complexes travel through the bloodstream to the kidneys, causing an inflammatory reaction within the organ. It could also be due to the deposition of immune complexes within the glomeruli, leading to glomerular damage. This disease itself is not contagious. Although these bacteria exist as triggers, they typically do not have the capability to infect other patients. Moreover, even if they were to infect others, it would not necessarily lead to nephritis.
How to treat occult blood in IgA nephropathy
IGA disease is a pathological type of chronic glomerulonephritis. This type of glomerular lesion often leads to positive occult blood in urine, and in some cases, may even cause gross hematuria visible to the naked eye. However, the relationship between hematuria and the severity or prognosis of the patient's condition is not very clear, so clinically, hematuria is not considered as a treatment target. Generally, during the active phase of the disease, patients can be treated with corticosteroids and other medications, especially those with more than 1g of protein in a 24-hour urine collection. Otherwise, most patients choose ACE inhibitors or ARBs as antihypertensive drugs to reduce the pressure inside the glomerulus. Additionally, avoiding colds can also help reduce occult blood in urine. (Specific medications should be administered under the guidance of a physician)
What tea to drink for hydronephrosis
Before hydronephrosis is adequately treated and before the obstruction in the urinary system is resolved, in areas such as the renal pelvis and calyces where there is fluid accumulation, it is advised that patients should not drink tea and should try to reduce their fluid intake. This is because the fluids cannot be excreted through the kidneys, and drinking large amounts of water at this time could worsen the obstruction and may also lead to edema. Therefore, patients are advised not to drink tea until the hydronephrosis is resolved. Once the causes of urinary tract obstruction, such as urinary system stones or tumors, have been removed, patients can increase their water intake, but it is still recommended not to drink tea because tea contains considerable amounts of oxalate, which can lead to the recurrence of kidney stones.
How is nephrotic syndrome diagnosed?
Nephrotic syndrome is a general term for a group of clinical symptoms. Its primary diagnostic criteria include a 24-hour urine protein quantification of greater than or equal to 3.5 grams and plasma albumin less than or equal to 30 grams per liter; these two criteria are essential for the diagnosis of nephrotic syndrome. Meeting these criteria is sufficient for the diagnosis. There are also two additional supporting diagnostic criteria for nephrotic syndrome, which include possible symptoms of edema and hyperlipidemia. These four elements are the main clinical manifestations and diagnostic criteria of nephrotic syndrome.
Why does nephrotic syndrome cause sleepiness?
Excessive sleepiness is not a common clinical manifestation of nephrotic syndrome; generally, patients with nephrotic syndrome rarely exhibit excessive sleepiness. If a patient does display sleepiness, it is necessary to investigate the causes, such as a reduction in blood volume and decreased blood pressure caused by nephrotic syndrome, leading to insufficient cerebral blood supply. Furthermore, in cases of nephrotic syndrome, the patient’s immune capacity decreases, making them more susceptible to various infections, such as infections of the upper respiratory tract and lungs. When inflamed, patients are also likely to feel excessively sleepy. In some patients, there is a risk of cerebral infarction, which can also cause sleepiness.
Can diabetic nephropathy with swollen feet be treated?
Diabetic nephropathy in the middle and later stages can cause edema, especially in patients with significant proteinuria or renal failure. Many patients can even experience generalized edema. For such patients, swollen feet and swelling in other parts of the body can be considered for appropriate use of diuretics to increase urine output and eliminate edema. However, generally, the extensive use of diuretics is not actively advocated because excessive diuresis can also lead to significant protein loss and even cause insufficient blood volume, affecting the blood supply to the kidneys. Nevertheless, some patients with severe conditions that cause pulmonary edema and heart failure may not respond well to diuretics. In such cases, dialysis ultrafiltration may be required to remove water, alleviate edema, and reduce cardiac stress.
Kidney disease IgA means IgA nephropathy.
Kidney disease IgA, formally known as IgA nephropathy, is an immunological diagnostic term for chronic glomerulonephritis. It is characterized by the deposition of immune complexes, primarily IgA, in the mesangial areas of the glomeruli. IgA is a type of immunoglobulin, which upon deposition in the kidneys induces inflammatory responses, leading to proliferation of mesangial cells, accumulation of mesangial matrix, and widening of the mesangial area. This can cause damage to the glomerular filtration barrier, manifesting as proteinuria and hematuria. Some patients may also develop crescent formations in the glomeruli, leading to renal failure.