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Li Liu Sheng
Nephrology
About me
Master, chief physician, deputy director of nephrology, master supervisor. Presided over and participated in 3 research projects, presided over a project that won the second prize of scientific and technological progress in Yichang City, won a third prize, published 26 papers in core journal magazines, and contributed to the compilation of a monograph "Urology". Member of the Hubei Biomedical Dialysis Engineering Society, youth member of the Hubei Nephrology Society, member of the Yichang Kidney Disease Quality Control Center.
Proficient in diseases
There is unique experience in the diagnosis and treatment of various chronic kidney diseases, including renal biopsy, central venous catheter placement, peritoneal dialysis, hemodialysis, etc.
Voices
How long should one with acute nephritis stay in bed for rest?
After the onset of acute nephritis, patients should rest in bed for 2-3 weeks until gross hematuria disappears, blood pressure returns to normal, and edema subsides. If the patient's condition is severe, with complications such as high blood pressure, noticeable edema, and significant hematuria, then bed rest should be extended to 4-6 weeks. Bed rest can increase renal blood flow and improve kidney function, which is beneficial for enhancing treatment effectiveness. Gradually, indoor activity can be increased. If the condition does not worsen after 1-2 weeks, the patient may begin outdoor activities. Patients with mild residual proteinuria and microscopic hematuria should be followed up and closely observed without the need for indefinite bed rest. If urine changes worsen again after activity, further bed rest is necessary. For students who develop acute nephritis, it is advisable to take a break from school to ensure enough rest time for recovery.
Symptoms of Uremia
Once diagnosed with uremia, patients exhibit numerous clinical symptoms, though these symptoms are not completely identical across different individuals. Typically, the primary symptoms of uremia include nausea, vomiting, loss of appetite, with these symptoms becoming more pronounced after eating. There might even be diarrhea, an increase in the frequency of bowel movements, and gastrointestinal bleeding. Additionally, patients show signs of edema, particularly around the eyelids and face, with very noticeable swelling in the lower limbs. Severe cases may also present with pleural effusion and ascites, accompanied by a reduction in urine output. Patients may also experience dizziness, headache, elevated blood pressure, and even exhibit pallor, anemia, itchy skin, bone pain, and intolerance to cold, among various other clinical symptoms.
Is IgA nephropathy grade 3 serious?
IgA nephropathy is divided into five stages pathologically, with stage three being the focal proliferative type. The higher the stage, the more severe the condition of IgA nephropathy. Stage three is in the early to middle phase, where generally the condition of the patients is comparatively good, and rarely worsens to uremia, belonging to the low-risk group. Clinically, patients with stage three IgA nephropathy often exhibit repeated occurrences of gross hematuria or persistent microscopic hematuria. Some patients may also experience varying degrees of increased urinary protein. Patients with this stage of IgA nephropathy rarely suffer from hypertension or renal insufficiency, but it is essential in daily life to avoid nephrotoxic drugs, prevent infections, seek medical attention promptly upon infection, and regularly follow up on routine urine and renal function changes. If the condition tends to worsen, active treatment should be pursued.
How is hydronephrosis detected?
The kidneys have a very strong compensatory ability. In the early stages of hydronephrosis, the amount of fluid may not be large, or the duration may not be long, and usually, the patient may have no symptoms. Hydronephrosis is often discovered during health examinations or through ultrasound or CT scans performed during hospital stays. Of course, if the hydronephrosis persists for too long and the volume is very large, the patient can gradually feel discomfort or a distended sensation in the lower back or upper abdomen. Moreover, if the hydronephrosis is caused by kidney stones, the patient often experiences severe back pain, and there might even be visible blood in the urine. Hydronephrosis can also lead to symptoms of urinary tract infections such as frequent urination, urgent urination, and painful urination. Prolonged hydronephrosis can lead to a decline in kidney function, resulting in symptoms like fatigue, loss of appetite, and poor overall health. Therefore, it is crucial for patients to undergo regular ultrasound examinations of the kidneys to detect hydronephrosis early.
What are the symptoms of kidney cancer metastasis to the lungs?
Kidney cancer tumor cells are particularly prone to metastasis, with the lungs being one of the common sites for metastases. Once lung metastasis occurs in patients with kidney cancer, numerous symptoms can appear. Typical symptoms include coughing, scanty sputum, severe irritating dry cough, palpitations, chest tightness, shortness of breath, and even chest pain, as well as coughing up blood or severe hemoptysis. Therefore, patients with lung metastases from kidney cancer who exhibit these symptoms should seek medical attention promptly and undergo a lung CT scan. Additionally, patients may experience an increase in body temperature, fevers, weight loss, dizziness, anemia, and particularly fatigue. There may also be a loss of appetite and a general feeling of weakness, which should draw the patients' attention.
Should people with hydronephrosis avoid certain foods?
Although there are many causes leading to hydronephrosis in patients, most hydronephrosis is related to stones, meaning that hydronephrosis occurs in patients due to ureteral kidney stones. Therefore, dietary restrictions are necessary for patients with hydronephrosis in daily life. If the hydronephrosis is caused by calcium oxalate stones, patients should avoid consuming foods that are high in calcium and oxalates, such as nuts, legumes, spinach, and beets. If the hydronephrosis is due to the formation of uric acid stones, patients should also avoid consuming excessive amounts of animal organs, such as pork liver and kidneys, avoid seafood, and try not to drink beer, as these contain a high amount of purines, which can easily lead to stone formation. Additionally, if patients with hydronephrosis also have renal insufficiency, they should follow a low-salt diet and avoid consuming particularly salty foods, including various pickles, etc.
Can acute nephritis be cured completely?
The main cause of acute nephritis is related to streptococcal infections. Many patients with acute nephritis often have a history of infections in the throat, upper respiratory tract, or skin before the onset of the disease. Therefore, once acute nephritis occurs, patients often exhibit hematuria, which can be either gross hematuria or microscopic hematuria. Severe cases of acute nephritis may also show swelling of the eyelids and face, as well as the presence of mild to moderate urinary protein. In addition, some severe cases of acute nephritis also show elevated blood pressure, decreased renal function, and overall poor outcomes from acute nephritis. Currently, there are no specific treatments available; the main approach is bed rest and symptomatic treatment. For example, diuretics can be used if there is edema, and antihypertensive drugs can be used if there is a need to lower blood pressure. If an infection still exists, antibiotics are used for treatment. With proper and standardized treatment, the vast majority of acute nephritis cases can be completely cured without recurrence.
Causes of Uremia
Uremia is a syndrome caused by the progressive development of various chronic kidney diseases that ultimately leads to bilateral renal failure in patients, unable to timely remove excess water, electrolytes, and various toxins from the body. The causes of uremia are many and complex. Common causes include chronic nephritis, diabetic nephropathy, and hypertensive nephropathy. Other diseases such as chronic interstitial nephritis, chronic pyelonephritis, uric acid nephropathy, chronic obstructive nephropathy, renal vascular diseases, and hereditary nephritis can also lead to uremia. Once uremia occurs, patients often exhibit symptoms of general discomfort and may need to choose dialysis treatment, which can be either hemodialysis or peritoneal dialysis, depending on individual circumstances.
Does uremia cause fever in its early stages?
Fever is not an early clinical manifestation in patients with uremia; therefore, patients in the early stages of uremia do not exhibit fever. Typically, in the early stages of uremia, patients only show symptoms such as fatigue, poor spirit, lack of appetite, and easy fatigue, and may experience edema, such as swelling of the eyes and facial area after waking up in the morning, making it difficult for patients to open their eyes, and swelling of the lower limbs. In addition, patients also exhibit high blood pressure, such as increased systolic and diastolic pressures, which are difficult to control. Patients often exhibit clinical symptoms such as dizziness and headache. Patients also experience a significant increase in the frequency of urination at night and an increase in urine output, which are all early manifestations of uremia.
Is hydronephrosis of both kidneys serious?
Clinically, bilateral hydronephrosis is serious, as it can lead to expansion of the renal pelvis. Long-term bilateral hydronephrosis can compress the renal parenchyma, leading to the development of chronic obstructive nephropathy, and thus cause chronic renal failure. Additionally, because urine cannot be expelled from the body in a timely manner in bilateral hydronephrosis, it is easy to combine with bacterial infections, which can lead to acute pyelonephritis. Patients may experience chills, fever, and severe back pain, as well as hematuria and general fatigue. Therefore, it is essential to identify the cause of bilateral hydronephrosis and treat it based on the nature of the hydronephrosis. Usually, the causes of bilateral hydronephrosis are related to stones, but tumorous diseases, bladder stones, or urethral strictures are also common causes.