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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 is IgA nephropathy caused?
IgA nephropathy is a common glomerular disease and a major cause of uremia. However, the exact cause of IgA nephropathy is not very clear. Current research suggests that it is caused by factors such as infections which stimulate the production of autoantibodies, forming immune complexes that deposit in the glomeruli. This leads to inflammation of the glomeruli, eventually stimulating mesangial cell proliferation and accumulation of extracellular matrix, causing glomerulosclerosis and interstitial fibrosis. IgA nephropathy is a very covert disease, often presenting as asymptomatic hematuria or increased urine protein. Many patients discover this condition incidentally during physical examinations. Some individuals have a history of upper respiratory or gastrointestinal infections before the onset of the disease, followed by the discovery of gross hematuria. IgA nephropathy is more common in children and adolescents.
How should acute nephritis be treated?
Patients with acute nephritis generally have a good prognosis after reasonable and standardized treatment, and rarely develop into chronic nephritis. The main means of treating acute nephritis is symptomatic supportive care, requiring patients to rest in bed during the acute phase. At the same time, spicy food should be avoided and salt intake should be appropriately controlled. If the patient has an infection, sensitive antibiotics should be actively selected for treatment. Additionally, diuretics can be appropriately used for patients with edema, and if the patient also has hypertension, antihypertensive drugs may be used to keep blood pressure within an appropriate range. Of course, some severe cases of acute nephritis may lead to heart failure or renal failure, in which case dialysis should be actively pursued. (Specific medication use should be carried out under the guidance of a doctor.)
How is hypertensive nephropathy treated?
Long-term hypertension can lead to abnormal kidney structure and function, also known as hypertensive nephropathy. Once hypertensive nephropathy is diagnosed, comprehensive treatment measures are often adopted, including both pharmacological and non-pharmacological treatments. In terms of non-pharmacological treatment, patients should maintain a low-salt diet in their daily life, focusing on a light diet, with a daily salt intake of about 4 grams. Regarding pharmacological treatment, the main goal is to control the patient's blood pressure and reduce urinary protein. Medications that can be used include angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists. Any of these medications can be chosen and used long-term to control blood pressure, protect kidney function, and reduce urinary protein. (Medications should be used under the guidance of a physician, and self-medication should be avoided.)
Symptoms of pre-uremia
The pre-uremic stage is the period of chronic renal failure. During the pre-uremic stage, many patients may have no symptoms at all. However, some patients do experience many uncomfortable symptoms, such as back soreness and weakness, fatigue, and feeling cold easily. During this stage, patients may also experience nausea and vomiting, especially pronounced nausea after waking up in the morning, as well as weight loss. Some patients in the pre-uremic stage exhibit symptoms of edema, which can occur in the eyelids, facial area, or in both lower limbs. Additionally, patients may experience feeling cold, anemia, and an increased frequency of urination at night. Of course, some patients may also experience itching of the skin on both lower limbs.
How do you get pyelonephritis?
Pyelonephritis is a clinical type of urinary tract infection, which refers to the inflammatory disease caused by the growth and reproduction of various pathogens in the renal pelvis. Pyelonephritis is usually divided into acute pyelonephritis and chronic pyelonephritis. Acute pyelonephritis is primarily characterized by frequent urination, urgency, painful urination, chills, fever, back pain, overall muscle soreness, and tenderness or percussion pain in one or both kidney areas. Chronic pyelonephritis, on the other hand, shows varying degrees of bilateral renal damage, reduced kidney size, rough surfaces, renal papillary scars, renal tubular atrophy, and chronic inflammation signs such as lymphocyte infiltration in the renal interstitium. Chronic pyelonephritis typically presents with low-grade fever, weight loss, backache, and anemia. Therefore, sufficient attention should be given to pyelonephritis, as chronic pyelonephritis can lead to uremia in patients.
Can you take cold medicine if you have nephrotic syndrome and catch a cold?
People with nephrotic syndrome have particularly weak immune systems, making them especially prone to infections and colds. Once a cold occurs in someone with nephrotic syndrome, the patient often experiences headaches, whole-body muscle soreness, sore throat, nasal congestion, runny nose, and sneezing. In other words, patients with nephrotic syndrome feel very uncomfortable when they catch a cold. If kidney function is normal, it is still possible to take cold medicine. Of course, before using cold medicine, it is essential to follow the doctor's advice for medication treatment. Moreover, after catching a cold with nephrotic syndrome, in addition to taking medication, it is important to rest, consume fresh vegetables and fruits, drink plenty of water, and maintain a light diet. Additionally, it is important to rest, avoid overwork, and if there is a concurrent bacterial infection, sensitive antibiotics should be used for anti-infection treatment, to avoid the recurrence or aggravation of nephrotic syndrome due to infections or colds.
How is pyelonephritis treated?
Whether it is the treatment of acute pyelonephritis or chronic pyelonephritis, first of all, personal hygiene should be emphasized, physical fitness should be enhanced, water intake should be increased, and urination should be frequent. In addition, for patients with acute pyelonephritis, the main treatment is the use of sensitive antibiotics, which can be either semi-synthetic penicillin or cephalosporins, and fluoroquinolone antibiotics can also be used. For chronic pyelonephritis, if the patient has urinary anatomical or functional abnormalities, such as the presence of urinary stones or urinary obstruction, active surgical treatment can be considered to relieve the obstruction. Furthermore, patients with chronic pyelonephritis who also have hypertension and edema can appropriately use antihypertensive drugs and diuretics to control blood pressure and edema, which can play a role in protecting kidney function. (The use of medications should be conducted under the guidance of a doctor.)
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.