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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 does acute nephritis require bed rest?
Acute nephritis is commonly seen in children. Once acute nephritis occurs, the main clinical manifestations in patients typically include hematuria, which can be visible or microscopic. It is also accompanied by varying degrees of edema, elevated blood pressure, and even transient renal failure. As for how long patients with acute nephritis need to stay in bed, current studies suggest a minimum of 2-3 weeks of bed rest. If the patient’s hematuria disappears, urinary protein decreases, and edema subsides, they can gradually start moving out of bed. If the condition remains stable, activities can shift from indoors to outdoors. However, if visible hematuria reoccurs, or if edema reappears after activity, it is necessary to continue bed rest for another 4-6 weeks. Therefore, students suffering from acute nephritis often need to take a leave of absence from school and should be closely monitored for changes in their condition under a doctor's guidance.
Can patients with IgA nephropathy eat beef?
Diet plays a very important role in the treatment of IgA nephropathy patients. For IgA nephropathy patients, the general dietary requirement is to eat a light diet, avoid spicy foods, and avoid fried foods. IgA nephropathy patients can eat beef. Beef contains animal protein, which is a high-quality protein with essential amino acids that are easily absorbed and utilized by the human body. Of course, if IgA nephropathy patients have normal kidney function, there aren't too many restrictions on their diet compared to healthy individuals. They should mainly consume fresh vegetables and fruits, and avoid pickles, salty vegetables, and fermented vegetables. If there is accompanying kidney dysfunction, it is advisable to minimize the intake of plant proteins and limit the consumption of plant-based proteins such as soy products.
How to treat acute nephritis?
Acute nephritis is commonly seen in children. The most typical clinical manifestations of acute nephritis include macroscopic or microscopic hematuria, increased urinary protein, and varying degrees of edema, particularly noticeable in the eyelids and facial areas. There may also be varying degrees of increased blood pressure, and even renal failure can occur. In terms of treatment, there are no specific drugs for acute nephritis; the main approach is symptomatic and supportive treatment. During the acute phase, patients should rest in bed and receive targeted treatment for their complications. If there is severe edema, diuretics may be used appropriately. If there is a significant increase in blood pressure, antihypertensive drugs should be used to control the pressure. In cases of severe heart failure, palpitations, chest tightness, and shortness of breath, diuretics should also be used to alleviate the cardiac load. If the patient experiences oliguria, hyperkalemia, or acute renal failure, temporary dialysis may be necessary. Furthermore, a low-salt, low-fat, and light diet should be maintained to prevent complications from excessive salt intake causing edema and high blood pressure. (Use of medications should be under the guidance of a doctor.)
IgA nephropathy stages 1, 2, 3 criteria
According to the standards of the World Health Organization, IgA nephropathy is classified into five stages pathologically. The first stage is where most glomeruli appear normal under light microscopy, with only minor mesangial proliferation or associated cellular proliferation, generally showing slight changes without damage to the tubules and interstitium; The second stage indicates mild lesions where over fifty percent of the glomeruli are normal, with only a small portion of the glomeruli showing mesangial cell proliferation, glomerular sclerosis adhesion, and other changes, without the formation of crescents; The third stage is focal segmental glomerulonephritis, characterized by diffuse proliferation of mesangial cells and widening of the mesangial areas, with the lesions exhibiting focal segmental changes and comparatively mild interstitial lesions.
Acute Nephritis Pathological Characteristics
The pathological features of acute nephritis include enlarged kidneys, and under the light microscope, there is diffuse proliferation of glomeruli, capillary endothelial cells, and mesangial cells. During the acute phase, there can be infiltration of neutrophils and mononuclear cells. In severe cases, constriction or occlusion of the capillary loops occurs, and the renal interstitium has edema and infiltration of inflammatory cells. Under immunofluorescence, there are deposits of IgG and C3 appearing as granular deposits along the glomerular capillary walls and mesangial areas. Under electron microscopy, there are hump-shaped electron-dense deposits beneath the glomerular epithelium. Acute nephritis is commonly seen in children, characterized by a sudden onset and symptoms such as hematuria, increased urinary protein, edema, and elevated blood pressure, even transient renal function decline may occur.
How should uremia patients rest?
Adequate rest plays a very important role in the recovery of patients with uremia. If the condition of the uremia patient is in an acute phase, for example, if the patient feels palpitations, chest tightness, shortness of breath after activities, or even has obvious edema and high blood pressure, the patient should rest in bed and try to avoid getting out of bed. They should eat and take care of personal hygiene while in bed. If they feel chest tightness, they can also use oxygen. Once the condition of the uremia patient has stabilized, especially after undergoing hemodialysis treatment, and the symptoms of uremia have improved, they can rest out of bed and should ensure they get seven to eight hours of sleep daily. Only through sufficient sleep can the patient's mental state significantly improve. During the rest period, patients can also engage in appropriate recreational activities, such as outdoor walks, singing, and other activities.
Causes of Uremia
Uremia is a syndrome caused by the progressive development of various chronic kidney diseases, eventually leading to renal failure in patients, where the kidneys are unable to promptly eliminate excess water, various electrolytes, and toxins from the body. There are many causes of uremia; chronic nephritis, diabetic nephropathy, and hypertensive nephropathy are the most common causes. Other causes include chronic tubulointerstitial nephritis, chronic pyelonephritis, chronic obstructive nephropathy, toxic nephropathy, hereditary nephritis, renal vascular diseases, and lupus nephritis. Once uremia occurs, the preferred treatment is dialysis therapy, which can be either hemodialysis or peritoneal dialysis. Only after dialysis treatment can the life of a patient with uremia be prolonged.
What are the symptoms of acute nephritis?
Acute nephritis is commonly seen in children. Most cases of acute nephritis are preceded by a history of streptococcal infection one to three weeks before the onset. Once acute nephritis occurs, the main symptoms include the development of edema, especially swelling of the eyelids and face after waking up in the morning. Additionally, patients with acute nephritis will also experience hematuria, which can be visible or microscopic, with increased foam in the urine and a change in color, and even a decrease in urine output. Of course, patients with severe acute nephritis will also experience a significant increase in blood pressure, leading to nausea, vomiting, headaches, palpitations, chest tightness, shortness of breath, and an inability to lie flat, resulting in heart failure. Therefore, patients with acute nephritis need to undergo reasonable and standardized treatment to avoid complications.
Is acute nephritis serious?
Acute nephritis is commonly seen in children, predominantly affecting male children. Often before the onset, there's a history of upper respiratory tract infection or skin infection. One to three weeks after these infections, patients may develop hematuria, swelling of the eyelids and lower extremities, and increased urinary protein. The severity of acute glomerulonephritis can vary; patients with milder forms of acute glomerulonephritis can be cured through appropriate treatment and standardized medication. However, if acute glomerulonephritis is not detected timely and treated properly, it can lead to severe complications, including uremia, heart failure, hypertensive encephalopathy, and other clinical manifestations. Therefore, acute nephritis must be taken seriously to avoid severe complications. Of course, with proper treatment, most patients with acute nephritis can fully recover and have a good prognosis.
acute nephritis symptoms
Acute nephritis is commonly seen in children and occurs more in males than females. It typically begins one to three weeks after an infection, mainly due to a post-streptococcal infection. The main symptom of acute nephritis is the appearance of edema, which is often an initial manifestation. Typically, this includes swelling of the eyelids in the morning, sometimes accompanied by mild swelling of the lower limbs. In addition, a urinalysis of patients might reveal blood, which can appear as either gross hematuria or microscopic hematuria. Furthermore, some patients with acute nephritis may also experience elevated blood pressure, primarily related to the edema. If managed through diuretic treatment, conditions may gradually return to normal. In severe cases of acute nephritis, symptoms can include dizziness, hypertensive encephalopathy, and even reduced urine output leading to acute kidney failure. Therefore, it is crucial to give significant attention to patients with acute nephritis and treat them actively to avoid severe complications.