Lower back pain is a common signs of kidney disease. When people feel that
they have lower back pain, they think it is kidney problem. Is lower back pain
indicating kidney problem? The experts in Beijing Yumei Kidney Disease Hospital
tell us:
Patients with kidney disease often have lower back pain. For example, when
patients have Acute Pyelonephritis, kidney emboli, Obstructive Kidney Disease,
rapid enlargement of kidney and suppurative inflammation around kidneys, they
will appear violent lower back pain. But not all patients with kidney problem
will have this symptom, such as Acute and Chronic Nephritis, Nephrotic Syndrome
and so on, they often just have slight discomfort or soreness of waist; few of
them appear violent lower back pain. In addition, other disease can also lead to
lower back pain, such as lumbar muscle strain, lumbar hyperosteogeny, lumber
sprain and women’s pelvic lesions (pelvic inflammation, annexitis and so on). So
not all lower back pains are indicating kidney problem. Patients should go to
hospital to take examination to confirm the reason.
Showing posts with label kidney. Show all posts
Showing posts with label kidney. Show all posts
Wednesday, February 26, 2014
Sunday, February 16, 2014
Whether Patients with Kidney Disease can be Pregnant?
Be with a child is an earnest wish for every women. But for the women with
kidney disease, are they suitable to be with a child? Will pregnancy worsen the
kidney damage? Is there any influence for the fetus? For the answers for these
questions, the experts said, there are many kinds of kidney disease. Whether the
patients can be pregnant and what time is best for pregnancy are depended on the
specific conditions.Generally speaking, the conditions of not suitable pregnancy
include:
1. Patients with Renal Failure. No matter male or female, patients with Renal Failure are not suitable for pregnancy, because the toxin accumulation may affect the quality of sperm and ovum. Particularly, women patients with pregnancy will further worsen kidney burden, which not only threat women’s life, but also lead to fetal malformation, abortion and dead fetus.
2. Patients with severe infectious kidney disease. Such as urocystitis, hydronephrosis, they are also not suitable for pregnancy, because they will use large amounts of antibiotics in the treatment process, which may affect fetus’s health.
But, patients with some kidney disease can be pregnant after controlling the disease. These conditions include:
1. Patients with severe infectious kidney disease after controlling well
Patients with severe infectious kidney disease wanting to have a child should be after controlling well the condition and stopping taking medicine for 2-3 months. For patients with kidney transplantation, they can have a child after one year for male and 2 years for female, also the dosage of anti rejection drugs is little. However, the risk of pregnancy and fetus malformation is higher than healthy people.
2. Women with mild Chronic Nephritis
For patients with Chronic Nephritis, if the condition is mild, and no high blood pressure and kidney damage, they can take it consider to be pregnant. But patients should closely observe blood pressure, urine protein and kidney function during the pregnancy.
If patients occur to blood pressure increase and kidney function worsening in the first 3 months of pregnancy, it’s indicated that patients are not suitable for pregnancy. If necessary, patients should terminate pregnancy under doctor’s guidance. Otherwise, both fetus and pregnant mother have a vital danger.
In addition, if one parent with autoimmune disease, like systemic lupus erythematosus, they must meet pregnancy requirements, like urine protein becoming negative, kidney function becoming normal, disease controlling well, stopping taking steroid for above half years.
1. Patients with Renal Failure. No matter male or female, patients with Renal Failure are not suitable for pregnancy, because the toxin accumulation may affect the quality of sperm and ovum. Particularly, women patients with pregnancy will further worsen kidney burden, which not only threat women’s life, but also lead to fetal malformation, abortion and dead fetus.
2. Patients with severe infectious kidney disease. Such as urocystitis, hydronephrosis, they are also not suitable for pregnancy, because they will use large amounts of antibiotics in the treatment process, which may affect fetus’s health.
But, patients with some kidney disease can be pregnant after controlling the disease. These conditions include:
1. Patients with severe infectious kidney disease after controlling well
Patients with severe infectious kidney disease wanting to have a child should be after controlling well the condition and stopping taking medicine for 2-3 months. For patients with kidney transplantation, they can have a child after one year for male and 2 years for female, also the dosage of anti rejection drugs is little. However, the risk of pregnancy and fetus malformation is higher than healthy people.
2. Women with mild Chronic Nephritis
For patients with Chronic Nephritis, if the condition is mild, and no high blood pressure and kidney damage, they can take it consider to be pregnant. But patients should closely observe blood pressure, urine protein and kidney function during the pregnancy.
If patients occur to blood pressure increase and kidney function worsening in the first 3 months of pregnancy, it’s indicated that patients are not suitable for pregnancy. If necessary, patients should terminate pregnancy under doctor’s guidance. Otherwise, both fetus and pregnant mother have a vital danger.
In addition, if one parent with autoimmune disease, like systemic lupus erythematosus, they must meet pregnancy requirements, like urine protein becoming negative, kidney function becoming normal, disease controlling well, stopping taking steroid for above half years.
Tuesday, January 14, 2014
How do we solve hyperkalemia in kidney failure?
Sunday, December 29, 2013
Chronic Kidney Insufficiency
Chronic Kidney Insufficiency
Chronic Kidney Insufficiency refers to primary kidney disease or secondary kidney disease continuous progression leading to kidney function continuous decrease until to renal failure, and thus occurs to metabolic product retention, water, electrolyte, acid-base balance disorder and all organs and tissues involvements and such a series of clinical syndrome.
The Clinical Stages of Kidney Insufficiency
National Standard
StagesCcr (ml/min)Creatinine (umol/L)
Renal function compensatory stage50--80133--177
Renal function decompensatory period20--50 186--442
Renal failure stage10--20 451--707
Uremia stage below10Above 707
International Standard
stagesymptomsGFR ml/minPrevention and treatment measures
stage IKidney disease occurring> 90 Relieve symptoms and reduce CKD progression
Stage IIGFR slight decrease60--89 Evaluate and reduce CKD progression, reduce cardiovascular complications
Stage III GFR middle decrease30--59 Reduce CKD progression and treating complications
Stage IVGFR severe decrease15--29 Systemic treatment and preparing dialysis
Stage V GFR(kidney failure)<15 If occurring to Uremia, patients should receive dialysis timely.
The Pathogenesis of Chronic Kidney Insufficiency
The essence of Chronic Kidney Insufficiency is kidney pathological changes. The final reason is intrinsic cells damage due to various factors and then it caused fibrous tissue proliferation, resulted to glomerular sclerosis and interstitial fibrosis, normal kidney structure damaged and functional nephron replaced by fibrous tissues. The decline level of renal function and renal fibrosis is in direct proportion.
The Factors Which Can Worsen Kidney Insufficiency Progression.
1. Hypertension: hypertension may not only accelerate kidney damage progression, but also may damage heart, brain and other vital organs.
2. Proteinuria: large volume of proteinuria may worsen the damage of glomerular and tubular, promote the progression of glomerulosclerosis and interstitial fibrosis.
3. High protein diet: high protein diet may cause high glomerular filtration and high tubular metabolism. If the Urine Protein ++ continues for one year, the GFR may decrease 10%-20%.
4. in function of Uremia: such as Methylguanidine, Parathyrin and henols, they all have toxin to kidneys.
5. erlipidemia: Hyperlipidemia may cause damage to glomerular mesangial cell and endotheliocyte cells and stimulate mesangial cell secreting extracellular matrix or induce glomerular mesangial cells apoptosis.
6. Chronic Hypoxia: Chronic Hypoxia may activate Angiotension II and certain growth factors and induce extracellular matrix increasing and then accelerate tubular---interstitial damage which plays an important role in renal tissue sclerosis and fibrosis.
7. Glomerular ischemia: the role of glomerular ischemia in interstitial fibrosis has been stressed. And it is also closely related with tubular atrophy and interstitial fibrosis.
The Dangerous Factors Which Can rapidly Worsen Chronic Kidney Insufficiency.
1. The diseases involved to kidneys recurrence or worsen.
2. Hypovolemia, low blood pressure, dehydration, shock and so on.
3. The renal local blood supplement rapidly reduce, such as artery stenosis or use ACEI, ARB and such drugs
4. Tissue injury or massive hemorrhage.
5. Serious infection
6. Renal toxic drugs
7. Severe hypertension which is unable to control.
8. Urinary tract blocking
9. Others: such as hypercalcemia, hypercoagulable or hyperviscosity, serious malnutrition and so on.
The Clinical Symptoms of Chronic Kidney Insufficiency
For Chronic Kidney Insufficiency, according to different clinical stages, the clinical symptoms may involve to all systems in the whole body, from slight to severe, from less to more.
1. Balance disorder of Water and electrolyte: water metabolic disorder presents urine concentration decrease leading to nocturia increase and specific gravity decrease. The electrolyte disorder includes low sodium, high potassium, low calcium, high phosphorus and high magnesium and so on.
2. Acid-base balance disorder: all patients with kidney failure may have different levels of metabolic acidosis, may have fatigue, poor appetite, the blood PH decline and HCO3 decline
3. Anemia: all patients with kidney failure have different levels of anemia.Generally speaking, the level of anemia is coinciding with the level of the disease. If the anemia is occurring earlier in interstitial damage, and the degree of the damage is not coinciding.
4. Hypertension: most of patients with kidney failure have different levels of hypertension, some of them may have refractory hypertension.
5. Heart insufficiency: it is the common complication and death cause.
6. Digestive system disorder: patients may have anorexia, nausea, vomiting, diarrhea, gastrointestinal bleeding and so on.
7. Respiratory system: when the patient is in serious acidosis, they may have deep respiration, and pulmonary edema
8. Nerve and mental disorder: patients may have uremic encephalopathy, peripheral neuropathy, its manifestation is restless legs syndrome.
9. Metabolic & endocrine disorder: The manifestation is metabolic disorder of carbohydrate-lipid-protein.
The Treatment of Chronic Kidney Insufficiency.
1. The general treatment: patients should pay attention to the diet, following the principle of ‘five low and one high’ (five low means: low potassium, low salt, low phosphorus, low lipid, low protein; one high means: high vitamin), pay attention to have rest and not catch cold and so on.
2. Symptomatic treatment:
1) To correct acidosis: when the carbon dioxide combing power is at 16--13mmol/L, patients may take some sodium bicarbonate and such alkaline drugs by oral taken or by vein injecting .
2) To correct low calcium and hyperkalemia: The common calcium supplement drugs include: calcium carbonate, Rocaltrol, Calcitriol, Caltrate and so on. Control hyperkalemia may use: oral taken ion-exchange resin, vein injecting calcium gluconate, intravenous drip 10% glucose 500 ml with 10 units insulin, and using diuresis to remove potassium. When the potassium is more than 6.5mmol/L, patients will prepare for dialysis.
3) To control hypertension: Some antihypertensive medicine can be used together, But one thing should be cared that when the serum creatinine is more than 264mmol/L, the ACEI and ARB should be used cautiously. It would be better if the blood pressure is to be controlled at 140/90 and 125/75
4) To correct Anemia: The common treatment is EPO subcutaneous injection and chalybeate supplying, etc.
5) To improve renal blood circulation: The common Chinese herbal drugs to promote blood circulation to remove blood stasis are: Salviae Miltiorrhizae, Flos Carthami, Herba Erigernotis and so on. The common western medicine is Sodium Ferulate,etc.
6) Treatment of other complications and primary diseases.
7) Dialysis: the indicators: for Diabetes, the creatinine is more than 530 mmol/L. For non-diabetes, the creatinine is more than 707 mmol/L, blood potassium more than 6.5 mmol/L, or patients have heart failure, refractory hypertension and so on.
Chronic Kidney Insufficiency refers to primary kidney disease or secondary kidney disease continuous progression leading to kidney function continuous decrease until to renal failure, and thus occurs to metabolic product retention, water, electrolyte, acid-base balance disorder and all organs and tissues involvements and such a series of clinical syndrome.
The Clinical Stages of Kidney Insufficiency
National Standard
StagesCcr (ml/min)Creatinine (umol/L)
Renal function compensatory stage50--80133--177
Renal function decompensatory period20--50 186--442
Renal failure stage10--20 451--707
Uremia stage below10Above 707
International Standard
stagesymptomsGFR ml/minPrevention and treatment measures
stage IKidney disease occurring> 90 Relieve symptoms and reduce CKD progression
Stage IIGFR slight decrease60--89 Evaluate and reduce CKD progression, reduce cardiovascular complications
Stage III GFR middle decrease30--59 Reduce CKD progression and treating complications
Stage IVGFR severe decrease15--29 Systemic treatment and preparing dialysis
Stage V GFR(kidney failure)<15 If occurring to Uremia, patients should receive dialysis timely.
The Pathogenesis of Chronic Kidney Insufficiency
The essence of Chronic Kidney Insufficiency is kidney pathological changes. The final reason is intrinsic cells damage due to various factors and then it caused fibrous tissue proliferation, resulted to glomerular sclerosis and interstitial fibrosis, normal kidney structure damaged and functional nephron replaced by fibrous tissues. The decline level of renal function and renal fibrosis is in direct proportion.
The Factors Which Can Worsen Kidney Insufficiency Progression.
1. Hypertension: hypertension may not only accelerate kidney damage progression, but also may damage heart, brain and other vital organs.
2. Proteinuria: large volume of proteinuria may worsen the damage of glomerular and tubular, promote the progression of glomerulosclerosis and interstitial fibrosis.
3. High protein diet: high protein diet may cause high glomerular filtration and high tubular metabolism. If the Urine Protein ++ continues for one year, the GFR may decrease 10%-20%.
4. in function of Uremia: such as Methylguanidine, Parathyrin and henols, they all have toxin to kidneys.
5. erlipidemia: Hyperlipidemia may cause damage to glomerular mesangial cell and endotheliocyte cells and stimulate mesangial cell secreting extracellular matrix or induce glomerular mesangial cells apoptosis.
6. Chronic Hypoxia: Chronic Hypoxia may activate Angiotension II and certain growth factors and induce extracellular matrix increasing and then accelerate tubular---interstitial damage which plays an important role in renal tissue sclerosis and fibrosis.
7. Glomerular ischemia: the role of glomerular ischemia in interstitial fibrosis has been stressed. And it is also closely related with tubular atrophy and interstitial fibrosis.
The Dangerous Factors Which Can rapidly Worsen Chronic Kidney Insufficiency.
1. The diseases involved to kidneys recurrence or worsen.
2. Hypovolemia, low blood pressure, dehydration, shock and so on.
3. The renal local blood supplement rapidly reduce, such as artery stenosis or use ACEI, ARB and such drugs
4. Tissue injury or massive hemorrhage.
5. Serious infection
6. Renal toxic drugs
7. Severe hypertension which is unable to control.
8. Urinary tract blocking
9. Others: such as hypercalcemia, hypercoagulable or hyperviscosity, serious malnutrition and so on.
The Clinical Symptoms of Chronic Kidney Insufficiency
For Chronic Kidney Insufficiency, according to different clinical stages, the clinical symptoms may involve to all systems in the whole body, from slight to severe, from less to more.
1. Balance disorder of Water and electrolyte: water metabolic disorder presents urine concentration decrease leading to nocturia increase and specific gravity decrease. The electrolyte disorder includes low sodium, high potassium, low calcium, high phosphorus and high magnesium and so on.
2. Acid-base balance disorder: all patients with kidney failure may have different levels of metabolic acidosis, may have fatigue, poor appetite, the blood PH decline and HCO3 decline
3. Anemia: all patients with kidney failure have different levels of anemia.Generally speaking, the level of anemia is coinciding with the level of the disease. If the anemia is occurring earlier in interstitial damage, and the degree of the damage is not coinciding.
4. Hypertension: most of patients with kidney failure have different levels of hypertension, some of them may have refractory hypertension.
5. Heart insufficiency: it is the common complication and death cause.
6. Digestive system disorder: patients may have anorexia, nausea, vomiting, diarrhea, gastrointestinal bleeding and so on.
7. Respiratory system: when the patient is in serious acidosis, they may have deep respiration, and pulmonary edema
8. Nerve and mental disorder: patients may have uremic encephalopathy, peripheral neuropathy, its manifestation is restless legs syndrome.
9. Metabolic & endocrine disorder: The manifestation is metabolic disorder of carbohydrate-lipid-protein.
The Treatment of Chronic Kidney Insufficiency.
1. The general treatment: patients should pay attention to the diet, following the principle of ‘five low and one high’ (five low means: low potassium, low salt, low phosphorus, low lipid, low protein; one high means: high vitamin), pay attention to have rest and not catch cold and so on.
2. Symptomatic treatment:
1) To correct acidosis: when the carbon dioxide combing power is at 16--13mmol/L, patients may take some sodium bicarbonate and such alkaline drugs by oral taken or by vein injecting .
2) To correct low calcium and hyperkalemia: The common calcium supplement drugs include: calcium carbonate, Rocaltrol, Calcitriol, Caltrate and so on. Control hyperkalemia may use: oral taken ion-exchange resin, vein injecting calcium gluconate, intravenous drip 10% glucose 500 ml with 10 units insulin, and using diuresis to remove potassium. When the potassium is more than 6.5mmol/L, patients will prepare for dialysis.
3) To control hypertension: Some antihypertensive medicine can be used together, But one thing should be cared that when the serum creatinine is more than 264mmol/L, the ACEI and ARB should be used cautiously. It would be better if the blood pressure is to be controlled at 140/90 and 125/75
4) To correct Anemia: The common treatment is EPO subcutaneous injection and chalybeate supplying, etc.
5) To improve renal blood circulation: The common Chinese herbal drugs to promote blood circulation to remove blood stasis are: Salviae Miltiorrhizae, Flos Carthami, Herba Erigernotis and so on. The common western medicine is Sodium Ferulate,etc.
6) Treatment of other complications and primary diseases.
7) Dialysis: the indicators: for Diabetes, the creatinine is more than 530 mmol/L. For non-diabetes, the creatinine is more than 707 mmol/L, blood potassium more than 6.5 mmol/L, or patients have heart failure, refractory hypertension and so on.
Sunday, November 10, 2013
12 articles about kidney disease, worth seeing.
What To Eat For Patient With FSGS
FSGS is a primary glomerular disease, and it can progress into kidney failure gradually. It is very important for patient with FSGS to choose their diet, which can make a significant influence to their health condition.
http://www.kidneyservicechina.com/diet/1597.html
What Are The Causes Of Dialysis Patients’ Shortness Of Breath
Shortness of breath is a common symptom in patient who is accepting dialysis, which is suffering for dialysis patient. And what are the causes of shortness of breath in dialysis patient?
http://www.kidneyservicechina.com/renal-failure-symptoms/1596.html
What To Eat For Patient With FSGS
FSGS is a primary glomerular disease, and it can progress into kidney failure gradually. It is very important for patient with FSGS to choose their diet, which can make a significant influence to their health condition.
http://www.kidneyservicechina.com/diet/1597.html
What Is The Dangerous Level Of Creatinine
Creatinine is a common standard to assess patient’s kidney condition. High creatinine level often means a dangerous condition for patient with kidney disease, while what is the dangerous level of creatinine?
http://www.kidneyservicechina.com/high-creatinine-level/1598.html
What Is The Effect Of Kidney Failure On Urine Output
Kidney failure can cause many problems to patient’s body health. As we know, the excess fluid in body will be excreted out by kidney in the form of urine, so kidney failure can cause obvious symptom on patient’s urine output.
http://www.kidneyservicechina.com/renal-failure-symptoms/1599.html
Kidney Diseases That Run In Families
Kidney disease can cause severe damage to body health. While some kidney diseases are genetic, and they can run in families, which is a huge threat for families who have these kinds of kidney disease.
http://www.kidneyservicechina.com/nephritis-basics/1600.html
How does IgA Nephropathy Affect Human Immune System
IgA nephropathy is an autoimmune kidney disease, which is caused by the accumulation of IgA in glomerular mesangium. This disease is caused by patient’s immune disorder, and it can affect patient’s immunity in turn. While how does IgA nephropathy affect human immune system?
http://www.kidneyservicechina.com/IgA-nephropathy-basics/1601.html
What’s Diet To Be Given To A Patient Suffering From Kidney Failure
Diet is important for kidney failure patient’s condition. A appropriate diet plan is very helpful for the improvement of patient’s condition, while a terrible dietary mode will boost the aggravation of patient’s disease. What’s diet on earth to be given to a patient suffering from kidney failure?
http://www.kidneyservicechina.com/diet/1602.html
Would There Be An Increased Presence Of Creatinine In The Blood Or Urine In Glomerulonephritis
Would there be an increased presence of creatinine in the blood or urine in glomerulonephritis? In fact, it is, and glomerulonephritis can cause very high creatinine level if patient has not accepted right treatment and care to control his condition.
http://www.kidneyservicechina.com/nephritis-basics/1604.html
What Does High Creatinine Mean
Creatinine is a common standard to assess patient’s kidney function, and patient may know high creatinine is a dangerous sign. It is necessary for patient to have a better understanding about this aspect, which is helpful for patient to deal with his condition.
http://www.kidneyservicechina.com/high-creatinine-level/1607.html
If Patient On Hemodialysis, Can Add olive oil To His Diet
If patient on dialysis, can add olive oil to his diet? Accepting dialysis means patient is already in stage 5 kidney failure, and patient will have strict restriction in his diet.
http://www.kidneyservicechina.com/renal-failure-healthy-lifestyle/1606.html
Foods To Avoid For Patient With 1.3 Creatinine Level
Creatinine 1.3 may mean severe kidney damage, so it is very important for patient to pay attention to his diet, because diet can make a significant influence to patient’s health condition. It is necessary for high creatinine patient to understand what foods he should avoid, because that is very helpful for patient to deal with his condition.
http://www.kidneyservicechina.com/diet/1605.html
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