Kidney friends, together to resist smoking, drinking amount

Author: Leo
Key words: nephropathy

Introduction
For good health, friends, we together to resist smoking, boycott secondhand smoke, drink the right amount, can do it?
Together to resist smoking
We often hear: cigarettes contain a lot of carcinogenic substances, can induce cancer, such as lung cancer. But small partners may not know, in fact, long-term smoking will increase kidney disease.
Nicotine in cigarettes will harden the blood vessels, and our kidneys are a very rich organ of blood vessels, and therefore will be affected by smoking.
Small partners want to keep the kidney function as much as possible, to stabilize the level of good blood pressure, then, it is necessary to understand that the smoke is not appropriate amount of the problem, but one is not pumping.
For long-term victims of second-hand smoke in the environment, you have to understand --- second-hand smoke is also a great harm, no less than haze, should take action to protect their health, from secondhand smoke environment.
Allowed, you can drink properly
There have been very many studies have shown that moderate drinking may have some benefits to health, and alcohol abuse will be harmful to the body.
Therefore, if the condition allows the kidneys, you can drink the right amount, the condition is:

1) Alcohol is not allergic
Some people will blush after drinking, from the rash, a serious drink will have a clear dizziness, cold sweat and other performance, any drinking there are these discomfort, that your body itself is not suitable for drinking!
This time against the body instructions to drink hard, it is a bit made.
2) no digestive diseases
There are liver-related diseases, pancreatitis, gastric ulcer and other digestive system problems, can not drink.
3) no high uric acid, gout
High uric acid, gout is best not to drink, especially can not drink beer!
4) is not taking antibiotics
When you take antibiotics, you can not drink! Some people can appear "disulfiram-like reaction".
What is a disulfiram-like reaction? In fact, many small partners have had this reaction: eat cephalosporins, go to drink, that sour cool! Drink a little bit to start "heart beat badly, sudden increase in blood vessels suddenly jump ......." had a good time to be able to line. Severe some, even breathing difficulties, chest pain, have to be sent to rescue!
So, if you eat antibiotics, do not drink!
There is no such problem, usually can be appropriate.
How appropriate?

To calculate the amount of alcohol, the general adult men and women a day, male alcohol does not exceed 25g, female alcohol does not exceed 15g.

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"Creatinine" from where to come

Author: Leo
Key words: nephropathy

Introduction
Outpatient many patients, in the test of renal function, because serum creatinine increased, the doctor told the renal insufficiency, and even diagnosed as uremia. So, where is the creatinine coming from?
Name: Creatinine Abbreviation: Cre
Category: serum creatinine, creatinine
Reference: male 44-132umol / L, female 70-106umol / L
How does creatinine come from?
Creatinine is a metabolite of muscle in the human body.
There are two major sources of serum creatinine: exogenous creatinine (decomposition of animal lean meat from food) and endogenous creatinine (in vivo muscle breakdown).

Normal serum creatinine reference value:
Male 44-132umol / L, female 70-106umol / L, due to the different hospital testing equipment, the reference range will be some differences.
Usually female creatinine value is lower than men, because the female muscle is not developed by men, the elderly blood creatinine value is lower than the young, because the elderly life, basic metabolism is low, muscle decomposition is slow.

Does serum creatinine reflect renal function?
Creatinine is a small molecule, mainly through the kidneys to excreted in vitro, renal tubules rarely absorbed.

Under normal circumstances, because the body's muscle mass and diet is relatively stable, so the amount of creatinine production is relatively constant, the body total creatinine = serum creatinine + urine creatinine.
Urinary creatinine row of the more the better, indicating a strong renal filtration function, and elevated serum creatinine levels that renal damage.
Therefore, the clinical use of serum creatinine as an important indicator of renal injury, and the degree of renal damage was positively correlated.
In addition:
Blood urea nitrogen can also reflect renal function, but it is affected by many factors, such as high protein diet, gastrointestinal bleeding, infection can increase it, and low protein diet, a large number of drinking water, chronic liver disease can lead to blood urea nitrogen concentration Lower, so the evaluation of renal function specificity is poor.
In addition to creatinine:
There are many substances in the human body through the kidney metabolism, but the creatinine metabolic pathway is relatively simple, relatively stable and reliable, so the clinical use of serum creatinine to evaluate the quality of renal function.
Normal serum creatinine function normal?
Check to find their blood creatinine value in the normal range, does not mean that your kidney function is no problem.
because:

Creatinine can be excreted by renal tubules, renal function decreased more by the renal tubular excretion of creatinine accounted for the greater proportion of renal creatinine clearance. While the elderly patients, their creatinine level is lower than the young people So blood creatinine value is not a sensitive indicator of renal function.
Kidney has a strong compensatory function, if the two kidneys are normal, then as long as a kidney function, serum creatinine can be maintained at normal levels.
That is to say:
When the discovery of elevated serum creatinine, nearly half of the kidney has been "broken" the.
How to accurately assess renal function?
Mainly to see glomerular filtration rate (GFR), that is, the amount of time per unit of renal filtration.
However, GFR can not be measured directly, can only be replaced by a certain marker of renal clearance, or calculated by the formula, called the estimated glomerular filtration rate (eGFR).
Inulin removal rate is a recognized standard for the detection of GFR, but because of the cumbersome measurement method, expensive, need continuous infusion and indwelling catheter, so the clinical is not commonly used.
Clinical methods commonly used to evaluate GFR
1, radionuclide labeling (ECT):
That is, intravenous injection of a radioactive substance 99mTc-DTPA, most of this material through the renal filtration, without any other changes, according to the rate of removal of radioactive drugs and the number of eGFR calculated. Compared with the inulin, this check is more simple and easy.
2, endogenous creatinine clearance (Ccr):
Ccr normal value 80-120ml / min. There are two ways to produce creatinine, and when the control of exogenous food and the avoidance of vigorous exercise, the daily production of endogenous creatinine is fairly constant, the endogenous creatinine is treated as a marker, and the endogenous creatinine is discharged by measuring the kidneys In vitro rate, can reflect the renal filtration function.
3, formula:
The formulas for estimating GFR are: CG formula, CKD-EPI formula, MDRD formula. That is, through the serum creatinine, age, sex, race, etc., to calculate eGFR, this method is most commonly used by kidney clinicians.
4, other

In addition, in recent years to check serum cystatin C, retinol binding protein, blood β-2 microglobulin can also reflect renal function early.

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Treatment and nursing of constipation in patients with dialysis

Author: Leo
Key words: nephropathy

Introduction
Dialysis patients with constipation is not a small problem, should cause patients and health care workers full attention, dialysis and constipation is mutual influence, to develop good bowel habits, the best 1-2 times a day, help to ensure good dialysis adequacy, Improve the quality of life of dialysis patients.
Dialysis crowd constipation and the general population of constipation treatment is still very different, such as the most commonly used to deal with constipation is a large intake of liquid off, for oliguria or anuria dialysis patients fluid overload can lead to edema, Heart failure and pulmonary edema, so dialysis patients are not allowed to increase the amount of liquid to relieve constipation.
Second, often encourage the common constipation crowd to eat high-fiber food methods, is not suitable for dialysis patients. Contains fiber foods are generally fresh fruits, vegetables and bran foods that are rich in potassium and phosphorus in these foods, and excessive use of dialysis patients can occur or aggravate hyperkalemia and hyperphosphatemia.
Hemodialysis patients with constipation and the occurrence of multiple factors, should be based on their own characteristics from the following aspects to maintain the stool:
1 to relax the mind, adjust the schedule, to develop regular bowel habits is essential. For uremic itself caused by constipation, under the premise of adequate dialysis, to guide the diet program, practice effective defecation movements, the establishment of normal defecation reflex.
2 according to the doctor's request to control dialysis interval weight gain, if constipation should be timely and blood purification center physician communication. For patients with excessive dehydration during dialysis, such as dialysis during the dry mouth, hoarseness, muscle spasms, abdominal pain, inconvenience, hypotension, etc., need to re-evaluate the dry weight, reduce the amount of ultrafiltration.
3 patients with less activity can carry out some suitable for their own aerobic exercise, such as doing gymnastics, playing tai chi, walking, etc., to promote gastrointestinal motility, improve digestive function, special patients can do abdominal exercise and massage.
4 to avoid abuse of laxative drugs, pay attention to the adverse reactions of laxative drugs. At present, laxative drugs can be divided into six categories: fluency laxatives, fecal softeners, fiber supplements, lumps of laxative agents, irritating laxatives, osmotic laxatives, etc., dialysis constipation patients should be under the guidance of doctors, Choose the appropriate laxative drugs, if necessary, but also with the gastrointestinal motility drugs, but should minimize the dependence on drugs.
Dialysis patients can usually use fecal softener, especially for bed rest or sedentary, stool hard knot patients, commonly used drugs are docetyl sodium. Lubricant laxatives, can change the hardness of feces, to prevent intestinal mucosal absorption of water. But long-term use may hinder the absorption of fat-soluble vitamins, preferably less or occasionally used, should be taken before going to bed.
Permeability, lubricity, volumetric and irritant laxatives have a long-term use of some adverse reactions. Such as: irritant laxatives, containing anthraquinone glycosides in the intestine by bacteria eventually decomposed into anthrone, anthrone has a strong cytotoxicity, damage the intestinal wall plexus, leading to electrolyte imbalance and colon melanosis. Abuse can produce dependence and resistance, causing laxative constipation.
Permeability laxatives are common sorbitol, polyethylene glycol, lactulose and salt laxative (magnesium), etc., can increase the intestinal osmotic pressure, intestinal water increased, easy to discharge feces.
However, laxatives or laxatives should be used with caution, use, you must monitor the value of the electrolyte, not long-term use. The use of drug enema should also be used with caution and the need to avoid the use of large amounts of saline and water enema, as liquid and saline through the small intestine can cause fluid load and sodium imbalance.

In short, dialysis patients with constipation is not a small problem, should cause patients and health care workers full attention, dialysis and constipation are mutual influence, to develop good bowel habits, the best 1-2 times a day, help to ensure good dialysis To improve the quality of life of dialysis patients.

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Cycling can also cause kidney disease recurrence

Author: Leo
Key words: nephropathy

From google images

Introduction
Said kidney disease combined with work and rest is conducive to the recovery of the disease, but this "labor" but no specific standards, many patients eat a dumb loss. Usually the first should pay attention to rest, serious illness when bed rest, the second note diet, low salt quality protein diet. After the illness can be appropriate exercise. A few days ago back to the hospital to review the old man encountered this situation, the original proteinuria improved very good, but because at home when riding a bike for too long, leading to recurrence.
The elderly are glomerulonephritis, from last year after treatment in our hospital after treatment, protein + -, protein quantification also fell to 0.5g or less. Last year in December came back to review is also very good. It seems that the indicators of the elderly have been kept very well. However, the weather is warmer, the elderly want to activities, can be an activity on the degree.
At that time riding a car home, the old man found the legs and edema, urine bubble is also much more than before, went to the county hospital physical examination found that the protein has become a plus. But the elderly did not panic, the next day directly to our hospital referral.
The old man's condition is not heavy, too timely, urine routine examination, the results show 1 +, after a systematic treatment, proteinuria has been significantly improved the phenomenon. Sports therapy is varied, such as walking, cycling, swimming, jogging, tai chi, gymnastics, martial arts and so on. Nephrotic patients should be moderate intensity of aerobic exercise to improve their cardiovascular function, enhance disease resistance and fatigue resistance, reduce the risk of recurrence of kidney disease. How reasonable distribution of exercise time and intensity, but also patients need to pay attention to the place.

Intuitively, the patient in the course of the movement can speak, but can not sing the song, and accompanied by more serious breathing, indicating that the current is the limit of the movement of patients. Patients should choose according to their own physical fitness, and under the guidance of a doctor, with particular attention to the relationship between exercise and rest, so as to avoid old and worse disease. Chronic nephritis exercise therapy in clinical practice and life mainly in the traditional sports health care methods, the traditional sports health care method is the main feature of static and dynamic combination, emotional dependency, both internally and externally, both physically and mentally.

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Renal function deterioration of the 10 major signals

Author: Leo
Key words: nephropathy

Guidance
Early symptoms of kidney disease is often not obvious, it is easy to be ignored, when patients appear obvious discomfort, often kidney disease has been heavy, and even life-threatening, so we must recognize the following signs of renal function decline, early detection Signs of kidney disease.
1. Lack of heart: kidney function is not good, a lot of waste is difficult to excrete from the urine, there will be lack of energy, fatigue, fatigue and so weak feeling. Kidney disease, protein and other nutrients leak from the kidneys, excreted through the urine, there will be no lack of performance. Some patients will think it is too tired, or other reasons, while ignoring the kidney problem.
2. appetite worse: the patient will appear a variety of gastrointestinal symptoms, especially because of gastrointestinal edema, often do not think of diet, abdominal distension and other symptoms of digestive disorders.
3. Nausea and vomiting When diabetic patients with renal failure, blood urea nitrogen increased intestinal bacteria will be broken down into ammonia ammonia, ammonia can stimulate the gastrointestinal mucosa, causing nausea, vomiting. Combined with the kidneys at this time on the urine of the enrichment function, it will increase the patient's nocturnal urine, and body water at night will be a lot of loss, blood concentration, morning blood urea nitrogen levels are relatively elevated. Therefore, morning when easy to disgust, vomiting increased.
4. urine bubble: there are many reasons for the bubble in the urine, kidney disease can cause this phenomenon. If the protein from the kidney to the urine, the urine will be a lot of foam.
5. Urinary incontinence is normal and healthy people every day the number of urination 4-6 times, urine output of about 800-2000 ml, if the number of urination and urine output too much or too little, we should pay attention.
6. urinary protein and urinary urinary urinary protein or occult blood, kidney is an important sign of disease, urine can be found. But sometimes non-kidney disease professional doctors will ignore this point, it is recommended to find the best doctor for kidney disease consultation.
7. Anemia patients often go to the Department of Hematology. In fact, the kidneys in addition to excretion of waste and other functions, there are secretion of hematopoietic function, but also a major signal of renal damage.
8. Hypertension and hypertension can cause hypertensive nephropathy, also known as hypertensive kidney damage, so people with high blood pressure to pay more attention. Of course, kidney disease can also lead to high blood pressure.
9. Gout hyperuricemia. Gout, hyperuricemia are caused by excessive uric acid in the blood, high blood uric acid, uric acid will be deposited in the kidney, so that impaired renal function.

10. urinary tract infection often urinary tract infection, a long time, may cause renal insufficiency.

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Imagine the gout behind the scenes of the murderer is a sugar drink

Author: Leo
Key words: nephropathy

Guidance
High purine content of food, has been a taboo on the recipe for gout patients. However, studies have shown that simply the level of purine content, to determine the impact of food on gout patients is one-sided, or even wrong.
1
Beans - flat injustice snow, is no longer taboo
Beans, with its higher purine content, has been regarded as a scourge. Accompanied by tofu, soy milk, bean sprouts and other soy products together as a blacklist.
New studies have confirmed that beans and other rich in purine vegetables intake and uric acid concentration has nothing to do!
Injustice for many years, and finally Ping injustice snow, after the gout patients can enjoy a variety of delicious beans and their products friends.
2
Hidden behind the scenes murderer - sugar beverages
Never imagined, purine content of 0 sugar drinks, and the incidence of gout and even!
Several studies have found that sugary drinks will increase the level of uric acid, not only will increase the risk of gout, but also increase the risk of hypertension and diabetes.
In addition to our familiar carbonated drinks, milk tea, etc., there are a lot of green tea, grapefruit tea, herbal tea, fruit juice, children's milk and other cover, but added a lot of sugar drinks, is secretly harm everyone healthy killer!
3
New helper - milk
Fortunately, nature has given us all the weapons of self protection.
Studies have confirmed that milk and its products can prevent the rise of uric acid and gout.
A cup of milk every day, whether for the elderly, children, or gout patients, are worth recommending.
4
Seafood, meat, wine - is still blacklist
Wine, and high purine animal foods have been proven to have a significant effect on uric acid levels.
Beer + barbecue, has always been the cause of acute gout.
In the acute onset of gout, should try to avoid such food.
Usually also through some tips to remove the food purine.
5
To purine technology
Will be sliced ​​or shredded into the boiling water, can effectively remove the purine.

Do not remember, boiled meat with water, to discard, can not drink!

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All control sodium control salt, control phosphorus you will

Author: Leo
Key words: nephropathy

Guidance
Hyperphosphatemia and renal bone disease, is a common complication of kidney disease, affecting the lives of patients with a large number of kidney disease. Dietary control of phosphorus in kidney disease prevention and treatment process is particularly important. It is recommended to choose food from CKD early to reduce phosphorus intake.
✓ theory we all understand, operation is not so simple
In clinical practice and real life, how to guide the patient is very challenging.
Usually ask the patient to understand the phosphorus content in the food, phosphoprotein ratio, etc., to help the food choice. However, often spend a lot of time, the effect is unsatisfactory.
How to quickly and effectively carry out patient education, is a lot of clinical care and nutritionists have been exploring the topic.
✓ New ideas, phosphorus pyramid, help food selection
The Py Pyramid is a visual tool designed to present the phosphoric acid load of various foods and to guide the patient's choice of food.
Pyramid is divided into six layers, taking into account the food phosphorus content, phosphorus protein ratio, phosphorus absorption rate and other factors.
level one
Food containing phosphorus additives
Including cola, processed meats, processed cheeses
Should be avoided as much as possible
Second floor
Phosphorus content is very high food
Including nuts, egg yolk, hard cheese
Suggested no more than 2-3 copies per month
the third floor
Phosphoprotein has a higher proportion of food
Including turkey, internal organs (liver, brain)
And shrimp, squid, salmon and soft cheese
Suggested intake is 1 per week
The fourth floor
Phosphoprotein is relatively low in animal food
Including lamb, rabbit, ham or fish
Suggest no more than 1 per day
Fifth floor
Plant food
Including cereals (white bread, pasta, rice, corn, etc.)
Or beans (peas, beans, soybeans, etc.).
Recommended intake is 2-3 copies per day
The sixth floor
Very low phosphorus content or very low utilization of food
Including vegetables, fruits, sugar, oil, low protein food
Will not affect the blood phosphorus
✓ Phosphorus reduction tips, boiling water boiled
Studies have shown that boiling boil can reduce food in the phosphorus, vegetable phosphorus reduced by 51%, 48% reduction in leguminous phosphorus, meat, phosphorus decreased by 38%.
It is gratifying that the reduction in protein in boiling water is negligible, resulting in lower levels of phosphoprotein than food.
✓ patient education, the effect is remarkable
The effective reduction of serum phosphorus decreased by 0.72 mg / dL after effective intervention, and increased to 1.07 mg / dL when education intervention lasted for more than four months.

Effective patient education is also one of the important means to reduce serum phosphorus levels in patients with nephropathy.

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