Because of a car accident, 30-year-old Xiao Hu went to the hospital for a physical examination, and the results were not serious, but uremia was found. Before Xiao Hu could think about how to tell his family about his illness, Xiao Hu's old mother went to the hospital for examination because she was unwell, and she was also found to have uremia.
Then, Xiao Hu's brother also went to the hospital for examination because of his abnormal face, and the result was also a diagnosis of uremia.
The attending doctor noticed the abnormality and suggested that Xiao Hu let other immediate family members go through a screening to check the cause of the "hereditary" of uremia. Following the doctor's advice, Xiao Hu took his 10-year-old daughter and 3-year-old daughter for a physical examination, and still found uremia.
Xiao Hu almost collapsed, a family of seven, five people confirmed uremia, how to live this day, is his family "cursed"?
Later, after a series of examinations, the doctor finally determined that the cause of the family's misfortune was the "polycystic kidney" suffered from Xiao Hu's mother.
1. Is there also a genetic risk to uremia?
Uremia is a terrible term in the minds of many people, and its prevention, treatment and hereditary nature have attracted widespread attention. Professor Wang Yiping, director of the Department of Nephrology of Anhui Provincial Hospital of Traditional Chinese Medicine, said that uremia is a serious damage to the kidney unit caused by a variety of chronic diseases, so that the body has a clinical syndrome of disorders in excretion, metabolism and regulation of water, electrolytes, acid-base balance, etc. The disease itself is not hereditary, but some of the underlying diseases that evolve into uremia have a family history, such as polycystic kidneys, diabetes and hypertension.
Among them, polycystic kidney (PKD) is an inherited kidney disease in which countless cysts appear in the cortex and medulla of the kidneys, which are divided into two types according to the genetic mode. One is autosomal dominant polycystic kidney (ADPKD), which generally does not appear until adulthood and can survive to old age, so it is also called the adult type. The second is autosomal recessive polycystic kidney (ARPKD), which is generally evident in infants, also known as infantile, and most children die shortly after birth. Among them, autosomal dominant polycystic kidney disease is the most common, the disease is a worldwide high incidence of genetic disease, the world every four hundred to one thousand people have a dominant polycystic kidney disease patient, according to the genetic law, the probability of inheritance to the next generation is generally 50%.
According to relevant reports, polycystic kidney has become the third leading cause of kidney failure, by the general attention of the society and the medical community attaches great importance to, the current modern medicine has drug therapy, surgical treatment, gene therapy, kidney replacement therapy and other methods.
However, Professor Wang reminded that for polycystic kidneys, it is still necessary to actively treat primary underlying diseases such as diabetes, hypertension, and gout that are prone to evolution and development. Data show that 15% of patients with hypertension will develop uremia, so patients with hypertension should control blood pressure at the ideal level, followed by regular checks on kidney function, generally once every six months. Patients with polycystic kidneys should have good medical monitoring, maintain an optimistic mood, and actively cooperate with doctors for treatment.
Kidney lesions such as polycystic kidneys can cause changes in urine output, and hematuria, proteinuria, and various kidney lesions can lead to chronic renal failure. It is understood that one in every ten adults suffers from chronic kidney disease, which is currently affected by factors such as the aging of the population, diabetes and hypertension, and the increase in the population base of chronic diseases, and many patients eventually progress to end-stage kidney disease that relies on dialysis. In the future, the burden of kidney disease treatment will continue to rise, and it has become a public health problem that needs urgent attention.
Second, the awareness rate of chronic kidney disease in China is only 12.5%
According to the Guidelines for the Screening, Diagnosis and Prevention of Chronic Kidney Disease in the Chinese Journal of Practical Internal Medicine, at present, the prevalence of chronic kidney disease in adults in China is about 10.8%, and there are nearly 130 million patients with chronic kidney disease, ranking first in the world. There are more than 1.5 million patients with end-stage renal disease who need renal replacement therapy, and the trend of increasing by 120,000-150,000 per year continues to rise.
However, due to the lack of public awareness of chronic kidney disease, the awareness rate is only about 12.5%, resulting in many patients can not be detected in the early stage, and when the diagnosis is confirmed, it is already in the stage of uremia, which increases the difficulty of treatment and has a serious impact on life.
Yu Xueqing, president of Guangdong Provincial People's Hospital, believes that genetic factors in the occurrence of kidney disease account for only 7%-12%, more is the impact of lifestyle, a good lifestyle can help reduce the risk of disease, including a reasonable diet, smoking cessation and alcohol restrictions, appropriate exercise, psychological balance. Bad living habits may become the fuse of the "bomb" explosion, so it is also necessary to improve the awareness of prevention and control in life and correct bad habits that hurt the kidneys.
1. Commonly used drinks instead of water
Yang Hong, director of the ICU of the Third Affiliated Hospital of Southern Medical University, said that sugar, phosphate, caffeine and other components in the beverage will promote calcium excretion, resulting in an increase in calcium content in the urine and easy to form stones. The flavors, pigments, spices, etc. in the beverage will increase the burden of glomerular filtration and detoxification, damage kidney function, and aggravate puffiness.
2, eat too salty
Urine protein is affected by a variety of factors, of which salt intake is one of the influencing factors, long-term high salt intake is easy to destroy the selective osmotic effect of the glomerular basement membrane, which will lead to aggravation of proteinuria.
3. Drug abuse
"It is a drug three-point poison", the kidney is an important organ of drug metabolism and excretion, improper use of drugs or the body is sensitive to drugs, will damage the kidneys, about 25% of patients with renal failure and nephrotoxicity of drugs. In particular, sulfonamides, quinolones, contrast agents, and aminoglycoside antibiotics are more likely to cause kidney damage.
In addition, bad habits such as excessive tobacco and alcohol, long-term staying up late, sedentary and less moving, overeating, and often holding back urine will also cause certain damage to kidney function and increase the risk of kidney disease, so if you want to protect the kidney and protect the kidney, you must first adjust your lifestyle.
Third, be vigilant! 4 distress signals from the kidneys
What are the "signs" of chronic kidney disease? Experts said that if there is frequent urination, urgency, pain in urine, blood in the urine, more foam and long duration when urinating, eyelids, legs and feet edema, increased frequency of nocturia, waist and abdomen pain, etc., this is likely to be the "distress signal" issued by the kidneys.
Once there is gastrointestinal discomfort, gastrointestinal bleeding, nausea, vomiting, pale face, limbs, face, body skin appear more red spots, limb joint pain, etc., should cause more vigilance. Typical symptoms of common chronic kidney disease are:
1. Abnormal urinary fluid
Urinary abnormalities include increased or decreased urine output, changes in urine color, the appearance of proteinuria, etc., such as the normal color of people's urine is transparent and light yellow, if there is no obvious external cause, but the urine color is red, or there is a lot of foam in the urine, it is necessary to pay attention to the nephrologist examination.
In addition, when the urine routine shows protein or red blood cells, it is likely to be a manifestation of kidney disease and further testing is required.
2. Itchy skin
In patients with end-stage kidney disease, because the urea in the body cannot be excreted through the urine, it will be excreted through the skin, thereby irritating the skin; in addition, the accumulation of toxins in the body can lead to peripheral neuropathy, which can also cause skin itching.
3. Anemia
In addition to the kidneys' functions such as excreting waste products, they can also secrete erythropoietin and promote hematopoiesis, so unprovoked anemia is also a major signal of kidney function damage.
4. Puffiness
Patients with chronic kidney disease have water and sodium retention due to decreased renal excretion, hormone disorders secreted by the kidneys and loss of urine protein, resulting in puffiness of the eyelids and lower limbs.
Because the early symptoms of kidney disease are often not obvious, it is easy to be ignored, and the disease has reached an advanced stage by the time of hospital treatment. To effectively delay the progression of renal impairment in patients with brady nephropathy, early diagnosis and early treatment are key. Commonly used nephropathy-related tests include urine routine, renal function, renal ultrasound, etc., and if necessary, renal aspiration biopsy is required to assist in diagnosis.
Summary: "Kidney health can be healthy", although kidney disease also has genetic factors, but if you can take good insurance and "lock" it in the safe, the risk can also be controlled to a certain extent, and a good lifestyle and increasingly accurate screening are the best insurance plugs to help us keep a good line of defense.
Resources:
[1] "Patients with chronic kidney disease have a cure at home". Health Report.2020-03-13
[2] "Prevention and Control of Chronic Kidney Disease And Lifestyle Change is Key". Shanghai Journal of Traditional Chinese Medicine.2013-12-20
Medication Options for Chronic Kidney Disease. China Medical News.2016-06-15
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