Text/Yangcheng Evening News all-media reporter Zhang Hua
Photo/Visual China
What surprises diabetics is that if risk factors such as blood sugar and blood pressure are not well controlled, they may suffer from diabetic nephropathy (referred to as "sugar kidney") after ten or twenty years, and even progress to kidney failure.
March 10 is the 17th World Kidney Disease Day, The President of the International Peritoneal Dialysis Society, the Executive Director of the International Society of Nephrology, and the President-Designate of the Asia-Pacific Nephrology Branch Yu Xueqing pointed out in an interview with the Yangcheng Evening News reporter that although the first cause of end-stage renal failure in mainland China is still glomerulonephritis, it is speculated that after 5-10 years, "sugar kidney" will be the first cause of chronic kidney disease. That is to say, in the future, patients with uremia and the need for dialysis are mainly diabetics.
Patients with future uremia and the need for dialysis are mainly diabetics
The "sugar kidney" will eventually become the first cause of uremia
In developed countries in Europe and the United States, diabetes has been overwhelmingly dominant by more than half of the population for the past few decades as the first cause of uremia. This is expected to happen soon on the mainland as well.
Talking about the development trend and characteristics of chronic kidney disease in the Asia-Pacific region in recent years, Yu Xueqing pointed out with a heavy heart, "In the Asia-Pacific region, such as China, Japan, South Korea and other places, there are certain differences in the spectrum of diseases on which kidney disease occurs. The first cause of end-stage renal failure in mainland China is nephritis, but in Japan, South Korea and other places, 'sugar kidney' has jumped to the first cause. According to the statistics and analysis of the national health commission's medical case homepage, diabetes has become the leading cause of chronic kidney disease in mainland China. Therefore, diabetic nephropathy has risen very quickly in recent years. From diabetes to diabetic kidney, and then from diabetic kidney to kidney failure is generally 10-15 years of course, so whether we have differences with other countries, from the increase in diabetes patients and the trend of course development, the final diabetic kidney will rank first in the cause of kidney failure (uremia), this process or 5 years or 10 years. ”
In fact, this trend is already evident in the nephrology departments of some hospitals. According to statistics, at present, in the Department of Nephrology of Guangdong Provincial People's Hospital, patients who have developed into uremia due to "sugar kidney" and need dialysis account for 25% of all dialysis patients. In addition, about 8% of the cases of renal aspiration biopsies each year are in people with diabetes. It can be said that in recent years, the number of "sugar kidney" patients has increased significantly.
Yu Xueqing, President of the International Society of Peritoneal Dialysis, Executive Director of the International Society of Nephrology, and President-designate of the Asia-Pacific Nephrology Branch/ Courtesy of the interviewee
Screening for "sugar kidneys", urine routine tests and urine microalbumin
Even though the incidence of "sugar kidney" has increased significantly, most sugar friends still have insufficient understanding of kidney disease. Yu Xueqing said: "Now the overall situation of kidney disease patients is not the same as before, most chronic kidney diseases are insidious, there are not too many symptoms in the early stage, unlike the previous acute nephritis will have eye swelling, foot swelling and other symptoms." Therefore, many patients with sugar kidneys are only found to have symptoms that are more obvious. ”
How can sugar friends detect kidney damage early? Yu Xueqing pointed out that in fact, the most important thing to detect kidney disease early is physical examination, urine routine test and urine microalbumin, which is the simplest and most effective method.
It is worth noting that the urine routine and urine protein of the general physical examination items are normal. When the urine routine shows a positive urine protein (+), the condition of "sugar kidney" has become more serious. Therefore, clinically, many diabetic patients have progressed to kidney failure when they find kidney disease. Experts emphasize that during the physical examination, sugar friends must check microalbuminuria (quantitative examination), which can detect kidney damage as soon as possible.
According to the reporter's understanding, the Guangdong Provincial People's Hospital recently led the launch of the chronic kidney disease management innovation plan, and conducted large-scale screening of urine routine, blood creatinine, uric acid, blood pressure, blood sugar and other large-scale screening of 100,000 people in communities and hospitals in 21 prefectures and cities in Guangdong Province, to understand the incidence of kidney disease in Guangdong Province, the high-risk population of kidney disease and the pathogenesis characteristics of patients with chronic kidney disease.
Sugar friends should regularly screen for urinalysis and urine microalbumin
Epidemiology in Guangdong shows a high proportion of drug-induced kidney injury
In addition to diabetes, which can induce kidney disease, its own structural and functional characteristics are also susceptible to drug-induced damage.
Studies have shown that the incidence of drug-induced kidney injury has shown an upward trend in more than 10 years, of which the incidence of antibiotic kidney damage is the highest, reaching 36%, in addition, the nephrotoxicity of some Chinese herbal medicines cannot be ignored. Epidemiological surveys in Guangdong show that among all the causative factors of kidney injury, the proportion of drug-induced kidney damage (including Western medicine and Chinese herbal medicine) is slightly higher.
Yu Xueqing pointed out that long-term use of certain drugs, although it shows low nephrotoxicity, but dripping water through the stone, will eventually cause kidney damage. Second, people who already have kidney damage are certainly more sensitive than others when taking nephrotoxic drugs. In addition, the use of drugs with strong nephrotoxicity will soon cause kidney damage, such as the common Chinese medicinal materials Aristolochia, Lei Gong Teng, Chuan Mu Tong, Guang Fang Himself and so on. In addition, when using traditional Chinese medicine, pay attention to the formal way to buy, because taking Chinese herbal medicines with heavy metals and exceeding the standard can also cause kidney damage.
Experts also stressed that try not to believe in ancestral secret recipes or folk remedies, and go to the hospital for formal treatment if you are sick. The so-called "three points of poison is medicine", under the guidance of doctors, take medicine when you should take medicine, and stop medicine when you should stop medicine. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Cui Wencan