Among our compatriots, the incidence of chronic diseases such as hypertension, diabetes, and hyperuricemia is high, and these patients are at risk of impaired kidney function. Seeing those who rely on dialysis to sustain their lives, patients worry that after kidney damage, there is still a chance that kidney function will be saved. How is the rapid decline in kidney function caused? How should I respond? What do I need to be aware of? Let's solve your doubts now.
Kidney function declined rapidly, the previous concept was acute renal failure, in 2005, the International Society of Nephrology and other academic institutions, the concept was renamed acute kidney injury, the English abbreviation is AKI. In 2012, the latest diagnostic criteria were an increase in serum creatinine levels of more than 1.5 times the base value over a 48-hour period, or 0.3 mg/dl, an hourly urine output of less than 0.5 ml per kilogram of body weight, a significant decrease in urine output lasting 6 hours, and these conditions occurred within 7 days. AKI, which can be divided into 3 periods according to changes in serum creatinine and urine output.
Acute kidney injury, the main manifestations are darkening of urine color, decreased urine output, itchy skin or rash, chest tightness or chest pain, shortness of breath, lower extremity edema, nausea, and some patients may experience confusion or seizures. It is worth noting that studies have shown that 5% of patients with chronic kidney disease develop acute kidney injury, and the proportion of acute kidney injury that occurs in 10 years can reach 50%. Usually, acute kidney injury can be reversed, while chronic renal failure is difficult to reverse, and acute kidney injury can also turn into chronic renal failure.
The causes of acute kidney injury can be divided into three categories, prerenal, retrorenal, and renal. Prerenal causes, mainly hypotension, excessive blood loss, dehydration and other effects on renal blood flow. The causes of retrorenal etiology are mainly urinary tract obstruction caused by urinary tract stones, prostatic hypertrophy, cancer, etc., which affect kidney function. Renal causes, mainly various factors leading to kidney damage, including infection, thrombosis, drug effects, rhabdomyolysis.
Drug-induced acute kidney injury, mainly drug toxicity or allergic reactions, causing acute tubular necrosis or interstitial nephritis. Drugs that can easily lead to acute kidney injury, including aspirin, ibuprofen, acetaminophen, paracetamol and other antipyretic analgesics; antibiotics such as penicillin, cephalosporin, sulfonamide, rifampicin, gentamicin; Chinese herbal drink tablets containing aristolochia or heavy metals, such as Guanmutong, Aoki incense, cinnabar, and xionghuang. In addition, contrast agents, chemotherapy drugs, animal gallbladders, and crayfish containing heavy metals can also cause acute kidney damage. Therefore, we need to remember that without the guidance of a doctor, do not abuse drugs, even if it is a common cold medicine, improper use, it will hurt the kidneys.
In recent years, excessive exercise has caused rhabdomyolysis, leading to an increasing number of cases of acute kidney injury. Strenuous exercise may damage skeletal muscle, cause rhabdomyolysis, and excessive thermogenesis can consume a lot of adenosine triphosphate, resulting in dysfunction of sodium and potassium pumps and calcium ion pumps, activating proteases, causing muscle cell death and release of large amounts of contents. Patients present with strong tea- or soy sauce-like urine, muscle swelling, pain, stiffness, nausea, vomiting, fever, and psychiatric symptoms that can lead to electrolyte abnormalities, arrhythmias, and even cardiac arrest. If strenuous exercise, combined with alcohol consumption, excessive intake of coffee, or use of illicit drugs, the risk of acute kidney injury is higher.
Acute kidney injury, the need for renal replacement therapy, at present, the new dialysis patients, about 10% is acute kidney injury, if after 3 months of treatment, patients still can not get rid of dialysis, will enter the end-stage kidney disease, is commonly known as uremia. Acute kidney injury that can be treated in time to obtain a reversal of renal function usually has 8 characteristics. 1st, kidney atrophy is not pronounced. Second, creatinine growth takes 3 to 6 months. Third, edema and decreased urine output occur. Fourth, the causes are dehydration, infection, urinary tract obstruction, drug effects, rhabdomyolysis. 5th, pathological examination reveals cell hyperplasia. Sixth, Cellular Crescent. 7th, renal interstitial edema. 8th, inflammatory cell infiltration. Acute kidney injury focuses on prevention, patients with chronic kidney disease, cardiovascular disease, hypertension, and anemia are high-risk groups, and need to pay close attention to changes in urine volume and creatinine levels, and the general population needs to avoid drug abuse and excessive exercise.
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