[1] Hu Yuan.Effect of detailed nursing on uremia hemodialysis patients[J].China Metallurgical Industry Medical Journal,
[2] Chen Fanglan.The "lifeline" of hemodialysis kidney friends, how to protect it in order to prolong life?[N].Medicine and Health Care News,2024-02-01
[3] Hu Haolan.Teach you how to choose between hemodialysis and peritoneal dialysis[N].Medicine and Health Care News,2024-01-17(014).
Chen Guoan is the owner of a small supermarket, and he likes to drink with his good friends and eat seafood on weekdays. He is 30 years old, just as he is thirty, and now he lives a happy life and lives and works in peace and contentment, which is the dream life of many people, but in June 2023, he was actually diagnosed with uremia and hyperkalemia, which is a shocking blow to him!
The cause of this incident has to start from January 2022, Chen Guoan found that there was a small bulge in the pinna, which was yellowish-white sesame-like, and it was quite soft to the touch, because it was not painful or itchy, so he didn't care much about it. Until one day a few months later, he was surprised to find that the small bulge on his ear had changed from the size of a sesame seed to the size of a small stone. So I rushed to the hospital for treatment.
When he arrived at the hospital, the doctor immediately opened a test according to his condition, and the small bulge on his ear was visible under a polarized light microscope with needle-shaped urate crystals, that is, tophi. Later, the blood test results also came out, the uric acid was as high as 450, and the hospital confirmed gout. Gout is a recurrent inflammatory disease caused by excessive uric acid production or low uric acid excretion, which causes uric acid in the blood to rise, and when the saturation is excreted, urate crystals are formed, and this substance is deposited in the joints.
The doctor told Chen Guoan that because uric acid is a metabolite of purines, gout patients should eat less high-purine foods. For example, seafood, offal, alcoholic beverages and other foods. He also told him to drink more water in his daily life to promote the excretion of uric acid, and to eat more fruits and vegetables.
Chen Guoan nodded and said that he knew, but what he thought in his heart was that he could no longer drink and eat seafood, he always thought that life was short and should be happy in time, so he should still eat and drink every day.
On December 1, 2022, when Chen Guoan was sleeping at midnight, he suddenly had tear-like pain in the first metatarsophalangeal joint, and the joint was red and swollen 3 hours later, accompanied by heat pain. Chen Guoan was in too much pain, so he immediately drove to the hospital.
If you don't listen to persuasion in the matter, you will regret it. In fact, Chen Guoan has acute gouty arthritis, and after arriving at the hospital, the doctor prescribed him aspirin, which is a kind of non-steroidal anti-inflammatory drug, which is to reduce pain sensitivity by inhibiting the synthesis of prostaglandins, thereby relieving pain.
The doctor told Chen Guoan that gout is a disease that needs long-term management, and if it is not taken seriously, repeated attacks can lead to chronic joint lesions and severe disability. Chen Guoan no longer dares to drink alcohol and eat seafood. Every time a friend asked him to go out for a drink, he would graciously refuse, saying that he had quit drinking.
Through taking medicine and daily life management according to the doctor's instructions, Chen Guoan's uric acid re-examination has always been within the normal range, but because he has to pay for previous mistakes, his joints will be red, swollen and painful from time to time, and Chen Guoan will go to the pharmacy to buy aspirin to relieve pain.
In November 2021, Chen Guoan found that in the past few days, he always felt tired and tired, low back pain, and muscle soreness, but he didn't think too much about it, because he was always caused by staying up late these days. However, a few days later, when he got up to go to the toilet, he found that he had no strength, and later found that the ascending muscles from his legs to his torso to his arms were weak. Chen Guoan was very worried that he would not be paralyzed at such a young age, so he quickly called his wife to take him to the hospital.
After arriving at the hospital, the doctor immediately arranged for Chen Guoan to be examined. The results of the examination came back, his blood potassium was as high as 7.2 mmol/l, and the electrocardiogram showed a high T wave, which could have a prolonged PR interval and a widened QRS complex. Unexpectedly, his creatinine was 1050ummol/L, and the glomerular filtration rate was only 12ml/min. The final diagnosis at the hospital was uremia with hyperkalemia.
Hyperkalemia is diagnosed when serum potassium is higher than 5.5 mmol/L, and severe hyperkalemia is diagnosed when it is more than 7.0 mmol/L. Hyperkalemia can cause muscle weakness and arrhythmias, and severe slowing of the heart rate can lead to cardiac arrest. In other words, Chen Guoan now needs to be rescued immediately and urgently treated with potassium reduction.
The wife looked at her husband who was being rescued urgently, but she could only stand aside, unable to do anything, and felt helpless and scared in her heart.
However, the doctor told them that Chen Guoan was already in the uremia stage, because the kidneys were almost completely incapacitated, unable to urinate, and the potassium ions in the body could not be excreted from the body, resulting in excessive accumulation of potassium ions in the body, and it was still easy to cause hyperkalemia in the future. At present, there are two ways to solve the problem, one is kidney replacement and the other is dialysis.
Chen Jiguo and his wife could not accept this result, and asked the doctor excitedly, he had no symptoms at all, why did he suddenly get uremia? He only had gout, the underlying disease, and gout and uremia were completely different diseases. After carefully talking to the doctor about his daily diet, this revealed the mystery of the real cause of his uremia, and the doctor angrily reprimanded me, gout patients in this situation eating fruit is tantamount to giving arsenic!
People with gout often take aspirin because of the pain, but long-term use of this drug can cause kidney damage. Studies have shown that aspirin causes renal vasoconstriction by inhibiting prostaglandin synthesis, reducing renal blood flow, resulting in a decrease in glomerular filtration rate and causing ischemic kidney injury. In addition, aspirin is broken down into salicylic acid in the body, which inhibits the excretion of uric acid in the blood and causes uric acid accumulation when absorbed in the renal tubules.
Because the doctor recommended eating more fruits, and Chen Guoji also likes to eat star fruit very much, he often eats star fruit in his life. Star fruit has a lot of vitamins and is a low-purine fruit, which is a friendly type of fruit for people with gout. However, it is not recommended for patients with kidney damage. Because star fruit can hurt the kidneys!
Star fruit is rich in oxalic acid, which may be induced by people with potential chronic kidney disease. And star fruit contains a powerful neurotoxin, which quickly induces energy accumulation in the blood and reaches the brain, and patients with severe kidney impairment can discharge serious neurological dysfunction after eating star fruit.
This toxic substance can be excreted in a normal human body through the kidneys, but people with poor kidney function do not have this detoxification effect. In addition to star fruit, strawberries are also fruits rich in oxalic acid, and when consumed in large quantities, oxalate may be produced in the kidneys, which is not good for the kidneys.
There are also these fruits in life will also hurt the kidneys, one is watermelon, because watermelon contains more water, water needs to be metabolized by the kidneys out of the human body, for patients with poor kidney function, the kidney's ability to regulate water is low, a large amount of watermelon will cause the body to take in too much water, can not be discharged in time, so that the burden of kidney discharge increases, may cause edema because of the increase in kidney osmotic pressure, and even induce acute heart failure, and in severe cases, it will be life-threatening.
The second is sugarcane, because sugarcane has a high sugar content, if eaten in large quantities, it will lead to an increase in blood sugar, increase the metabolic burden on the kidneys, and sugarcane also contains a lot of dietary fiber, which may increase the burden on the gastrointestinal tract after excessive consumption, which is not easy to digest, thereby aggravating the discomfort symptoms of the gastrointestinal tract, and may even lead to the appearance of diseases such as indigestion, such as abdominal pain and bloating.
Patients with poor kidney function try to eat a lot of fruits in life, such as bananas, oranges, tomatoes, such fruits are high in potassium and easy to burden the kidneys.
，