Renal failure is a pathological condition in which various chronic kidney diseases progress to a later stage and cause partial or total loss of renal function. It can be divided into two categories: acute renal failure and chronic renal failure. Acute renal failure (ARF) refers to a clinical syndrome in which the glomerular filtration rate suddenly or continuously decreases, causing nitrogen waste in vivo storage, water, electrolyte and acid-base balance disorders, resulting in complications of various systems. Decreased renal function can occur in patients with a predominantly asymptomatic kidney disease, or in patients with predominantly stable chronic kidney disease, with a sudden sharp deterioration in renal function.
There are many causes of acute renal failure, which can be divided into three categories: prerenal, renal and retrorenal. Common causes of prerenal ARF include volume depletion, reduced effective arterial volume, low cardiac output, changes in renal hemodynamics, and mechanical obstruction of renal arteries. The cause of retrorenal acute renal failure is mainly acute urinary tract obstruction. Renal acute renal failure refers to renal parenchymal injury, commonly due to renal ischemia or nephrotoxic damage to tubular epithelial cells (eg, acute tubular necrosis, ATN), as well as sharp declines in renal function associated with glomerular disease, renal vascular disease, and interstitial lesions.
There are many causes of ATN, common infections, various factors that lead to a decrease in effective circulating capacity or blood pressure, various nephrotoxic drugs and other triggers, and susceptible people with ATN include the presence of underlying kidney disease, hypertension, diabetes, cardiovascular disease and advanced age.
Shigella is a class of gram-negative bacilli that cause bacterial dysentery. The common symptoms of Shigella infection in the clinic are abdominal pain, vomiting, diarrhea, pus and bloody stools, and shock. Shigella is hardy and can survive in ice for up to 3 months. Food poisoning is mainly shigella will produce endotoxins and exotoxins, destroy the intestinal mucosa, cause inflammation, ulcers, etc., leading to the onset of disease. If you eat contaminated food with too much bacteria at one time, the bacteria break through the stomach acid barrier and enter the intestine, causing infection. Weak elderly people and children are susceptible to infection. It can cause hemolytic uremic syndrome and acute renal failure.
Boys eating fried squid causes acute kidney failure, and there is still a risk of emergency treatment
Case: Patient xxx, male, 11 years old, lives in Dongguan, Guangdong Province. Originally lively and cute, he suffered severe abdominal pain from eating squid that had been left in the refrigerator for nearly a week.
One night in October last year, the patient was rushed to the hospital for treatment after eating fried squid. The squid was bought at the supermarket on September 29, and the squid is covered with only a layer of plastic wrap and has no production date. Originally, I planned to fry it on the same day, but when I returned to my hometown temporarily, I put the squid in the refrigerator freezer and froze it for several days. On the evening of October 3, the family returned to Dongguan. At noon on October 5, when the sisters and brothers were cooking lunch at home because their parents were at work, the squid was taken out and fried. It's been almost a week since the time of buying the squid. The patient likes to eat squid, the sister only eats a little, and most of the squid is eaten by the patient.
It didn't take long for severe abdominal pain to roll on the ground. When my sister saw the situation, she quickly called her parents and then rushed to a nearby hospital for medical treatment. After examination, it was diagnosed that food uncleanness caused acute enteritis. After two days of hospitalization, his condition still did not improve and the situation became more and more serious. On 7 October, the patient was transferred to another hospital, and after examination, the doctor diagnosed that the bacteria infected by the intestine caused acute kidney failure, and the condition was very critical. He was then transferred to the pediatric intensive care unit of a hospital, where the patient convulsed on the way. After examination, it is diagnosed with hemolytic uremic syndrome, the cause of which is caused by an intestinal infection.
The hospital immediately performs plasmapheresis, hemodialysis filtration, and anti-infective and anticoagulant therapy. The generalized edema has improved, breathing has stabilized, but it has not left the danger period, and there are still exudations from the lungs with a small amount of pleural fluid. 24-hour continuous hemodialysis filtration is carried out, and 600 ml of new plasma is transfused every day. Urine output is very small.
Doctors said that the patient belongs to severe hemolytic uremic syndrome, hemolytic uremic syndrome during treatment, no urinary symptoms will last for 2 to 4 weeks. Mainly through hemodialysis and filtration, the replacement of kidney function helps patients expel metabolic waste products in the body and pull out excess water. Patients are 50% likely to develop chronic renal failure and receive dialysis for life. There is also a risk of organ damage due to infection and microthrombosis.
Shiga toxin in food causes hemolytic uremic syndrome
Doctors said that hemolytic uremic syndrome, a syndrome caused by the destruction of microvessels, is a syndrome characterized by hemolytic anemia, thrombocytopenia and acute renal failure, and is one of the most common causes of acute kidney failure in children.
Shiga toxin is currently thought to be the main cause of most episodes of hemolytic uremic syndrome, with E. coli O157:H7 being the most common cause. Shigella dysentery, Salmonella, etc. may also be related to hemolytic uremic syndrome.
When people eat food containing Shiga toxin, the toxin is absorbed into the bloodstream, which will destroy red blood cells and lead to microvascular bleeding, hematuria, abdominal pain, vomiting, and then kidney disease, and affect the blood vessels of important organs such as the heart and brain. Among them, if the kidneys are seriously damaged, long-term dialysis is required. There are other factors, such as bone marrow transplantation, chemotherapy for cancer, diseases of the immune system, certain drugs for heart disease or coagulation disorders, pregnancy, etc. may also lead to the emergence of hemolytic uremic syndrome.
Most patients who die in the acute phase are caused by brain problems, including cerebral edema and herniation, as well as the formation of microthrombosis in the brain. If left untreated, 25% of children die in the acute phase.
How is hemolytic uremic syndrome treated?
Experts said that hemolytic uremic syndrome, at present, there is no specific treatment in Western medicine, but it can strengthen nursing, actively prevent and treat infection, supplement nutrition, and timely and effectively deal with acute renal failure. The treatment principles typical of hemolytic uremic syndrome are predominantly supportive. Strengthen clinical care, actively prevent and treat infections, pay attention to nutritional supplementation, and symptomatic supportive treatment.
Treatment of acute renal failure, dialysis is performed in patients with oliguria, hypertension, volume overload, or severe acidosis hemolytic-uremic syndrome. Treatment of atypical hemolytic-uremic syndrome, including: fresh frozen plasma transfusion and transfusion; plasma exchange; glucocorticoids, and immunosuppressants. The use of some new drugs is expected to reduce the incidence of hemolytic uremic syndrome.
Dialectical treatment of hemolytic uremic syndrome in Traditional Chinese medicine:
1. Acupuncture point application. Raw rhubarb, salvia, motherwort, barley kernels, Sichuan root and sweet sui are processed into coarse minced and mixed well, soaked in sesame oil and boiled in a sand pot until paste. Attached to the kidney Yu and Guan Yuan acupuncture points, so that the drug penetrates through the skin and stimulates the acupuncture points, the meridians directly act on the kidneys, so as to achieve the effect of warming the kidneys, activating the network, diuresis, and clearing the turbidity.
2. Traditional Chinese medicine for internal use. The course of uremia is entangled, the disease mechanism is complex, and divided into different stages, the treatment must be based on the characteristics of the disease dialectical treatment, generally can choose raw astragalus, appendages, cordyceps, fairy spleen, Bayantian, ginger half summer, danshen, psyllium, Su Terrier, Huang Lian, rhubarb, peach, angelica, safflower and other warm kidney diarrhea, stasis and other drugs, these drugs can help correct the root, activate blood stasis, dispel evil without harming the right qi, there is a new way, improve kidney blood flow, reduce urea nitrogen, blood creatinine, correct acidosis and other effects, It can significantly improve clinical symptoms, improve body metabolism and immune function, accelerate the excretion of toxic substances, prevent further damage of glomeruli, inhibit the rise of urea nitrogen and creatinine, and promote the rise of hemoglobin.
3. Chinese medicine enema. It has a certain colon dialysis effect, which is an important way to remove nitrogen in the body, and is a supplement for oral drugs, especially for patients who cannot take drugs orally. Rhubarb, appendages, raw oysters, soil poria and dandelion are generally selected to drain the intestines, promote the excretion of toxins from the intestine, inhibit protein decomposition, increase the peristalsis of the intestine, prevent the absorption of toxins in the intestine, promote the excretion of toxic substances in the body, and help reduce the load of healthy kidney units, thereby controlling the rise of toxic substances such as blood creatinine and urea nitrogen.
4. Umbilical cord therapy. The umbilicus is the last closed part of the abdominal wall during embryonic development, with no adipose tissue under the skin, and the subumbilical peritoneal blood vessels are abundant. Umbilical therapy is to put the drug on the umbilical eye or umbilical cord to achieve a kind of external treatment method for the treatment of diseases, because the umbilical cord communicates with the sutras, it can make the meridian circulation and communicate in the internal organs, limbs and skeletons, and the drug will be circulated directly to the disease, thereby driving away the disease and promoting the recovery of the body. Rhubarb, appendages, spices, astragalus, motherwort, psyllium are made into pills, applied to the umbilicus, so that the drug enters the blood through the umbilicus, plays the role of the drug, and plays a therapeutic role in nourishing the spleen and kidneys, reducing turbidity and detoxification, reducing swelling and water.
5. Medicinal bath. Generally, most drugs are used that are easy to enter the body through the skin. Such as ephedra, guizhi, Qianghuo, danshen, safflower, Sichuan root, windproof, fine spices, etc., with the help of the warm effect of the medicinal bath water, the drug components directly act on the body surface, due to the increase in the skin temperature on the body surface, the skin capillary dilation, promote the circulation of blood and lymphatic fluid, so that the poison with sweat excretion increases, can make the damaged kidney have the opportunity to recover on its own, the amount of urine increases, the edema subsides, improve the body's immune ability.