Among uremic patients, chronic nephritis is the most common cause, accounting for about 36%. Therefore, it is necessary for patients with chronic nephritis to take early measures to avoid uremia.
According to different pathological and physical signs of patients, the treatment of nephritis vary. But in the following, we list three main methods to help you.
The influence of blood pressure on kidney disease ranks first. If kidney patients have high blood pressure, the risk of Kidney Failure will increase dramatically. Blood pressure is directly related to the life expectancy of kidney patients.
All kidney patients should monitor blood pressure regularly. And patients with hypertension should be monitored at home every day. If they exceed the standard, they should be fed back to the doctor to discuss the countermeasures. The ideal blood pressure of kidney patients is below 130/80mmHg. If the urinary protein has been completely relieved, the blood pressure can be relaxed to below 140/90mmHg, and the elderly patients can also be relaxed appropriately.
The first choice of antihypertensive drugs is RAS blocker, that is, ACEI/ARB drugs (except for renal artery stenosis, hyperkalemia and pregnant patients), which can reduce urinary protein and protect renal function while lowering blood pressure. If a single antihypertensive drug fails to control blood pressure or the initial systolic blood pressure reaches 150, calcium antagonists can be added.
Low salt diet is another important way to reduce blood pressure. Every day when salt intake is lowered by 1 g, blood pressure can be lowered by 1 mmHg. Low salt diet usually reduces systolic blood pressure by 5-10 mmHg.
Low salt diet means that daily salt intake is less than 6g, equivalent to 24 hours urine sodium control at 100 mmol level. If the 24-hour urinary sodium exceeds 100 mmol, it means that salt intake is too large, and you should reduce it.
24-hour urinary protein quantification is more than 1g for a long time, which is usually a sign of poor prognosis of nephropathy (membranous nephropathy is 4g).
Patients with urinary protein quantification above 0.5g should consider taking ACEI/ARB drugs to reduce urinary protein. Some kidney patients may need to take them for life.
If the urinary protein is still greater than 1g, the dosage of ACEI or ARB should be increased within tolerance, or low dose spironolactone should be added, and integrated Traditional Chinese Medicine and Western medicine should be adopted. Chinese medicine can further reduce urinary protein, reduce the side effects of Western medicine and eliminate occult blood. Steroids, immunosuppressants and monoclonal antibodies may be considered in patients whose urinary protein is still greater than 1 g after routine treatment.
24-hour urinary protein quantification below 1 g is the treatment target of most patients with proteinuria. Long-term excessive urinary protein will lead to progressive progress of nephropathy. The target value of urinary protein in young patients should be lower than 0.5g, in order to maintain renal function for a longer time.
Chronic nephritis has a nickname: cold sequelae. Take IgA nephritis, the main part of nephritis, for an example, it is initially induced by infection in most cases. Nephropathy is generally prone to recurrence. In the course of treatment, cold infection is also an important factor leading to recurrence.
Kidney patients with 24-hour urinary protein of less than 2g should actively exercise to enhance disease resistance.
Pay attention to plasma albumin and immune function. If necessary, we can take plasma albumin transfusion and immunopotentiator to treat it. Don't let immunity be too low.
Influenza vaccine and pneumococcal vaccine are recommended for nephrotic patients.
In addition to protein reduction, blood pressure reduction, and infection prevention, anticoagulation, lipid reduction, diuresis and other treatment for kidney disease is also very helpful. For more information on CKD treatment, please leave a message below or contact online doctor.