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2016年3月13日星期日

CKD basics

CKD basics
CKD has been a worldwide worrisome health problem in recent years. CKD is defined as either kidney damages or decreased GFR of less than 60 mL/min/1.73 m2 over 3 month (The Kidney Disease Outcomes Quality Initiative (K/DOQI) of the National Kidney Foundation).
CKD can be categorized to 5 stages, ranging from nearly normal kidney function to renal failure, which denotes the total or near-total loss of your kidney function and requires dialysis or kidney transplant.
According to the definition from the Renal Association, CKD can be divided into 5 stages:
Stage 1: normal or increased GFR﹥90 mL/min/1.73 m2 with protein in the urine
Stage 2: mild reduced kidney function (GFR: 60-83 mL/min/1.73 m2)
Stage 3: moderate reduction of kidney function (GFR: 30-59 mL/min/1.73 m2)
Stage 4: severely reduced kidney function (GFR: 15-29 mL/min/1.73 m2)
Stage 5: end-stage renal failure (GFR < 15 mL/min/1.73 m2 or on dialysis)
* All GFR values are normalized to an average surface area (size) of 1.73m2.

2016年3月3日星期四

Proteinuria

There exists protein in urine called proteinuria, also named urine protein. There contains minimum small molecule protein in normal urine, while it cannot be recognized in normal routine urine test. When the volume of protein in urine increased, it is diagnosed as proteinuria if the condition existed in routine urine test. Proteinuria is one of the syndrome of kidney disease, and the syndrome of proteinuria may exist when illnesses occurred from head to feet.

Name Proteinuria Common Etiology After strenuous exercise, one feel extremely hot and may take high-protein diet; nutcracker phenomenon may exist, also there comes all kinds of kidney diseases and renal vascular disease




Department Nephrology Common Syndrome Back Pain
Etiology

There are lots of cases that may cause proteinuria, which include functional proteinuria & postural proteinuria or pathologic proteinuria. After strenuous exercise, one feel extremely hot and may take high-protein diet; nutcracker phenomenon may exist, also there comes all kinds of kidney diseases and  renal vascular disease.

Clinical Manifestation
Syndromes are different when the back pain is caused by different cases, such as,
1. Functional Proteinuria
Generally, the volume of proteinuria in urine in 24 hours will not exceed 0.5-1g. Normally, functional proteinuria occurs among young people, which the syndromes include tense & cold or hot & tired after long walk & exhausted after hard work & cardiac heart failure or after taking high-protein diet.
2. Postural Proteinuria
There exists no protein in urine in the morning, while the volume enlarges hours by hours. The volume of proteinuria goes up when walked or stood for a long time. And the volume goes down when rested for a while. The conditions occurs among slender youths or adults.
3. Pathologic Proteinuria
The condition of proteinuria exists continuously, and there contains blood in urine & leucocyturia and cylindruria in routine urine test. Other kidney diseases may exists along with pathologic proteinuria, such as hypertension and swelling.

Test
The tests of proteinuria include natural test & quantitative test and special test.

Diagnose
According to the condition of proteinuria, along with swelling & hypertension & diabetes & allergic purpura & gout & the use of harmful kidney medicines and family history, according to general test such as hydrothorax and ascites & anemia and the condition of heart & liver and kidney, diagnose by all kinds of tests.

Treatment
Treat accordingly in different cases.

Prevent
Avoid taking high-protein diet in daily life. Take physical examination regularly to avoid proteinuria. Those with diabetes & hypertension and gout over 5-10 years shall take routine urine test every half year. Avoid taking medicines which may impair kidneys, including analgesic-antipyretic & some antibiotics and TCM which contains unknown components. One may take the above medicines according to the recommendation of his doctor.