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Comprehensive And Systematic Treatments For Chronic Renal Failure To Avoid Dialysis


2019-01-11 13:48

Chronic Renal Failure,Systematic Treatments,Avoid DialysisChronic Renal Failure is a serious stage of chronic renal insufficiency, which is the result of the sustained development of various Kidney Diseases. If you do not know whether your conditions are serious that you can do test to CLICK HERE directly in free.

The main manifestations are retention of metabolites, water, electrolyte, acid-base imbalance and systemic symptoms, also known as uremia.

1. Clinical manifestations

Night urine, weakness and fatigue are early manifestations. Gastrointestinal symptoms (anorexia, nausea, vomiting, gastritis, bad taste) are common, and gastrointestinal ulcers and bleeding are common in late stage. Cardiovascular symptoms included hypertension, heart failure and pericarditis. Neuromuscular symptoms include muscle fibre convulsions, peripheral nerve diseases with sensory and motor disorders, muscle spasms and convulsions. Skin can change to yellowish brown, sometimes forming uremic cream, itching is unbearable. Blood urea nitrogen and creatinine increased, plasma sodium could be normal or decreased. Acidosis is usually moderate and serum CO2 content is 15-20 mmol/L. Serum potassium was normal or moderately increased, and hypercalcemia and hyperphosphatemia were common. Urine volume - usually in 1-4 L/day, late common wax tube type.

2. Diagnosis

According to the medical history, clinical manifestations and laboratory examinations, the diagnosis of chronic renal failure is not difficult, but the etiological diagnosis should be made as clear as possible and the deteriorating factors of renal function should be searched for in order to facilitate treatment.

3. Treatments

(1) Treatment of primary diseases and correction of reversible factors.

(2) Dietary therapy: Restriction protein, generally O.6g/kg of high-quality protein per day, well adjusted according to glomerular filtration strand (GFR). High calorie intake, about 125.5 kilocalories per day. If the GFR is less than 5 ml/min, the daily protein intake should be reduced to 20 g, and essential amino acid therapy should be added. The general dosage is 0.1-0.2 g/kg/day per kg, orally taken three times or intravenously dripped slowly.

(3) Correct the imbalance of water, electrolyte and acid-base: keep the product of serum calcium and phosphorus between 30 and 40, take active vitamin D30.25ug/day orally in hypocalcemia, take calcium carbonate 26 at meals, and limit the intake of phosphorus. Sodium salt intake decreases with the decrease of GFR. When hyponatremia and hypernatremia occur, water intake or water intake are limited. Hyperkalemia, 6.5mmol/L, should be treated urgently. In metabolic acidosis, when the carbon dioxide binding force is above 13.5 mol/L, sodium bicarbonate should be taken orally for 1-6 days, 3 times/day, and 13.5 mol/L lower. Intravenous alkali infusion should be used.

(4) Treatment of cardiovascular complications: The use of antihypertensive drugs is the same as that of general hypertension, furosemide is better in diuretics. Uremic pericarditis may be ameliorated after active dialysis. Pericardiotomy and drainage should be done when the pericardium is tamponade. The treatment of heart failure is similar to that of general heart failure, and the effect of peritoneal dialysis is quite satisfactory.

(5) Anemia patients were supplemented with iron, folic acid and recombinant human erythropoietin. When hemoglobin was less than 60g/L, a small amount of multiple transfusions were given. Neuromuscular symptoms can be supplemented with nutrition and active vitamin D3. Skin symptoms can be treated with emulsifiers, oral antihistamines, ultraviolet radiation, and phosphorus intake can be controlled.

(6) The use of drugs should avoid nephrotoxic drugs. The dosage of drugs should be determined according to factors such as drug metabolism and excretion pathway, creatinine clearance rate and the influence of dialysis on them.

(7) Dialysis therapy and kidney transplantation: Dialysis therapy can replace the excretion function of kidney, and its application depends on blood biochemical index, individual difference and clinical decision.

(8) Micro-Chinese Medicine Osmotherapy can help repair damaged kidney and improving kidney functions.

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