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Expert: diabetes hypertension become the main cause of chronic kidney disease in the elderly

In order to effectively protect the kidney, it is important to distinguish between the primary and secondary causes of kidney disease and the more effective treatment of the disease It is best for a normal person to have a regular urine tes...

Expert: diabetes hypertension become the main cause of chronic kidney disease in the elderly

May 06, 2017 by Kidney Disease Expert

In order to effectively "protect the kidney", it is important to distinguish between the primary and secondary causes of kidney disease and the more effective treatment of the disease

It is best for a normal person to have a regular urine test every year, and do B and kidney tests if necessary

Professor wei lianbo, director of the department of kidney diseases at the department of medical guidance/southern medical university

The epidemiology of kidney disease in China is changing, and the main cause of chronic kidney disease in China is diabetes and hypertension, not primary kidney disease. How to detect bad seedlings in time, to prevent early treatment? Expert advice: the normal person had better make a routine check-up every year regularly, do B hyperis and kidney function check if necessary. Once diagnosed with kidney disease patients with basic diseases, should be under the guidance of targeted examination, both the standardization of the kidney disease and other diseases treatment. Patients with diabetes had better trace albumin check once every six months, and actively accept standardized treatment, have high blood pressure and cardiovascular disease must be good control of blood pressure.

Status: kidney disease prevention "four high and low" is a concern

The most common mention of chronic nephropathy is chronic nephritis, nephrotic syndrome, chronic kidney failure and so on. But professor wei lianbo, director of kidney diseases at the southern medical university of southern medical university, said such understanding was too narrow. He pointed out that both urinalysis, blood tests, ultrasound, CT, measurement of renal glomerular filtration rate < 60%, none of these conditions as long as the abnormal time more than 3 months, should be considered for chronic kidney disease.

According to wei lianbo, there is a typical "four high" and "three low" status of kidney disease in China. "Four high" namely high incidence, high disease of heart head blood-vessel complication and mortality rate is high, the high cost of treatment, "three low" awareness low, reasonable treatment and complication awareness is low, which bring much difficulty to kidney disease prevention and control.

Epidemiological data have shown that the United States in 2009 the entire population prevalence of chronic kidney disease was 11.5%, Japan population prevalence was 13%, more than 20, 2008 in the Beijing area 20 years of age or older population prevalence was 13%, at least one person per 10 people suffering from chronic kidney disease. More than 10% at present, the prevalence of chronic kidney disease, the prevalence of uremia is about three over ten thousand ~ 5, more than 1 million uremia patients needed blood dialysis treatment, at the present time, there are 20 in patients receiving hemodialysis treatment to 300000 people. Each dialysis patient spends between 10 and 150, 000 yuan a year on treatment, both in health care and in families.

Cure: kidney disease "brother difficult brother" many treatment before seek a certain cause

"To treat kidney disease should be as far as possible to protect the kidney, the kidney disease is often accompanied by other diseases, are" equals ". To effectively protect kidney, still should first distinguish kidney disease is a primary or secondary, for finding the cause can be more effective treatment." Lian-bo wei explained that there is no any reason to cause primary nephrotic kidney's own inpidual organs disease, secondary kidney disease is a clear other system diseases which in turn caused by kidney disease, such as hepatitis b related kidney disease, caused by hepatitis b caused by systemic lupus erythematosus (sle) with lupus nephritis, diabetes caused by diabetic nephropathy.

Primary nephropathy is relatively simple in treatment, and the kidney itself is generally considered. While treating secondary nephropathy, "protecting the kidney", it will also actively treat other systemic diseases that cause kidney disease. , such as: treatment with lupus nephritis patients of lupus disease by itself in addition to damage the kidneys, may also damage the heart and other organs, causing with lupus cardiomyopathy, with lupus pneumonia, with lupus, liver disease, etc., so it's very important to control lupus disease actively. Also, hypertensive nephropathy should actively control blood pressure and diabetic nephropathy to treat diabetes positively.

Note: diabetic hypertension is the leading cause of chronic kidney disease in old age

In developed countries such as the us and the UK, the main cause of end-stage kidney disease is diabetic nephropathy. But in our country, according to a report of kidney disease epidemiology, happening in old age is a major cause of chronic kidney disease diabetes and high blood pressure, rather than primary glomerular disease. As a result, wei lianbo reminds people with diabetes and high blood pressure to screen for kidney disease early and prevent early detection.

Control of blood pressure for kidney disease and "heart protection"

"Kidney disease and cardiovascular disease are two brothers." The occurrence of kidney disease can accelerate the deterioration of the cardiovascular system, wei said. In the early nephropathy, some cells within the kidney feel kidney ischemia, it can release a contraction of substances in the blood vessels, can increase the whole body blood pressure, increase the flow of blood to alleviate kidney ischemia. This for kidney organic damage problems arouse the renal hypertension of antihypertensive agents is not very sensitive, but lack of long-term control and easy to cause heart failure, if the dose is difficult to control with conventional blood pressure drugs, should be under the guidance of increased blood pressure medication doses, and efforts to control blood pressure.

Cardiovascular risk, on the other hand, can add nephropathy, especially some long-term patients with high blood pressure, lack of control in glomerular capsule pressure increases, glomerular fibrosis, atrophy and renal artery sclerosis, develop into secondary hypertension, kidney disease, can appear kidney damage, leading to renal insufficiency, serious and even kidney failure.

The sugar Pal should check the albumin regularly

"Diabetic nephropathy is not a terrible disease," he said. "three days ago, it was perfectly well controlled and treatable." According to lian-bo wei, a total of five stage of diabetic nephropathy, the top three periods of clinically seldom find symptoms, such as in the fourth period found symptoms when the disease has almost difficult to control. As a result, early prevention is key. In prevention, he warned that diabetics must be positive, correct and effective, with strict diet, exercise and drug control. Because the disease is well controlled, it can delay or even prevent the development of diabetic nephropathy. In addition, diabetics were also examined regularly, check once every six months the urine trace albumin, it is more early than ordinary routine urine tests can detect diabetic nephropathy. If abnormality is detected, it should be treated as early as possible.

Tip: it's important to check urine regularly

"The kidney is healthy, but there is a reason for it." According to lian-bo wei, chronic kidney disease are the most common early performance of eyelid leg edema, hematuria, urine color deepened, urine bubble increased, high blood pressure, night urination number increase, legs at night cramps, etc. And development to the middle-late, can have high blood pressure caused by dizziness, blurred vision, anemia caused by the pale face, lack of power, bosom frowsty, severe appear even nausea, vomiting, coma were found.

"But the early performance mentioned above is a general generalization, and a lot of people don't necessarily show up." Wei lianbo believes that the early symptoms of a patient are lucky, a timely warning from the body. Unfortunately, many people are asymptomatic in the early stages and have missed the reversible phase of treatment after developing late-stage symptoms.

"Therefore, it is important to regularly check for abnormal urine." Wei lianbo pointed out that most kidney diseases began in the earliest stages of abnormal urine. On the clinical side, it is convenient and simple to take urine as a test, and the price is cheap, and the average person is better off doing regular check-up every year. If the urine is examined for abnormal indicators such as urinary protein, latent blood (cryptoblood), red blood cell, and tube type, it should be further diagnosed by the nephrologist.


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