Saturday, 14 July 2012
iga nephropathy occult blood abatement is to allow many patients troubled by things, so first we want to clear the iga nephropathy cause.
iga nephropathy is one kind of mucosal immune function deficiency disease, IgA nephritis mainly by iga antibodies or immune complex deposition in the glomerular mesangial area, complement components, leading to the inflammatory reaction, activation of the complement system , which led to the obstacles of coagulation and fibrinolysis, resulting in a series of inflammatory mediators, and promote kidney tissue ischemia, hypoxia and damage of capillary endothelial cells to attract the blood circulation of inflammatory cell infiltration, and release of inflammatory mediators of the pathogenic glomerular basement membrane damage, kidney increased permeability, decreased ability to block the red blood cell leakage, clinical hematuria, kidney tissue is impaired.
The elimination of the occult blood in here to remind the appearance of occult blood only one kidney damage, commonly used hormones to control the clinical, hormonal control occult blood by inhibiting the immune response, but can not solve the root causes of kidney damage, can not be cleared immune complexes, immune complexes, there has been constant will cause kidney damage, the patient's own immune disorders lead to hypersensitivity, resulting in the aggravation of the disease. Therefore, even if clinical symptoms disappeared, the late event of the predisposing factors will relapse, most patients are distressed, the condition repeatedly delayed healing will only result in further deterioration of the disease.
Therefore, for the treatment of the disease on the one hand, control of occult blood some of the clinical presentation, the most important thing is to clear the immune complexes deposited in the kidneys, at the same time also pay attention to the low-salt diet, low protein diet, soy products, seafood, beef forbidden to eat the lamb, spicy foods, the diet with the treatment, the same can get a good effect, so as to achieve the fundamental purpose of the treatment.
Hematuria can be divided into early end of hematuria, hematuria, total hematuria. Detailed methods are three cups of urine testing. Take 3 a clean of glass cup, patients each urination Shi, is divided into Qian, and in the, and Hou 3 paragraph urination, respectively row into 3 a glass cup in the, if 1th Cup in the for hematuria, remaining 2 cup normal, is for early hematuria, reminds urine liquid in the blood from urethral; if 1th, and 2 cup in the no hematuria, only 3rd Cup has hematuria, called end is not hematuria, reminds lesions in Hou urethral, and prostate, and bladder neck and triangle; as three Cup in the are has hematuria, called full hematuria, reminds lesions in kidney, and Ureteral, or for bladder within pervades bleeding.
Causes of hematuria, female causes of hematuria in 10 years what is 2 plus? Mainly has following several aspects: ① urinary system diseases such as nephritis, stones, infection, tuberculosis, cancer, deformities, injuries, etc. ② urinary tract organs in the vicinity of lesion, such as prostatitis, prostatic hypertrophy, pelvic inflammatory disease, appendicitis, etc. ③ systemic diseases, such as infectious diseases, blood diseases, cardiovascular diseases, and so on. ④ drug-induced factors, such as taking sulfa drugs, anticoagulants, or injection of mannitol. ⑤ hematuria after exercise.
Hematuria associated with other systemic symptoms, you can thus analyse the causes of differences between serum uric. Current adoption of urinary erythrocyte morphology of the public prosecutor's Office, to assume that sources of hematuria, in line with the rate of 90% per cent. Detailed approaches are centrifugal urine, placed on a slide, use a microscope to observe the morphology of urinary red blood cells in. Source of Glomerular hematuria, red blood cell deformation of red blood cells in the urine, that red blood cells emerged a variety of forms, such as a ring-like, strawberries, water droplets, even broken red blood cells, reminding hematuria due to Glomerular lesions as a result. Female hematuria caused by what is? non-source of Glomerular hematuria, red blood cells in the urine is normal or maybe normal form.
In addition, the identification of gross hematuria should be matched to hemoglobinuria. Hemoglobin in urine was due to haemolytic disease, plasma free hemoglobin in increased renal threshold was crossed, from glomerular filtration, who entered in the urine. Hemoglobin in urine color can be red, brown or even black color. Identification of hematuria and rely mainly on the microscope the public prosecutor's Office, hematuria urine contains large amounts of red blood cells, hemoglobin in the urine without red blood cells, this is the fundamental difference between the two.
Treatment for six months no negative IgA nephropathy is the glomerular mesangial iga iga deposition-based, with or without other immunoglobulins in the glomerular mesangial deposition of primary glomerular disease . The clinical manifestations: recurrent gross hematuria or microscopic hematuria may be associated with varying degrees of proteinuria in some patients with severe hypertension or renal insufficiency.
You are in the stage of renal insufficiency, abnormal indicators of increased renal pathological damage caused by kidney filtration and detoxification function decline. Now is how treatment? Treatment not only emphasis on the manipulation of the clinical indicators and, more importantly, from the start of the etiology of the disease, able to effectively repair and reverse the pathological damage of the kidney. Such a condition to get the fundamental manipulation, now active treatment effect is good, this is a chronic progressive disease, we recommend aggressive treatment as soon as possible, in order to avoid the disease is continuous progress to miss the timing of treatment.
Anticoagulant: the increase of inflammatory cells in the blood, to a certain extent, increase blood viscosity, which increases the micro-thrombosis in the glomerular capillary. The use of anticoagulants to prevent the formation of microthrombi, blood flow, further lay the foundation for the repair of mesangial cells.
What is it? Latest treatment iga nephropathy drugs and vasodilators: Why do you want to vasodilators it? Iga immune complexes after stimulation cause kidney capillaries, mesangial cells, ischemia and hypoxia the vasodilators's purpose is to improve renal blood circulation, relieve kidney ischemia and hypoxia of the intrinsic cell repair for the next phase in mesangial cells provide a good environment.
What is the treatment of iga nephropathy medicine? Degradation: the increase of inflammatory cells in the glomerular capillaries and blood vessels in the micro-thrombosis and the iga immune complex deposition will lead to glomerular capillaries, mesangial cells of the sediments aggregation and extracellular matrix increase, So we must use drugs to degradation of the deposition of extracellular matrix excreted with the urine to avoid glomerulosclerosis.
Attention problems in diagnosis and treatment of IgA nephropathy in process
I should be regular follow-up of IgA nephropathy urine protein quantitative, blood pressure, urine, renal function and renal b-.
II reducing proteinuria, should control the protein in urine in patients with IgA nephropathy to below 0.3 g/24 hours
In patients with recurrent attacks of III eye of IgA nephropathy with hematuria, tonsillectomy;
V positive control of hypertension, blood pressure should be reduced in patients with hypertension 130/80mmHg or 125/75mmHg the following;
Diagnosis of primary IgA nephropathy in patients with IgA nephropathy daily needs to pay attention to? Answers to the above we have, here is the check of IgA nephropathy, on this issue, we work together to get an idea.
Can you cure IgA nephropathy in early stage?
Found in physical examination: the majority of no abnormal signs, and some patients may have a dual-percussion pain in kidney area, swelling and mild to moderate increase in blood pressure.
Accessory examination: mostly mild to moderate proteinuria (<3G/d), hematuria is polymorphic, diversity or mixed. Some patients with elevated serum IGA, serum IGA fibronectin in particular polymers (iga-FN) increased more meaningful. May have reduced creatinine clearance, hematuria effect of nitrogen and creatinine increased. According to the clinical preliminary diagnosis of IgA nephropathy (inflammation), diagnosis of immune pathology of renal tissue must be done.
Medical history and symptoms: upper respiratory tract infections (acute gastroenteritis, peritonitis, or osteomyelitis) after 1-3 days appear vulnerable to recurrent episodes of hematuria by naked eyes, under lasting several hours to a few days later to hematuria, may be accompanied by abdominal pain, low back pain, muscle pain or heat. Some patients found during a physical examination of urinary anomalies, asymptomatic proteinuria and (or) under the microscopic hematuria, a small number of patients have persistent hematuria and proteinuria to varying degrees to the naked eye, and may be accompanied by edema and hypertension.
Many smokers know smoking is bad for health, but was unable to give away, then for creatinine high smoking? is the habit of smoking patients it is necessary to "endure pains silently to give away what one loves" out?
According to understanding muscle anhydride high of patients on smoke wine are is to limit of, because smoke wine of poisoned main is on kidney, and vascular of poisoned, smoking, and drinking more more on kidney vascular injury on more large, more early of increased has renal arteriosclerosis, more promoting renal ball of hardening, so, Shijiazhuang nephropathy hospital nephropathy expert Yang Dongping Director pointed out that, regardless of is renal features normal also is renal features exception muscle anhydride high of patients are to strictly quit ring wine, avoid caused kidney more large of damage.
Thus, for smoking in patients with serum creatinine high does this issue clearly has very clear, except in patients with serum creatinine level of restrictions on tobacco and alcohol to, in addition to serum creatinine high in dietary restrictions:
① vitamin intake to moderate: creatinine high in renal failure patients to choose foods rich in vitamin a, vitamin B2, vitamin c foods. If only people with kidney failure in patients with renal insufficiency creatinine high swollen but no less urine, no patient could not help salt and water, maintain a low salt diet. If you have severe edema, as well as high blood pressure and even heart failure should be strictly limited ban salt.
② to limit the salt: in general compensatory phase of renal insufficiency, with function of nitrogen in patients with serum creatinine is high, and minor clinical symptoms start, but because of injury in the pathology, Visual no high blood pressure, and edema, control the amount of salt intake, respectively, giving low-salt or salt-free diet.
③ protein supply must be reasonable: in order to prevent the continued deterioration of the renal function in patients with creatinine high, should control the protein intake, selection of high quality protein diet rich in high quality.
Thursday, 5 July 2012
Diabetic nephropathy is caused by different causes and onset mechanism of insulin in the absolute and the relative lack of that sugar, protein and fat metabolism disorders, chronic high blood sugar, the main clinical manifestations of systemic disease. Can diabetes damage the kidneys of those damages by different means involving the kidney structure, but only glomerular sclerosis and diabetes, also known as diabetic nephropathy, is one of the microvascular complications of diabetes systemic. Diabetic patients in the event of kidney damage persistent urinary protein, the disease is irreversible tend to develop to the end-stage renal failure. Diabetic nephropathy has become the leading cause of death in diabetic patients.
Diabetic nephropathy is more common in patients with diabetes duration of more than 10 years of proteinuria is the earliest manifestations of diabetic nephropathy, the onset mechanism is very complex, yet completely clarified. The research data show that the onset mechanism of diabetic nephropathy is multifactorial, mainly in the following areas:
1, the renal hemodynamic abnormalities
Play a key role in diabetic nephropathy, and may even be the initiating factor.
(1) hyperglycemia, glomerular hyperperfusion, hyperfiltration state, across the capillary wall pressure, so that the expansion of mesangial cells, epithelial cell foot process fusion and produce dense droplets, glomerular epithelial cells from off on the basement membrane. (2) the glomerular basement membrane collagen type Ⅳ messenger sugar nucleic acid increased basement membrane thickening, the final form of diffuse mesangial nodular lesions, the occurrence of glomerular sclerosis.
(3) In the case of pressure, increased protein filtration can also be deposited in the mesangium and glomerular basement membrane, promoting stromal proliferation constitute a vicious cycle, and can cause nodular and diffuse glomerular sclerosis.
Diabetic nephropathy is closely related to high blood sugar, poor blood sugar control can accelerate the occurrence and development of diabetic nephropathy good glucose control clearly slow down the development. Hyperglycemia and advanced glycation end products increased production caused by the proliferation of mesangial cells increase extracellular matrix, mesangial expansion, glomerular basement membrane thickening.
3, genetic factors
Most diabetic patients eventually kidney disease does not occur, the same, there may be some good long-term glycemic control in patients with diabetic nephropathy. Glucose transporter protein -1 (GLUT1) is the major glucose transporter in mesangial cells. Recent studies have found that diabetic patients from different individuals mesangial cell GLUT1 menu of the differences in the regulation may be one of the factors of some patients susceptible to kidney damage. And diabetic nephropathy also showed family aggregation in some family history of hypertension in diabetic patients, the incidence of diabetic nephropathy is also significantly higher in patients without hypertension, family history. In addition, the incidence of diabetic nephropathy between the different races there are also differences. That show the occurrence of diabetic nephropathy and genetic factors.
4, high blood pressure
With diabetic nephropathy are not directly related to microalbuminuria urine protein of the blood pressure can accelerate the progress of diabetic nephropathy and deterioration of renal function, increased urinary albumin excretion of the original high blood pressure or duration.