It should be noted some problems in the pathological diagnosis of primary glomerular diseases

In recent years, renal biopsy technology is the rapid spread of the pathological diagnosis of kidney disease, in particular, considerable progress in the diagnosis of glomerular disease. But indeed there are some urgent attention and improvement. The first clear pathological diagnosis of renal biopsy light microscopy, immunopathologic, and electron microscopy diagnosis. Around as soon as possible to create conditions for active collaboration, so that with the necessary conditions of the renal biopsy diagnosis. Some units (including the low quality of some of the conditions of good general hospital) producer, such as optical mirror slice is too thick (should be 2 to 3μm), the lack of special stains (PASM, PAS, Masson, and other necessary special stains, etc.); The renal biopsy specimen of the small number of units without immunofluorescence or immunohistochemistry, namely the pathology report; quite a number of unit power microscope, ultrastructural examination is not into the routine examination in the pathology. Some units lack pathologist familiar with the kidney pathology or kidney disease have a more extensive knowledge of pathology, general practitioners, or both, the lack of close cooperation and discussion. Above, greatly affect the correct pathological diagnosis of renal biopsy, should pay more attention and timely improvement of the Journal of Nephrology. Second edition, Beijing: People's Health Publishing House, 1996.424 ~ 435]. We focus on the pathological diagnosis of primary glomerular diseases in China could easily cause confusion and deserves our attention some of the issues the child proposed for the reference and correction of their fellow
1, minimal change nephropathy (MCD)
Necessary to conscientiously observe the ultrastructural changes of the electron microscope, diffuse foot process fusion and glomerular generally electron dense, even in the vice mesangial small electron dense as an important pathological features of MCD. Immunofluorescence specimens unsatisfactory or no glomerular rely only on observed by light microscopy to be confused with mild lesions with mild mesangial proliferative glomerulonephritis and early membranous nephropathy, can even be mistaken for the normal glomerulus. In the diagnosis of insufficient evidence, temporarily known as the glomerular minor lesion may be more appropriate.
Despite international IgM nephropathy is still controversial or different views, a massive proteinuria or nephrotic syndrome, renal pathology immunofluorescence showed mesangial area clear of IgM deposition under the light microscope can be mild mesangial proliferative , although electron microscopy of glomerular epithelial cell foot suddenly wide range of integration, we should still diagnosis of mesangial IgM nephropathy, and should be further follow-up. Middle-aged patients with minimal change disease, erythrocyte sedimentation rate abnormal increase in the fast should be carefully excluded the possibility of malignancy.
2, focal segmental glomerulosclerosis (FSGS)
Note first of all distinguish the glomerular lesions of focal segmental glomerular sclerosis with focal segmental sclerosis, which may occur in a variety of glomerular diseases, while the former is a specific renal ball disease. In recent years, many scholars abroad to promote the classic FSGS, collapsing glomerulopathy and state-of-the-art glomerular injury in two subtypes should be increased. Collapsing glomerulopathy (collapsing glomerulopathy, CG) has its own pathology and clinical particularity. CG of the pathological features of the glomerular capillary loops showed the limitations of segmental collapse. Sometimes as a global collapse, GBM performance wrinkled, folded, glomerular epithelial cells were significantly swelling, hypertrophy and hyperplasia of epithelial cells was more nuclear, cytoplasm containing a transparent kind of DROP or vacuolization, the vast The majority of patients were nephrotic syndrome, urinary protein> 10g/24h, the efficacy of hormonal and cytotoxic drugs, the majority of patients with renal function deterioration. Therefore, CG is considered to be the poor prognosis of a special kind of pathological changes of FSGS. According to reports, CG is a high incidence among blacks, CG about 5% to 15% of [the Kidney Int FSGS in 1994,45:1416 1424]. State-of-the-art glomerular damage (glomerular tip lesion) means the glomerular sclerosis uttermost parts in the urine of the vascular pole, and is generally believed that this kind of pathological changes in patients on hormonal and cytotoxic treatment response is better, FSGS in prognosis relatively good kind of pathological changes.
Pathological type of FSGS in elderly patients with nephrotic syndrome should be excluded from renal amyloidosis, diabetic nephropathy, light chain nephropathy and multiple myeloma nephropathy may be, can be combined with clinical and Congo red staining, the specific antibody immune staining (such as anti-Kappa or lambda light chain antibodies) and ultrastructure of careful observation to be identified.
Several domestic Kidney Disease Research Center of primary nephrotic syndrome, renal biopsy data analysis showed that the FSGS proportion of large difference can be> 15% or <5%. This variation causes speculation and pathologist to master standard, diagnostic thinking, especially glomerular diseases associated with glomerular lesions of focal segmental sclerosis appropriately diagnosed, yet to be domestic kidney disease academic as soon as possible unified.
3, membranous nephropathy
Atypical membranous nephropathy (ie, addition to the pathology of membranous nephropathy itself, there are varying degrees of mesangial cells and mesangial matrix, immunopathologic, and electron microscopy with membranous nephropathy), consideration should be given to the type Ⅴ lupus nephritis or hepatitis B virus associated glomerulonephritis secondary to glomerular diseases may, clinical, serological, serum HBV antigen detection and kidney slices by immunohistochemical detection of antigen (such as HBV antigen) further confirmed.
In the light microscope, the early membrane lesion (Ⅰ of membranous nephropathy) often lack a clear pathological changes, such as the lack of immunofluorescence specimens glomerular immunofluorescence specimens is not ideal, necessary for careful observation in the electron microscope the GBM epithelial cell side with or without electronic dense material (ED) and (or) using paraffin section immunohistochemistry to observe the distribution and the formation of IgG, C3, should not solely on the basis of the results of light microscopy misdiagnosed as mild disease, minimal change or mild mesangial proliferative nephritis.
Pathologically confirm the diagnosis in patients with membranous nephropathy, particularly ESR abnormal increase in the elderly patients should be the detailed examination to exclude malignancy (such as lymphoma, lung cancer), renal amyloidosis may.
4, mesangial proliferative glomerulonephritis (MsPGN)
China with a high incidence can have a variety of different clinical manifestations, response to treatment and prognosis of variation is great. Generally based on the characteristics of immunofluorescence into IgA and non-IgA mesangial proliferative glomerulonephritis, the former immunofluorescence IgA-based, the latter of IgG or IgM-dominated deposition in the mesangial area. Light microscopy should be based on the mesangial cells and stromal hyperplasia of the degree of glomerular capillary loops open and pressure, divided into light, medium and heavy three. Different response to treatment and prognosis.
For MsPGN patients should be combined with the clinical and the laboratory examination, pay attention to the differentiated kidney damage caused by systemic diseases and allergic purpura, systemic lupus erythematosus and cirrhosis. The primary MsPGN patients should also consider whether the dissipation of the capillary proliferative glomerulonephritis (acute infection glomerulonephritis) of.
Patients with hematuria, renal pathology immunofluorescence negative, thin light microscope, normal or showed mild mesangial proliferative lesions should be carefully investigating the family history of the hematuria, and careful observation of the GBM ultrastructural changes and the relevant checks to exclude basement membrane nephropathy or the possibility of early Alport syndrome.
5, the capillary proliferative glomerulonephritis
Should be noted that the difference of the capillary proliferative glomerulonephritis dissipation of mesangial proliferative glomerulonephritis, electron microscopy former GBM epithelial cells of the "Hump" to dissipate moth-eaten legacy lucent zone to assist in identifying; In addition, the combination of acute nephritic syndrome history, C3 dynamic change, ASO titer, and infection and the onset interval to help both identify all help.
Capillary proliferative glomerulonephritis characteristic pathological types of glomerulonephritis in the acute infection, many cases of domestic IgA nephropathy light microscope, the pathological changes in the endothelial cells, mesangial cell proliferation, capillary loops compression for outstanding performance, it should be based on immune fluorescence and clinical manifestations (serum IgA level, ASO, C3, infection and onset interval, etc.) to distinguish between the two.
Ⅳ lupus nephritis can be expressed endocapillary proliferative nephritis pathological changes, it should be combined with antinuclear antibodies and other immunological tests and other clinical manifestations of carefully identified.
6, membrane proliferative glomerulonephritis (MPGN)
Idiopathic nephritis should be carefully observed in the electron microscope, the distribution of parts according to the electron-dense material, and in combination with other pathological features (if double-track sign, immunofluorescence features) distinguish Ⅰ, Ⅱ, Ⅲ type.
Western developed countries MPGN type Ⅰ the MPGN incidence rate decreased significantly, and may improve related health conditions, air pollution. In the pathological type accounting for primary nephrotic syndrome in 10% to 15% of the vast majority of type MPGN Ⅰ.
Pathological manifestations of MPGN patients, in conjunction with clinical and laboratory tests (including kidney immune pathology examination), carefully exclude the hepatitis B virus associated glomerulonephritis, hepatitis C virus associated glomerulonephritis, cryoglobulinemia kidney damage and lupus nephritis possible.
7, crescentic nephritis
In recent years, anti-neutrophil cytoplasmic antibodies (ANCA) testing is widely used in clinical practice, crescentic nephritis is traditionally divided into Ⅰ, Ⅱ, Ⅲ type of classification is under attack, most scholars recently advocated basis for ANCA and anti- glomerular basement membrane (GBM), results in greater detail is divided into five types [of The kidney 5th ed. Philadephia: WBS Saunders Company, 1996. 1 392 ~ 1 432].
Based solely on light microscopic examination to confirm the diagnosis of crescentic glomerulonephritis is not enough, should be combined with immunofluorescence, serum anti-GBM antibody and ANCA detection and clinical manifestations (such as hemoptysis, etc.), carefully identify the crescentic glomerulonephritis of what kind of type, take reasonable treatment, the prognosis is crucial. Anti-GBM antibody-positive rapidly progressive glomerulonephritis (RPGN) I light microscope and electron microscope in the early lesions often can be observed in a clear and serious GBM rupture, degeneration; ANCA positive RPGN Ⅲ type (Many scholars believe that the small blood vessels inflammation of the kidneys localized) in most patients with renal biopsy specimens can be observed more diffusely distributed segmental capillary loops fibrinoid necrosis, and a small number of patients (20%) can be found in necrotizing renal arteritis. Show the different types of crescentic nephritis their pathological features. Must be pointed out that the RPGN I type renal biopsy specimen by immunofluorescence examination, the early shows IgG and C3 along the GBM was smooth lines, kind of typical distribution, but the course of the disease later, because of the GBM rupture, degeneration and / or anti-GBM and GBM combine to form immune complexes and which led to the generation of the second antibody, some patients with IgG and C3 can be presented to the granular distribution along the GBM, etc., often misdiagnosed as immune complex-mediated type II RPGN. Type III RPGN kidney specimens by immunofluorescence negative or only weak IgM and / or C3 deposition. We believe that the RPGN patients with conventional anti-GBM antibodies and ANCA testing, carefully observe the pathological changes and clinical data for the right to distinguish between different types of RPGN is very important.
8, sclerosis of glomerular nephritis and sclerosing glomerulonephritis
Various types of glomerulonephritis sustainable development, so that part of the (more than 50%) completely destroyed leading to global sclerosis. Glomerulus, the surviving structure can still identify the type of the original glomerular pathology may be said of a certain type of glomerulonephritis caused by proliferative sclerosing glomerulonephritis. If the structure of the remaining glomerulus has been unable to identify the type of primary glomerular lesions, can be collectively referred to as proliferative sclerosing glomerulonephritis. More than 70% of the total number of glomerular glomerular sclerosis, can be called sclerosing glomerulonephritis. Glomerulosclerosis by other systemic diseases such as diabetes, amyloidosis, hypertension, small vessel vasculitis, systemic lupus erythematosus and other systemic diseases caused should be noted that the identification of renal pathology and clinical Changsha: Hunan Science and Technology Press, 1993.41 53.]
In summary, the diagnosis of primary glomerular disease should be closely combined with clinical and related inspections, serious rule out the possibility of systemic or genetic disease, response to light microscopy, immunofluorescence and electron microscopy Ultrastructural pathological changes, careful observation and comprehensive analysis in order to obtain a correct diagnosis of pathological types of primary glomerular diseases.

FSGS Patients Give Immunotherapy the Golden Opinions

Reasonable diet of patients with nephrotic syndrome

Patients with nephrotic syndrome need to add the "quantity of the protein
Nephrotic syndrome due to a large number of protein loss from the urine of serum albumin levels were significantly reduced, patients with decreased resistance, appear malnourished children will affect the growth and development, it is very necessary to increase plasma albumin. The past have advocated high-protein diet (> 1.6 g / kg / day), some competition as much as 3 to 4 g / kg / day, attempt to compensate for the loss of protein in the urine, maintaining blood levels of albumin, to prevent malnutrition . Numerous studies have demonstrated no benefit of high-protein diet on patients with nephrotic syndrome. For patients with renal function has been damage, such as high-protein diet but is "worse", but can not be used. In addition, the tendency to an error, that the strict control of protein intake can reduce proteinuria in patients with kidney disease. In fact, the intake of protein is too small, <0.3 g / kg / day, can only further decline in plasma protein, to make the patient more vulnerable to infection, edema repeated exacerbations, malnutrition, the same is not desirable. Studies have shown that to ensure adequate calories (35 kcal / kg / day) and moderate protein diet, the general protein quality of 0.8 to 1.0 g / kg / day. In case of severe hypoalbuminemia (serum albumin <20 g / l) can be relaxed protein restriction, can be 1.0 to 1.2 g / kg / day; such as renal insufficiency, serum creatinine> 200 micro mol / l, The protein content of 0.5 to 0.7 g / kg / day.
Patients with nephrotic syndrome need to add the "quality of the protein
Here related to kidney patients are very concerned about the issue of whether eating beans and soy products. Past the vast majority of scholars advocate high-quality protein, strict restrictions on the plant protein (legumes and soy products). But in recent years, new studies show that soy protein is beneficial to kidney disease. Patients with nephrotic syndrome soy foods, urinary protein excretion decreased, and also reduces blood lipids. Soy protein and animal protein in reducing proteinuria, lipid, and the protection of renal function is more superiority.
We believe that: 0.8 to 1.0 g / kg / day protein supplement is appropriate, animal protein and soy protein. Such as egg protein, chickens and ducks and other poultry, beef, lean pork and so on. Generally the former accounting for 1/2 to 2/3.

The Prognosis of Focal Segmental Glomerulonephritis (FSGS)

Also the use of ACEI to reduce the glomerular pressure, so that proteinuria decreased, but the patients with histological changes did not improve. Therefore, FSGS patients with morphologic changes and functional changes are often inconsistent.

Schulman and other prognosis observed two groups of FSGS in children and found that the clinical and morphological parameters by the following poor prognosis.

As we all know, renal biopsy can be more correctly guess the prognosis of patients. Pathologists often find considerable tissue damage function parameters to speculate on the prognosis. Proteinuria is usually first consider the clinical indicators, however, proteinuria in FSGS patients to remind not seem to meet the prognosis of benign and malignant. It was found that the MCD in patients with massive proteinuria, glomerular no sclerosing lesions to the contrary, when the FSGS patients with proteinuria reduction, it may indicate the increase in the number of FSGS lesions involving the glomerulus; also the use of ACEI to reduce the glomerular pressure, decreased proteinuria, but in patients with histological changes has not improved. Therefore, FSGS patients with morphologic changes and functional changes are often inconsistent.

The main reason for this function is out of line and shape including:

① The lesion of focal and segmental distribution.

② sclerotic glomeruli transitional compensatory.

③ nephron number is reduced.

④ renal blood flow abnormalities.

⑤ plasma colloid osmotic pressure changes.

⑥ changes in glomerular pressure.

FSGS can be Efficiently Treated by Micro-Chinese Medicine Osmotherapy

FSGS treatment and prognosis

Focal segmental glomerulosclerosis (focal segmental glomerular scerosis, FSGS) is the primary glomerular diseases in a unique set of clinical and pathological syndrome, lesions characteristic is the part of some of the glomeruli and glomerular capillary climbthe segmental sclerotic changes and hyaline change, and the deep renal cortex next to the marrow glomerular First of all involved; clinical manifestations of proteinuria, nephrotic syndrome, poor response to a variety of treatment, the disease was chronic progressive process, and ultimately, chronic renal failure.
Clinical manifestations
FSGS seen in any age, usually occurs in children and adolescents, with an average age of 21. Men than women. No characteristic clinical manifestations, the most common first symptom of nephrotic syndrome, and about 2/3 of patients with massive proteinuria and severe edema. Microscopic hematuria common, accounting for 90%, gross hematuria.Small subset of patients is found in a routine urine examination, urine protein, and this type of asymptomatic proteinuria sustainable for a long time, the prognosis is good.Proteinuria and the vast majority of non-selective, but early high or moderate selectivity.Light, blood pressure and severe rise. Renal impairment seen in newly diagnosed, but more in the course of the gradual emergence. Serum C3 levels were normal. IgG levels decline. Often the performance of proximal tubular dysfunction, such as grapes, diabetes, and amino acid in urine. The above symptoms of upper respiratory tract infections or allergies can make worse. Most patients with glomerular filtration rate decreased.
Treatment
The treatment of this disease more difficult to advocate more comprehensive treatment.
(1) General treatment: in patients with renal insufficiency should be low-protein diet plus keto acid preparations for treatment can delay progress. Edema, hypertension, sodium restriction, diuretic, antihypertensive drugs such as converting enzyme or receptor inhibitors, calcium channel blockers.
(2) Hormones: observed in recent years to extend the hormone treatment can make the effective rate of 40%. Minimal change to the disease, history of hormone-sensitive response to treatment are mostly good. Prednisone 0.5 to 1mg / (kg × d) '6 ~ 8 weeks.Then gradually reducing the transition to every other day therapy, the total course of more than one year. However, patients with a higher hardening rate, the use of hormones should be careful. (
3) immunosuppressive agents: this is still controversial. Alkylating agents: cyclophosphamide, tumor Ning, azathioprine, hormone-sensitive, immunosuppressive agents can significantly reduce the recurrence rate and prolong the remission period, reducing the hormone dosage. Hormone antagonist, it was suggested that cyclophosphamide allows the original hormone antagonistic to sensitive. In recent years, was also noted with cyclosporine A or mycophenolate, etc. have some efficacy in the treatment of this disease.
(4) Other treatments: converting enzyme inhibitors and receptor blockers can reduce the amount of urinary protein, reducing pressure and glomerular basement membrane permeability of the ball and protect renal function. This disease there are systemic and renal hypercoagulable state, anticoagulation therapy have a certain effect. Often used dipyridamole, heparin, urokinase, defibrase warfarin. Vitamin E is an endogenous antioxidant, protection of renal function.
Prognosis
The prognosis of a variety of factors:
(1) the degree of proteinuria: the nephrotic syndrome and nephrotic syndrome five years survival rates were 76% and 92%. (2) response to treatment: where very little development of hormone-sensitive to renal failure. Complete remission of end-stage renal failure rate was 15%, not in complete remission compared to 85%.
(3) the time of biopsy, serum creatinine, high blood pressure and poor prognosis.
(4) BIOPSY: the extent of damage, especially the degree of interstitial fibrosis is a reliable indicator to predict end-stage renal failure incidence.
(5) serum C3 levels prognosis is good.

After Kidney Transplant, FSGS Comes Back again

World-class and Latest Treatment for FSGS

FSGS is actually a from a very difficult to treat kidney disease. Most cases in the long dialysis patients to waiting for a kidney transplant. But FSGS is after kidney transplantation, the highest kidney disease recurrence. The medical development fall now is there a better way FSGS treatment?
Many patients will find, traditional treatment just to be able to alleviate the symptoms of certain, and slow the disease, but can not be treated well. So many patients have to face frequent FSGS recurrent urinary tract infections, malnutrition, high blood pressure, etc.
Immunotherapy is not a signal therapy, but a complete treatment system including diagnosis, medications and latest therapies.
Immune therapy suppresses the immune factor is mainly the ultra immune reaction to the normal cells in the kidney damage. To prevent further damage to the kidneys and FSGS recurrence.
It can control symptoms by restoring the filters (glomeruli) in kidneys. Therefore, it can improve the impaired renal function remarkably.
And through the improvement of the immune system, to curb FSGS recurrence, and other complications can defend.

Which Treatment can Help FSGS Patient

Latest Treatment for FSGS Immunotherapy

The principle of immunotherapy
1.Mediation human internal balance, mediation of human body immunity
2.　Can stimulate the growth of normal cells, the reconstruction of the immune system, resist infection, reduce FSGS recurrence.
3.Can make protein repair have been destroyed the glomerulus.
4.Through the human immune system reconstruction, can make the patients gradually get rid of to hormone FSGS dependence.
5.Immune therapy, combined with the new Chinese medicine purification technology, which makes the people down to the side effects of very low, reducing the drug use on the body of damage.
Immune therapy will be much use of your time?
FSGS is a refractory and chronic disease.
There is no shortcut to its cure. The length of treatment varies with different patients, depending on the following factors:
1. How long have FSGS
2. The damage rate of the kidney
3. The health of the body degree, and any other complications
4. The recurrence of FSGS frequency
What to expect after treatment?
Short-term treatment effect
Systemic toxicity symptoms disappeared;
Gastrointestinal symptoms and intend to enhance;
Electrolyte imbalance is fixed;
Blood pressure restore stability;
Anemia and other related diseases recovery.
Long-term treatment effect
Blood creatinine returned to normal;
Protein urine disappeared;
GFR returned to normal level;
The immune system to resume normal function of fighting the disease.

Immunotherapy Helps FSGS Patients Get Rid of Sufferings

High Sodium Foods The Patients with FSGS Need to limit

Normal adult daily 2.5 g of potassium content of potassium is abundant in natural foods, regular diet for 2-4 grams a day, can meet the physical needs. About 90% of potassium enters the body, in a relatively short period of intestinal absorption, the rest excreted with the feces of potassium intake in participating in the cellular metabolism in the body through the kidneys, intestines and sweat glands discharge, normal adults row of potassium The main way the urine (approximately 80%).


Patients with chronic renal failure the kidneys ability to regulate potassium metabolism was significantly lower in the case of acute endogenous and exogenous load increases, it is difficult to maintain the balance of potassium metabolism, and hyperkalemia. The hyperkalemia main hazard is the cause arrhythmia, decreased blood pressure, cardiac arrest, respiratory arrest and other serious consequences, ECG can help diagnose hyperkalemia. When potassium is higher than 6mmol / L, ECG V1-V4 leads will have a typical tip T wave, Q-T interval prolongation, P affected R wave to reduce, QRS widening wave group, the S-T segment depression.

The daily diet of meat, beans, vegetable species, such as food in the potassium rich, followed by rice, eggs less. Among them, shrimp, soybeans, black beans, mung beans, lily, arrowhead, lily, red amaranth, tomato sauce (canned), seaweed, mustard, pickled potherb mustard, dried mushrooms, dried mushrooms, fresh dates, dried dates, grapes, dried peanuts the food content of the kernels, tea, malted milk, vinegar, and chronic renal failure patients should be careful eating. Following five categories of food rich in potassium: the potassium-rich food of the following five categories:

Fruit: bananas, apples, grapes, watermelon, apricots, oranges.

Vegetables: spinach, amaranth, coriander, rape, cabbage, eggplant, tomato, cucumber, celery, onion, leek, lettuce, potatoes, yams, fresh peas, soybeans, taro, beans, potatoes, lentils, mushrooms, spinach, toon and so on.
Seaweed: seaweed, kelp, pomfret, catfish.

Food: buckwheat, corn, sweet potatoes, soybeans.

(5) tea.

Common list of high potassium food food groups cereals and products of bacteria and algae dairy and products, dry beans and products of bacteria and algae algae cereals and products, dry beans, dry beans and products, and products, dry beans and products, fruits and Nuts, seeds bacteria-like algae dry beans and products algae food sub-categories corn mushroom milk soy algae fungi wheat soy soy soy food name cornmeal (enhanced soybean meal) Mushroom (white mushroom) milk powder (multidimensional milk) soy flour seaweed (dry) white fungus (dry) [tremella wheat germ meal, soybean [soybean] soybean meal and black beans, black beans], for every 100 grams of potassium content (mg) 3370 3106 1910 1890 1796 1588 1523 1503 1 391 1377 1348 1244 1225 1215 1155 tropical and subtropical fruits longan ( dry) tree nuts, fungi kidney beans fungi hazelnut (dry) mushrooms (dry) kidney beans (red) mushrooms (dry) hair shank of gold wire bacteria] dry beans and products, broad bean broad beans kidney beans potato flour tofu brain [Laodou] lentils (white) (Miscellaneous skin) mung bean noodles, raisins, tomato sauce scallops (dry) [scallops] onion.


How to Treat Focal Segmental Glomerulosclerosis (FSGS) with Immunotherapy

FSGS Treatment Guidelines

Kidney International Supplement 2012, 6
Glomerulonephritis in 2012 the KDIGO treatment guidelines (Adult) 1 adult minimal change disease (MCD)

1.1 Adult MCD is the first treatment

1.1.1 Recommended use of hormones (1C) in the first treatment in patients with nephrotic syndrome.
1.1.2 The recommended single dose of prednisone or prednisolone daily 1mg/kg (maximum 80mg) every other day dose of 2 mg / kg (maximum 120mg) (2C).
1.1.3 The proposal achieved complete remission, but also tolerated the initial dose of hormones to maintain at least four weeks, if not to achieve complete remission, up for 16 weeks (2C).
1.1.4 in patients in remission, it is recommended that the hormone experienced six months of slow reduction (2D).
1.1.5 In patients with hormone relative contraindication to or can not tolerate large doses of hormones (if not control of diabetes, mental illness, severe osteoporosis, etc.), recommended oral cyclophosphamide or calcineurin inhibitors (CNIs), such as in frequent recurrence of MCD usage (2D).
1.1.6 is recommended that non-frequent recurrence, the initial dose and time of the hormone, such as 1.1.2, 1.1.3 and 1.14 are recommended (2D).

1.2 frequently relapse (FR) / steroid dependent (SD) MCD treatment

1.2.1 recommends oral cyclophosphamide 2-2.5mg/kg/d weeks. (2C).
1.2.2 recommended, despite the use of cyclophosphamide is still recurrence FR / SD MCD patients, or the need to preserve the reproductive function, the use of CNIs (the cyclosporine 3-5mg/kg/d tacrolimus, 0.05-0.1 mg / kg / d graded for 1-2 years (2C). 1.2.3 can not tolerate hormones, cyclophosphamide and CNIs, we recommend the use of mycophenolate mofetil (MMF) 500-1000mg daily treatments - 2 years (2D).

1.3 steroid-resistant MCD treatment

1.3.1 steroid-resistant MCD re-evaluate whether there are other reasons (no rating).

1.4 support treatment

1.4.1 the proposed merger of AKI in MCD patients, if it reaches the indications for renal replacement therapy, hormone therapy (treatment as the first of MCD) (2D).
1.4.2 During the first treatment of MCD patients with nephrotic syndrome does not recommend the use of the D class drug treatment of hyperlipidemia is not recommended in normal blood pressure, use of ACEI or ARB drop of urine protein (2D).
For reference only, and any errors or omissions, please correct me
The Kidney International, the Supplement 2012, 2 adults with idiopathic focal segmental glomerular sclerosis (FSGS) nephritis

2.1 Initial assessment of FSGS

2.1.1 full assessment to exclude secondary of FSGS (unrated).
2.1.2 is not conventional to do genetic testing (unrated).

2.2 initial treatment of FSGS

2.2.1 The recommended only in the nephrotic syndrome in patients with idiopathic FSGS, before considering the use of hormones and immunosuppressive therapy (1C).
2.2.2 prednisone daily single-dose administration, start the dose 1mg/kg/d (maximum 80mg / d) or every other day the dose 2mg/kg/d (maximum 120mg / d) (2C).
2.2.3 sufficient quantities of prednisone daily oral administration of at least four weeks, if tolerated, until relief up to 16 weeks (2D).
2.2.4 complete remission, it is recommended hormone slow the reduction of 6 months (2D).
2.2.5 dose corticosteroids contraindicated or not tolerated in patients (such as control of diabetes, mental illness, severe osteoporosis, etc.), it is recommended as first-line treatment (2D) using CNIs.

2.3 the treatment of recurrent

2.3.1 The recommended FSGS patients with nephrotic syndrome relapse treatment and relapse of recommended treatment options with adult MCD (2D).

2.4 steroid-resistant FSGS treatment

2.4.1 given CsA 3-5 mg / kg / d times serving at least 4-6 months (2B).
2.4.2 If a partial or complete remission, it is recommended that continued treatment for at least 12 months, and then slow reduction (2D). 2.4.3 for the hormone resistance can not tolerate the FSGS patients with CsA, the proposed joint use of MMF and high-dose dexamethasone therapy (2C).
For reference only, and any errors or omissions, please correct me


Immunotherapy Helps Patients Avoid or Stop Dialysis Treatment

What foods do you need to limit?

Most people with kidney disease need to limit salt (sodium), protein, and fluids. Some also have to limit minerals, such as potassium and phosphorus.
There is no one diet that is right for everyone with kidney disease. Your doctor or dietitian can tailor a diet for you based on how well your kidneys are working.
To be successful with your diet, you will need to:
· Read food labels and look for hidden sodium. For example, sodium may be listed as monosodium glutamate (MSG) or disodium phosphate.
· Learn about sources of protein. Most people know that meats, fish, and dairy products are high-protein foods. But you may not know that foods such as breads, cereals, and vegetables also contain protein.
· Know which foods have minerals you need to limit. For example, dairy products, nuts, seeds, and beans have a lot of phosphorus. Potatoes and bananas are sources of potassium, but it is also found in other fruits and vegetables as well as many meats, grains, and milk.
It may seem like there is a lot to learn, but your doctor or dietitian can help. A dietitian can plan meals for you that are healthy and give you the right amounts of foods you need to limit.
It may be hard to change your diet. You may have to give up many foods you like. But it is very important to make the recommended changes so you can stay healthy for as long as possible.

Laboratory tests of FSGS

A urine routine examination, microscopic hematuria, proteinuria, and often aseptic white blood cells in urine, grape diabetes. Impaired renal tubular function, urinary amino acids and phosphate in urine, its high incidence of other types of NS. 2 blood tests have significantly lower serum albumin, serum albumin is usually less than 25g / L, and a few up to 10g / L below. Decline in glomerular filtration rate (GFR). BUN, creatinine increase. The majority of patients with hyperlipidemia. Serum C3 is usually normal IgG level decreased, C1q is mostly normal. 10% to 30% of patients positive for circulating immune complexes. Hypovolemia can cause the increase in hematocrit. Normal white blood cells and classification. Platelets slightly elevated. Water retention will result in lower sodium concentration, the long period of sodium or acquired adrenal insufficiency, can lead to lower sodium concentration. Hyperlipidemia can cause pseudo-hyponatremia, and platelets in vitro release of potassium ions, thrombocytosis can also cause pseudo hyperkalemia.

If you want to know the symptoms of FSGS, PLEASE CLINIC THIS LINK.

Other laboratory examinations

1 typical FSGS lesions characteristic of renal biopsy by light microscopy examination of focal segmental glomerular damage focal segmental glomerulosclerosis lesions

Lesions involving a small number of glomeruli and glomerular some segments of hyaline sclerosis. The lesions are often deep from the cortex or nearly medullary parts of the glomerulus began, and gradually extended to the renal cortex. Glomerular lesions showed segmental glomerular sclerosis, uninvolved normal of glomerular mesangial matrix increase. Hyaline material deposited in the damaged capillary loop endothelial cells, hardened area with occasional foam cell formation, proliferation of epithelial cells of the common limitations. Early lesions may only local epithelial cells and basement membrane from the epithelial cell swelling, vacuolar degeneration, basophilic cytoplasm. Hardening of the capillary loop wall adhesions with Bowman. Each segmental glomerular damage of a different range of disease progression may contribute to global sclerosis. Fully developed cases of lesions, easily mistaken for the "non-specific chronic sclerosing glomerulonephritis, and through immunofluorescence differential diagnosis. Renal tubular damage often appears as a focal thickening of the basement membrane and atrophy. Coexist, such as focal tubular damage and mild glomerular changes should be suspected of FSGS. Renal tissues of focal, global glomerulosclerosis performance of FSGS often late, also associated with severe tubulointerstitial lesions in pediatric patients up to 30%. The typical adult hormone-sensitive minimal change can be seen a small number of global sclerosis of glomeruli, with FSGS phase difference. In addition to primary FSGS, many diseases of the kidney tissue can be seen of FSGS-like change. FSGS may also overlap with primary glomerular diseases. Electron microscopy a large number of proteinuria cases most or all of the glomerulus shows diffuse or segmental foot process change. Early visible in the capillary wall and (or) mesangial foam cells, mesangial matrix increase and part of the capillary collapse. Endothelial cells and mesangial area corresponding to the electron dense deposits, mesangial cell proliferation, large electron-dense material under the light microscope hyalinization and immunofluorescence IgM and C3 deposition. Ball collateral membrane area and endothelial cells can also be found fine granular electron dense deposits. 3 immunofluorescence in the hardening or necrotic areas can be found in the C3 or IgM and C1q was irregular, granular or nodular distribution. Glomerular lesions were negative. Occasionally mesangial have IgM and C3 distribution and IgG, IgA, rare.

The symptoms of FSGS

The disease mostly occurs in children and adolescents, men slightly more than women.Minority suffering from focal segmental glomerulosclerosis imaging
Persons before the onset of upper respiratory tract infection or allergic reactions. Most common clinical symptom is the nephrotic syndrome, about 2/3 of patients with massive proteinuria and severe edema, urine protein 1 to 30g / d, more than about 50% of patients with hematuria, microscopic hematuria common and occasionally gross hematuria. 30% ~ 50% of the adult patients with mild persistent hypertension or manifestations of chronic nephritic syndrome, patients with 24h urinary protein <3.5g / d, the edema is not obvious, often hematuria, hypertension and renal insufficiency, and 50% was renal comprehensive performance significantly "three high and one low clinical manifestations. A small number of patients with no obvious symptoms, and occasionally found in routine urinalysis proteinuria. This type of asymptomatic proteinuria sustainable a long time, a better prognosis. A small number of patients with this type of gradual development of end-stage renal failure. Proteinuria and the vast majority of non-selective, but early high or moderate selectivity. Serum C3 concentration of normal IgG level decreased. Often proximal tubular function is impaired performance. The above symptoms of upper respiratory tract infections or allergies can make worse. Slight differences in the different pathological types of clinical manifestations of the disease, typical FSGS and glomerular hypertrophy, urinary protein less; cell FSGS often massive proteinuria (> 10g / d), and prone to renal insufficiency. Have reported that 60% of cell FSGS patients with serum creatinine> 2mg/dl, while only 10% of patients in a typical FSGS serum creatinine increased. Collapsing type of FSGS also significant proteinuria, often> 10g / d and renal insufficiency are more serious than other types, and hypertension is relatively small. This type of rapid onset, rapid progression, usually 1 to 2 years after the onset into the end-stage renal failure (ESRF). The clinical manifestations of pediatric patients and adults, mostly with nephrotic syndrome, while the proportion of the occurrence of hypertension and renal insufficiency than in adults is low. The majority (40% ~ 60%) FSGS showed a chronic progressive, eventually leading to kidney failure, a small number of patients (10% to 15%) rapid progress of the disease, earlier onset of renal failure.
if you what to know the most effective treatment for FSGS,please clinic this link

Diagnosis of Acute Glomerulonephritis

Acute glomerulonephritis in the pioneer history of infection, edema, hematuria is accompanied by hypertension and proteinuria, the diagnosis is not difficult. The acute period of increased anti-streptolysin O titer, decreased the concentration of serum complement, urine FDP levels increased more helpful in the diagnosis. Individual patients with acute congestive heart failure or hypertensive encephalopathy, the symptoms at first, or early disease, only edema and high blood pressure and only slight or no urine routine change, should be asked in detail about the history of the atypical cases, system checkup and laboratory integrated analysis in order to avoid misdiagnosis, the difficulties of clinical diagnosis, if necessary, a renal biopsy before being diagnosed. do you want to know the complications and symptoms of this disease,if so please click this link Severe Complications of Acute Glomerulonephritis in Children The typical acute nephritis is not difficult to diagnose. Asymptomatic interval of 1 to 3 weeks after the streptococcal infection, edema, hypertension, hematuria, acute glomerulonephritis (with varying degrees of proteinuria), coupled with blood complement C3 dynamic changes to a clear diagnosis. 1 to 4 over a week before the onset of upper respiratory tract infections such as tonsillitis, pharyngitis, lymphadenitis, scarlet fever or skin infections, including impetigo, boils, swollen, a history of streptococcal infection. (2) edema. Oliguria and hematuria. (4) high blood pressure. Severe cases, the following complications: the ① circulatory congestion and heart failure; the ② hypertension encephalopathy; ③ acute renal failure. 6. Laboratory tests ① urine red blood cells, mainly mild or moderate protein or granular casts. ② a transient increase in blood urea nitrogen in the oliguric phase. The ③ ESR is increased in the acute phase. The anti-"O" titer increased, the majority of more than 1:400. ④ serum complement (C3) determined the onset of two weeks significantly decreased and returned to normal in 1 to 2 months. Diagnostic criteria 1, kidney enlargement, kidney size are increased especially thick diameter is obvious, so that the protuberance of the kidney shape, full spherical development of acute glomerulonephritis. The kidney capsule of unclear outline the boundaries are not clear, blurred edges. 3, thickening of the renal parenchyma, the echo diffuse enhanced fuzzy points of light, like cloud cover, without distinction of the renal cortex and renal medulla, renal sinus echo is relatively dilute, or even the whole section content seamless, no way of a normal kidney structure. Four different pathological changes of acute glomerulonephritis, although the mutual differences in the performance of the sonographic differences, such as the shape of the state of the degree of envelope and blur the clarity of the degree of renal corticomedullary distinction, renal sinus echo state the extent of mutual differences. But the overall characteristics of the inflammatory lesions.

How to treat diabetes by traditional Chinese Medicine

Chinese medicine treatment of diabetes, how to fix the kidney? TCM therapy is the treatment of diabetic nephropathy TCM treatment of diabetic nephropathy is different from Western medicine treatment of the biggest feature is fundamentally adjust. In particular, the latest research and development of targeted medicine living pancreatic infiltration therapy is brought into full play the fundamental advantages of Chinese medicine, so that patients with diabetic nephropathy to see hope! So, how targeting Chinese medicine treatment of diabetic nephropathy? Chinese medicine believes that: diabetic nephropathy is falling diabetes Shangyin gas consumption, sinister and Yang, Qi and Yin deficiency, yin and yang and chronic illness into the network, phlegm evil heat, blood stasis, qi cemented to each other to form a "micro-Zhengjia renal body damage, kidney due to loss of the Secretary. Clinical stage of diabetic nephropathy, nephron injured, gasification No, endogenous toxic cloud of toxic cloud can be more harm to the kidneys, Hao Shang blood, block the air-lift access, and ultimately uremia "off grid" crisis designate. Treatment when emphasis on Huazhuo detoxification priorities to protect renal function. Targeting Chinese medicine living pancreatic infiltration therapy to block renal fibrosis and fundamental treatment of diabetic nephropathy can take advantage of the micro-processing of Chinese medicine traditional Chinese medicine treatment of this feature, again effective link in the chain of broken Chinese medicine molecules, the formation of the new features but can also damage the glomerular basement membrane, the removal of immune complex deposition in the basement membrane and diseased tissue blocking the process of renal fibrosis, and repair damaged basement membrane. Traditional Chinese medicine treatment of diabetes, how to fix the kidney? Targeting Chinese living pancreatic penetration treatment of diabetic nephropathy is gene repair the lesions of diabetic nephropathy, kidney disease and damaged cells, and activate the damaged tissue cells, DNA replication, prompting the damaged kidney structural changes , so that impaired kidney function was restored.

Insulin injections and diet

Many patients do not pay attention to the process of insulin on the regulation of the diet, some people believe that: I played the insulin, diet, I can easily eat, this view is wrong in the process of insulin injections in the diet, we still need to pay attention. Insulin and diet exactly what kind of relationship? Diet for the treatment of insulin also plays what role?
1, the diet can effectively adjust the insulin dosage
Regular feeding, the role of the insulin effectively, but also could be better, faster insulin dosage and adjusted to the optimum level.
2, the diet can prevent low blood sugar
Why the use of insulin therapy, easy to hypoglycemia reaction it? Because of the slow subcutaneous injection of insulin, insulin absorption and effect. The purpose of the injection of insulin before the meal is a postprandial blood glucose down to a 2-hour postprandial blood sugar down when the subcutaneous injection of insulin is slowly absorbed, its role has not disappeared entirely, so the 2-hour postprandial of blood glucose in insulin action, but also continued to decline. Then, if the food intake, can cause low blood sugar. Low blood sugar can cause a lot of accidents, such as cerebrovascular accidents, cardiac events. Avoid postprandial hypoglycemia, it is necessary to lower blood sugar has gone up a small amount of snacks in the 2-hour postprandial.
3, the diet help reduce the amount of insulin
In general, high-calorie dietary intake, the activities of a small amount of insulin needs large amount of dietary intake is low in calories, volume of the activities insulin requirements. If the diet is reasonable, is bound to rationalize the amount of insulin, can also enhance the body's sensitivity to insulin, thus helping to reduce insulin doses.

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Best hospital in China for diabetes

The Shijiazhuang nephropathy Hospital was founded in 1986, so far after 25 years of development. , Shijiazhuang kidney disease hospital in the past 25 years developed into a set of medical, teaching, scientific research is one of the new modern treatment facilities. Has become the nation's largest kidney treatment centers, diabetic treatment center is a focus on diagnosis and treatment of kidney disease hospital departments, has now developed into advanced equipment, strong technical force, a significant treatment effect of outstanding departments, Hebei Province, Medicare designated diabetes specialist hospitals.
Diabetes Treatment Center - System monitoring, scientific medicine
Shijiazhuang the nephrotic hospital diabetes treatment center treatment of diabetes and its complications are: system testing, scientific diagnosis, the diagnosis is unclear without medication. Introduced to our hospital diabetes and its complications diagnosis is the most advanced equipment in the international system and software systems, non-mydriatic fundus monitoring of both lower extremities EMG monitoring three ECG and advanced inspection equipment, at this stage of international and domestic advanced, most accurate diagnostic system. In addition, according to the characteristics of the Chinese people, adding unique test indicator system. This system, not only personalized analysis of disease and pathologic characteristics of each patient, and can provide clinicians with drug standards and recommendations, provided a guarantee for the safe and effective treatment of diabetes, and truly achieve a more standardized, and diabetes treatment standards more reasonable!
Diabetes Treatment Center - team of experts and powerful, individualized treatment zone tyranny
Diabetes Treatment Center has a strong team of experts, strong technical force. Specialist treatment, strictly to the no holiday Hospital, outpatient experts 24 hours weekdays. Patients according to their own arrangements for timely medical treatment; during the hospitalization, the ward have clinical experience of veteran experts tracking guidance and treatment, the implementation of a thoughtful and detailed diagnosis and treatment. In addition, in two decades, the Center experts has been committed to the clinical research of diabetes successfully established a set of characteristics, the treatment of diabetes theoretical system, diagnosis system, medication system. Establishment of three, living in multi-target medicine pancreatic infiltration therapy main driving my center diabetes treatment to a higher level. Specific course of treatment, scientific medicine, the specification due to treatment, starting from damaged pancreatic β cells, multi-target target positioning and treatment, and succeeded in raising the diagnosis and treatment of diabetes.
The application of multi-target penetration therapy of Chinese medicine to break a pessimistic understanding of Western medicine on the treatment of diabetes, overcome hypoglycemic agents, insulin injections alone but chose to maximize the protection of diabetes in patients with pancreatic β cell function. With the depth of the diabetes research and clinical practice experience is gained. Diabetes treatment center caused by the different causes of diabetes and the condition in which the different stages, a special type 1 diabetes, type 2 diabetes, diabetic nephropathy, diabetic foot, diabetic neuropathy, diabetic eye disease such as diabetes treatment area, thus facilitating the expert zone to regulate and targeted treatment.
Diabetes Treatment Center - the perfect combination of advanced foreign technology and traditional Chinese medicine!
Powerful, the Hebei diabetes treatment center team of experts and professional treatment of diabetes for a long time, experienced, and the medicinal properties of the pathogenesis of diabetes a better understanding of the use of drugs is also more comprehensive and more targeted. Hospital experts after years of research, the creation of unique therapy for oxidative stress treatment of diabetes, the therapy of traditional Chinese medicine syndrome differentiation treatment as the outline of Chinese medicine, the external treatment of advanced foreign clinics France combine , called the fruitful results of the diabetes therapeutic areas, it reached the modern electronics, drug treatment and repair the damaged cells of the perfect combination allows patients to get rid of the long-term use of drug problems, to achieve a fundamental purpose of the treatment of diabetes, is a solve the problem of natural therapy, green therapy.
Diabetes Treatment Center - new therapy presents a new situation in the flowers together!
Diabetes treatment center, always walk in the forefront of the times, so that the times, based on years of clinical experience, response to the requirements of the majority of patients, anxious patients are worried about what patients want, and constantly new, developed to enable patients to clapping tune powdered sugar and adjust sugar bread, reaching the purpose nutrition islet cells, stabilize blood sugar. Can also tune powdered sugar processed into noodles, instant noodles, biscuits, bread and other pasta, sugar Friends is no longer because of the fear of blood glucose fluctuations have enough to eat, adding to the deterioration of the condition, so that the majority of sugar Friends of blood glucose can easily stable in the normal range. In addition, there are traditional Chinese medicine medicated bath, sugar eye Kang, sugar pancreas Kang, Ma pain Kang, Downing One and other characteristics of drug development, reinforce the strength of the Diabetes Treatment Center, the hearts of the majority of patients the most loyal to rely on!
The new century and new stage, in order to more rehabilitation patients with diabetes, to provide better services for patients, hospital closely around the "all patient-centered" service concept, vigorously strengthen ideological and political construction of academic talent, for Shijiazhuang nephropathy Hospital Diabetes Treatment Center into a first-class domestic and international influential innovative features residents and unremitting struggle!

Suffering from renal failure by dialysis can live several years longer

Suffering from renal failure rely on dialysis to live several years longer? This issue experts to make the following analysis: bladder, of course, older men because prostate hypertrophy, residual urine, easy to inflammation of the bladder, ureter, benign or malignant tumor, in fact, on inflammation. Its causes: infection, schistosomiasis, chloramphenicol, to sparse tensiomin acid proline, serology discovery of C1q mesangial and subendothelial deposition of the phenomenon of increased plasma viscosity, kidney patients, allergic purpura amyloidosis, diphtheria, macrophage proliferation. The presenting symptoms were: with the hypoglycemic, white blood cells (-), laboratory serum creatinine 214umol / L, with foamy urine "I, dysuria and 42 years, serum creatinine the highest 160umol / L the incidence of poor oral herbal treatment in the local, distinct card Hou, blood urea nitrogen 9.75mmol / L, check aspects: adjustment of electrolyte imbalance, the condition improved, the law Qi, have a history of chronic kidney June 29, 2010 Army General Hospital of Lanzhou check serum creatinine 173.3umol / L, Urea: 33.46mmol / L, should be followed to further clarify the cause of renal failure because the primary disease diagnosis whether the impact of the incentive of worsening renal function such as urinary tract obstruction, stay at our hospital, Hb <60g / L, for the sake of further treatment, permanent deep venous catheter or an artificial blood vessel. clinical treatment programs: the kidney area of ​​Chinese medicine ions into treatment, to establish the cure faith, from the body immune complexes, directional penetration of traditional Chinese medicine treatment, patients by TCM holographic 15 days of treatment, and with the oral medicine given to the implementation of a comprehensive standardized treatment and at the same time, with the six standards and to make patients pay attention to rest, changing the body's internal environment, a clear diagnosis, care and rehabilitation care: regularly to the hospital, the nails should not be too short to strengthen the understanding and learning of the knowledge of the disease. timely given the perianal and perineal cleaning after a bowel movement, use of diuretics. diet Note: Limit protein, low purine content, can not eat onions, shepherd's purse should choose food, Mangosteen phlegm Attention to personal hygiene, bathe Huanyi, Qin nails barber, keep the skin clean. Correct to treat the disease, maintaining optimism, appropriate physical activity, but also to avoid fatigue, and patients have confidence in the treatment of contact with the attending physician in a timely manner. , Avoid seafood, beef, lamb, spicy spicy food, wine and all the fat things, noon nap after lunch, a little activity, and then take a nap for half an hour to one hour is appropriate. Cola drinks containing cocoa beverage daily moderate activity but not tired, such as: lean meat.

Dialysis still long to live

Under normal circumstances, dialysis for kidney patients, only life-saving, not for medical treatment, dialysis can replace kidneys temporary rule out the toxins from the body, to relieve symptoms, but can not replace the kidney function of the body's organs do not waste long-term dialysis causes residual renal function gradually scrapped. , Dialysis What are the advantages and disadvantages of it? 1, the advantages of dialysis: symptomatic relief of symptoms of poisoning to a certain degree. To a certain extent, the dialysis machine to play the artificial kidney function, it can reduce serum creatinine indicators, to allow some of the toxins from your body, and remission in patients with symptoms of poisoning. Early in uremic patients undergoing dialysis is a positive, proactive and timely. It advances the quality of life, dialysis and reduce future adverse reaction, give full play an important part of the original renal function and key. Dialysis: great to rely solely on dialysis for renal damage. Dialysis, does not mean that in uremic patients would then sit back and relax. On the contrary, dialysis only means to alleviate the symptoms, and renal function can not be equal with uremia will not result in cure. After dialysis, patients with advanced uremia systemic organ damage, serious complications and increased quality of life is poor, survival time was short, running out of the original kidney function loss. Moreover, with the dialysis increase in the number of patients on dialysis will have a strong dependence with the further deterioration of renal function, the frequency of dialysis will be getting higher and higher, until the glomerular function is completely lost, the lives of patients left to an end. , Dialysis still long to live? If the patient's condition can also now 24 hours a day, urine output is still more than 400ml, or oliguric period not exceeding 3 months, it indicates that there are still some remnants of renal function, or the value of conservative treatment. · Kidney disease hospitals original pure characteristic of TCM therapy "of micro-penetration therapy of Chinese medicine treatment is not required to dialysis and kidney transplant, pure Chinese characteristics, treatments straightforward role in pathological tissues, the complete eradication of immune complexes and necrotic tissue, for the impaired renal ball basement membrane, to remove the precipitated immune complexes in basement membrane and diseased tissue, repair damaged basement membrane, and activate the body's immune system, accelerate its metabolism and repair. Micro-based medicine is invented a unique kidney disease and kidney disease hospital after nearly 20 years of clinical research and practice, the Group therapy. The therapy according to the principle of the motherland medical disease outside the government "to" fire "as the means of delivery, method of guided massage, skin, sweat glands, acupuncture points, capillary line, the active ingredient in Chinese medicine penetrate into the kidneys, leading to activation of the renal unit, so that the glomerular sclerosis atrophy restore normal physiological function, so that renal rehabilitation Live kidney series of prescriptions, transfers systemic immune function, repair of the glomerular basement membrane. With the traditional Chinese medicine of Chinese micro-penetration therapy therapy to penetration of active ingredients of drugs after acupuncture points spread to patients with kidney, active through the kidney, blood circulation, reduce turbidity detoxification methods to clear the kidneys, the activation of renal function for the purpose. TCM micro-based traditional Chinese medicine the permeation therapy has the following characteristics: 1, taking the safe and efficient, without any side effects. 2, the vital essence, improve microcirculation, the progress of their immune system. Dialectical administration, a wide range of applications. Living kidney detoxification, rapid decomposition and reduce the patient's body creatinine and urea nitrogen, toxins from the urine of discharge. 5, after taking the straightforward into the blood, short-term rapid manipulation of the disease, so many years of relying on the dialysis uremic patients to reduce the number of dialysis until stagnation dialysis. 6, of the micro-penetration therapy of Chinese medicine to promote renal blood circulation and metabolism. 7, activation of the renal unit, the kidneys grow to normal renal function returned to normal. 8, the Chinese herbal formula, treating the symptoms, treatment to eradicate.

Kidney dialysis can be much longer

Kidney dialysis much longer. Renal failure, hemodialysis can be much longer? Many kidney patients to renal failure period will be for hemodialysis. Kidney specialists expert guest renal failure treatment and rehabilitation network answers to the diet, kidney disease can be much longer "the treatment of common sense. Detailed "renal dialysis much longer related to the contents of this article give a reference. The Nephropathy much longer elected: Nephrotic syndrome, kidney disease much longer can live either cold deterioration much longer iga nephropathy can be much longer nephrotic syndrome can be much longer nephrotic syndrome nephrotic syndrome can be much longer General renal failure can be much longer? Of nephropathy hospital specialist hospitals director of the kidney specialists pointed out that renal failure is not so terrible as people think, as long as the effective scientific cure, heal effect is still very ideal. Kidney dialysis much longer. Nephropathy hospital specialty hospital transplant study group of experts experts renal failure kidney transplant can be much longer exposition transplant nephropathy heal and talk features, worthy of comparison and understanding. Nephropathy can be much longer hemodialysis long to live. Renal failure patients but also much longer? Is related to the adoption of the patients with treatment measures. China and France in patients with renal failure have been there have been breakthroughs, kidney hospital application of pure Chinese medicine advantages of therapy Kidney dialysis much longer. Penetration of the micro-based medicine to block renal fibrosis therapy in the treatment of chronic kidney disease and end-stage renal failure has a unique effect, the active ingredient in the stereotypes of Chinese medicine in the high-tech processing, direct lesions through the back kidney area, enhanced drug targeted and effective, not only on early chronic kidney disease patients can achieve blocking renal fibrosis process to stop the progress to kidney disease end-stage renal failure, renal failure patients from repair damaged kidneys start after with Western dialysis, and symptomatic treatment may also improve renal function, and thus the ultimate survival of ESRD patients with benign renal failure patients in the end can be much longer? Hemodialysis can be much longer. General renal failure can be much longer? The nephrotic hospital director of the kidney specialists pointed out that the renal failure is not so terrible as people think, as long as the effective scientific treatment, the treatment effect is still very good. So, why many of the renal failure patient's life be saved? Due to their improper treatment, not from a renal intrinsic cells to repair damage from the fundamental, but for a variety of symptoms, treatment, kidney damage gradually increased, thereby accelerating the speed of the patient's death

Complications of peritoneal dialysis

The early complications of peritoneal dialysis: (1) intubation complications visible wound bleeding, a small amount of bloody fluid in the abdominal cavity, visceral perforation, mild intestinal obstruction after intubation, dialysis fluid leakage, the tunnel inside the dialysis tube distortion, poor drainage dialysis fluid dialysis tube obstruction and displacement and so on. (2), peritonitis is the most common complications, including bacterial, fungal, tuberculosis, chemical and eosinophil cells increased peritonitis, and recurrent infections peritoneal thickening, adhesions, dialysis efficiency decreased, eventually leading toCAPD failure. (3) excessive abdominal pain, peritonitis, abdominal swelling, stimulation of hypertonic glucose dialysate pH, improper preparation or concentration is too low and improper location of dialysis tube can cause abdominal pain. (4) suited to peritoneal dialysis or decreased bowel initially can produce bloating bloating. (5) vagal reflex symptoms in some patients in the input or discharged dialysate bradycardia, hypotension and dyspnea vagal reflex symptoms. (6) The electrolyte and acid-base balance disorder due to dialysis is inadequate, does not control or poor diet, can cause hyperkalemia or hypokalemia. (7), hypotension, dry weight underestimated, or use inappropriate high glucose, hypertonic dialysate, a lot of dehydration may cause hypovolemia, hypotension. (8), pulmonary insufficiency irrigation fluid increased intra-abdominal pressure affect pulmonary function, diaphragm elevation. (9) Other, such as low back pain, adhesions, hemorrhoids aggravated and so on. Peritoneal dialysis long-term complications are: (1) loss of the syndrome in CAPD patients a day lost by the peritoneal dialysis fluid protein of about 5 ~~ 10g, individual differences in ~~ 20g / d; daily loss of free amino acids 2 ~ 4g, 80% of essential amino acids; loss of water-soluble vitamin B1, C, B6, folic acid, as well as enteric vitamin D Therefore, long-term peritoneal dialysis can lead to malnutrition, hypoalbuminemia, neuropathy, immunocompromised and susceptible to infection. (2) peritoneal dialysis loss of ultrafiltration peritoneal dialysis patients with ultrafiltration volume <400ml / d, are ultrafiltration failure, peritoneal dysfunction. To peritoneal mesothelial cells are damaged mainly the so-called type 1 ultrafiltration failure, expressed as intra-abdominal dialysate glucose absorption rate and fast, causing the permeability quickly lost, but the increase in the permeability of urea, dialysate urea, creatinine, D / P values. Another due to multiple adhesions of the peritoneum and / or hardening caused by the irreversible change in type 2 ultrafiltration failure, should extubation change hemodialysis. (3) increase of glucose load, abnormal lipid metabolism in CAPD patients daily can absorb glucose in the dialysate volume of 70% (100 to 200g / d), long-term peritoneal dialysis can cause obesity, can cause blood triglyceride rise increase in insulin secretion, leading to abnormal lipid metabolism. (4) cardiovascular complications in end stage renal failure patients often have heart damage, high cycle capacity in the process of dialysis treatment, dialysis is inadequate and anemia, can make existing heart disease increase. (5) metabolic bone disease. Vitamin D in patients with metabolic abnormalities in the blood calcium and phosphorus balance disorders, leading to secondary hyperparathyroidism, plus iatrogenic photo aluminum increased, resulting in dialysis osteodystrophy and metastatic calcification, and gradually increased. (6) any time the pulmonary complications of peritoneal dialysis patients with pleural effusion, and even can be a sudden increase to the right side is more common. (7) abdominal hernia in CAPD patients about 20% of the concurrent abdominal hernia, inguinal hernia, incisional hernia. Cataract in peritoneal dialysis patients (8) differences in solute concentration within the crystal in the blood too much, coupled with an increase in glucose concentration in the blood, and micronutrient deficiencies, so that the crystal protein glycosylation, the crystal to produce large amounts of sorbitol, promote fibrosis, caused by cataract . (9) can also cause hearing loss, carpal tunnel syndrome, acquired renal cysts and renal cancer and other complications.

Complications of peritoneal dialysis

The early complications of peritoneal dialysis: (1) intubation complications visible wound bleeding, a small amount of bloody fluid in the abdominal cavity, visceral perforation, mild intestinal obstruction after intubation, dialysis fluid leakage, the tunnel inside the dialysis tube distortion, poor drainage dialysis fluid dialysis tube obstruction and displacement and so on. (2), peritonitis is the most common complications, including bacterial, fungal, tuberculosis, chemical and eosinophil cells increased peritonitis, and recurrent infections peritoneal thickening, adhesions, dialysis efficiency decreased, eventually leading toCAPD failure. (3) excessive abdominal pain, peritonitis, abdominal swelling, stimulation of hypertonic glucose dialysate pH, improper preparation or concentration is too low and improper location of dialysis tube can cause abdominal pain. (4) suited to peritoneal dialysis or decreased bowel initially can produce bloating bloating. (5) vagal reflex symptoms in some patients in the input or discharged dialysate bradycardia, hypotension and dyspnea vagal reflex symptoms. (6) The electrolyte and acid-base balance disorder due to dialysis is inadequate, does not control or poor diet, can cause hyperkalemia or hypokalemia. (7), hypotension, dry weight underestimated, or use inappropriate high glucose, hypertonic dialysate, a lot of dehydration may cause hypovolemia, hypotension. (8), pulmonary insufficiency irrigation fluid increased intra-abdominal pressure affect pulmonary function, diaphragm elevation. (9) Other, such as low back pain, adhesions, hemorrhoids aggravated and so on. Peritoneal dialysis long-term complications are: (1) loss of the syndrome in CAPD patients a day lost by the peritoneal dialysis fluid protein of about 5 ~~ 10g, individual differences in ~~ 20g / d; daily loss of free amino acids 2 ~ 4g, 80% of essential amino acids; loss of water-soluble vitamin B1, C, B6, folic acid, as well as enteric vitamin D Therefore, long-term peritoneal dialysis can lead to malnutrition, hypoalbuminemia, neuropathy, immunocompromised and susceptible to infection. (2) peritoneal dialysis loss of ultrafiltration peritoneal dialysis patients with ultrafiltration volume <400ml / d, are ultrafiltration failure, peritoneal dysfunction. To peritoneal mesothelial cells are damaged mainly the so-called type 1 ultrafiltration failure, expressed as intra-abdominal dialysate glucose absorption rate and fast, causing the permeability quickly lost, but the increase in the permeability of urea, dialysate urea, creatinine, D / P values. Another due to multiple adhesions of the peritoneum and / or hardening caused by the irreversible change in type 2 ultrafiltration failure, should extubation change hemodialysis. (3) increase of glucose load, abnormal lipid metabolism in CAPD patients daily can absorb glucose in the dialysate volume of 70% (100 to 200g / d), long-term peritoneal dialysis can cause obesity, can cause blood triglyceride rise increase in insulin secretion, leading to abnormal lipid metabolism. (4) cardiovascular complications in end stage renal failure patients often have heart damage, high cycle capacity in the process of dialysis treatment, dialysis is inadequate and anemia, can make existing heart disease increase. (5) metabolic bone disease. Vitamin D in patients with metabolic abnormalities in the blood calcium and phosphorus balance disorders, leading to secondary hyperparathyroidism, plus iatrogenic photo aluminum increased, resulting in dialysis osteodystrophy and metastatic calcification, and gradually increased. (6) any time the pulmonary complications of peritoneal dialysis patients with pleural effusion, and even can be a sudden increase to the right side is more common. (7) abdominal hernia in CAPD patients about 20% of the concurrent abdominal hernia, inguinal hernia, incisional hernia. Cataract in peritoneal dialysis patients (8) differences in solute concentration within the crystal in the blood too much, coupled with an increase in glucose concentration in the blood, and micronutrient deficiencies, so that the crystal protein glycosylation, the crystal to produce large amounts of sorbitol, promote fibrosis, caused by cataract . (9) can also cause hearing loss, carpal tunnel syndrome, acquired renal cysts and renal cancer and other complications.

Peritoneal dialysis complicated by peritonitis

Chronic renal failure in patients with malnutrition, poor physical fitness, low resistance, dialysis treatment to be repeated to do gymnastics and the dialysate, the dialysis tube to stimulate a number of reasons, therefore, easily lead to peritonitis. The clinical cause peritonitis, a common cause of: (1) catheter cavity infection most of the catheter cavity infection occurs in the interface of accidental contamination, such as hand contact with contaminated dialysis tube mouth torn off, the bacteria into the tube. Now, with the application of the Y-shaped pipe and titanium joints, tube infection has decreased significantly. (2) infection around the catheter exit site or subcutaneous tunnel infection, bacterial infection along the catheter around the subcutaneous tissue into the abdominal cavity. (3) to wear the intestinal wall infections more common in ischemic bowel disease or intestinal interest-room patients, anaerobic bacteria or a variety of bacteria cultured in the dialysate should be suspected infection from intestinal bacteria. (4) The blood-borne infection, tuberculous peritonitis, cirrhosis with ascites in patients with spontaneous bacterial peritonitis, a very small number of patients with acute upper respiratory tract infection, bacterial peritonitis may also occur, positive blood cultures. (5), environmental infection in patients with a bath, the water from the exit into the abdominal cavity can occur peritonitis. Diagnosis of bacterial peritonitis, the following three criteria should have at least two: ① peritonitis symptoms and signs; ② dialysate turbidity, WBC> 100 / mm3, neutrophils> 50%; ③ by Gram stain or culture that abdominal through the liquid in the presence of bacteria. Fungal peritonitis, tuberculous peritonitis, you must find a fungal or tuberculosis. Peritonitis following four: ① bacterial peritonitis: meet the diagnostic criteria, antibiotic treatment is effective. ② chemical peritonitis: more than the same time seen in patients with the same batch of dialysate. Many dialysate pH is too low, the quality is too poor, or some of the chemical composition of peritoneal irritation causes antibiotic therapy. ③ fungal peritonitis: actions by the fungal contamination of the dialysate, antibiotic therapy and anti-fungal drug treatment. ④ eosinophils increased peritonitis: eosinophilic cells in the peritoneal dialysis tube of silicone allergy or heparin on peritoneal dialysis fluid, allergies due to antibiotics, and more with drug fever, eruption, increased eosinophils in the blood and dialysate increased. Antibiotic treatment is not valid. Looking for allergens, remove the allergens to be effective anti-allergy treatment. If you can avoid infection factors can prevent peritonitis. The specific measures are as follows: ① replace the dialysate in strict accordance with the rules, not any negligence. ② avoid drugs, to join in the dialysate bag if you must join, under strict sterile conditions. ③ attention to catheter care and cleaning of the mouth. (4) attention to personal hygiene to prevent catheter mouth water bath, you should take a shower, absolutely can not take a tub bath. ⑤ Once the exit of the reddening of the skin, pain and discharge, immediately actively. ⑥ usually pay attention to exercise, to prevent colds. ⑦ maintain defecate unobstructed, and prevention of intestinal infection. If improper care, the occurrence of peritonitis situation to timely and effective treatment to prevent peritoneal adhesions, hypertrophy and loss of function. The following principles: ① educate patients in the discovery of peritoneal sign, immediately peritoneal fluid drainage out of fluid drainage bag on the side, ready to the hospital for testing and training. ② immediately with 1.5% of the dialysis fluid 1 liter flushing the abdominal cavity, three consecutive times to remove inflammatory products ease the pain. The ③ immediately to the hospital, adding antibiotics and heparin, fresh dialysate bag before each exchange of dialysate. ④ the first 24 hours should replace the outside to take over and prevent re-infection of the abdominal cavity. The ⑤ antibiotics generally should be preferred to vancomycin and aminoglycosides or cephalosporins, and when dialysate inspection results out, replace the antibiotics according to culture and sensitivity results. ⑥ treatment should be until the clinical symptoms of dialysis fluid is clear, release fluid white blood cell count of less than 100 / mm3 and culture negative. ⑦ such a potent antibiotic treatment 2 weeks later still can not control peritonitis should extubation stop through. The temporary change of hemodialysis, a month later, as appropriate catheter to re-start dialysis.

IgA nephropathy treatment is what

Clinical is widely recognized that there is no fundamental treatment of IgA nephropathy, but the treatment of IgA nephropathy is imminent, according to the data show that: glomerular disease in the incidence in the country, IgA nephropathy accounts for about 26% to 34%, male than women, good cutting age of 10 to 30 years old. That IgA is not a benign disease, only a minority (4%) can be a natural ease. From this disease tracking more than 20 years, about 20% to 30%, even 20% to 50% of patients progress to end-stage renal disease, leading to one of the most common cause of end-stage renal failure. In view of such a serious situation, IgA nephropathy should how treatment? IgA nephropathy treatment is what? With this question, we visited the People's Liberation Army 309 Hospital Kidney Consultation Center experts. IgA nephropathy treatment is what? Experts say: of IgA nephropathy at present there is no fundamental treatment is still in the stages of treatment to relieve symptoms and treatment experience. Is generally believed that the following circumstances should be given active treatment: the ① recurrent gross hematuria; ② hypertension; ③ massive proteinuria or nephrotic syndrome, renal pathological changes were relatively mild; ④ acute nephritic syndrome or rapidly progressive Pathological examination showed proliferative glomerulonephritis or cell crescentic glomerulonephritis, nephritic syndrome.Asymptomatic urinary abnormalities (microscopic hematuria accompanied by slight proteinuria), normal or pathological examination showed mild glomerular lesions and stable renal function, and pathology of glomerular sclerosis, fibrous crescents, tubularatrophy, interstitial fibrosis and other diseases, most tend to regularly observe the relatively conservative treatment. For now, the Consultation Center of the People's Liberation Army 309 Hospital, nephropathy the ney circulation therapy "is one of the kidney disease treatment of IgA nephropathy in the field the best method. Ney circulation therapy "adopted by the Beijing People's Liberation Army 309 Hospital, kidney disease treatment center experts from molecules, cells, the overall study, the combination of point of view of traditional Chinese medicine dialectical theory of governance, research and create the core of kidney therapy. Ney circulation therapy "principle: Ney circulation therapy "follow" but in reality diarrhea "," virtual fill "principle, according to the vacuity of the specific circumstances, or diarrhea in fact, or make up for the virtual attack evil rule declared scattered wind-heat, heat and dampness, purging fire, detoxifying or qi and blood circulation method; tonic rule to be law for the nourishing blood, spleen and kidney Liver. The treatment of kidney disease the root start by clearing away heat and promoting blood circulation, kidney, astringent, Spleen Qi, expelling wind and dampness, the elimination of clinical symptoms such as hematuria, protein, and quickly lead to hypersensitivity of the immune complexes removed repair the damage of kidney tissue to correct the disorder of the immune system environment, and restore the damage adjustment glomerular function, enhance immunity, promote renal dynamic equilibrium state, thus a complete reversal, eliminating the pathological features achieve the purpose of curing diseases . The ney circulation therapy treatment Ney circulation therapy "according to the different stages of IgA nephropathy, the distinction between acute and chronic phase, staging and treatment; according to the disease where parts of the lung, spleen, kidney, dialectical severance side, in accordance with hematuria duration of disease, Chinese and Western medicine combined , the effective activation, regulation of renal cytokines and growth factors to improve the physical symptoms, hematuria disappeared, reduce inflammation and fibrosis, control or delay the progress of kidney disease, with the external treatment of kidney disease treatment technology to effectively improve efficacy and overcome the hormone such as adverse drug reactions. Daily with natural therapies and nursed back to health (health management), stable disease, consolidation effect, the rapid recovery of renal function. Four advantages of the ney circulation An accurate dialectical special disease cures, symptoms, laboratory tests, histopathological changes effective organic integration into the TCM system to ensure that the dialectical accurate, precise medication differentiation, a significant effect. 2, integrative medicine, significantly enhance the efficacy of the elimination of symptoms such as hematuria, protein, clear immune complexes, and promote the repair of the renal immune balance, while reducing, to avoid adverse reactions, and ultimately played a good therapeutic effect. Medicine + in vitro treatment techniques and advanced extraction technology purification, safe and without side effects, the prescription on the basis of the dialectic of pure Decoction of the main, high-energy short-wave optical power, herbal ion medicine fumigation, etc., to promote the efficacy attracted to effectively repair damaged glomeruli, promote the recovery of renal function. Comprehensive regulation, IgA nephropathy is a systematic project, in addition to medication, but also an entire way of life to be adjusted. Advanced health management methods to help patients with daily habits, to achieve the purpose of not relapse.