Wish the patients with kidney disease a happy Christmas day ahead of time

2011年10月22日星期六

What are Nephrotic syndrome

Nephrotic syndrome is a nonspecific disorder in which the kidneys are damaged, causing them to leak large amounts of protein (proteinuria at least 3.5 grams per day per 1.73m2 body surface area) from the blood into the urine.
Kidneys affected by nephrotic syndrome have small pores in the podocytes, large enough to permit proteinuria (and subsequently hypoalbuminemia, because some of the protein albumin has gone from the blood to the urine) but not large enough to allow cells through (hence no hematuria). By contrast, in nephritic syndrome, RBCs pass through the pores, causing hematuria.
According to NephCure, most often, Nephrotic Syndrome is defined by its primary diseases that attack the kidney’s filtering system. Some of these cases are idiopathic.
Signs and symptoms
It is characterized by proteinuria (>3.5g/day), hypoalbuminemia, hyperlipidemia and edema which is generalized & also known as anasarca or dropsy. Common among 2–6 years old boys. The edema begins in the face. Lipiduria (lipids in urine) can also occur, but is not essential for the diagnosis of nephrotic syndrome. Hyponatremia also occurs with a low fractional sodium excretion.
Hyperlipidemia is caused by two factors:
  • Hypoproteinemia stimulates protein synthesis in the liver, resulting in the overproduction of lipoproteins.
  • Lipid catabolism is decreased due to lower levels of lipoprotein lipase, the main enzyme involved in lipoprotein breakdown.
A few other characteristics seen in nephrotic syndrome are:
1 The most common sign is excess fluid in the body due to the serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravate the edema. This may take several forms:
  • Puffiness around the eyes, characteristically in the morning.
  • Pitting edema over the legs.
  • Fluid in the pleural cavity causing pleural effusion. More commonly associated with excess fluid is pulmonary edema.
  • Fluid in the peritoneal cavity causing ascites.
  • Generalized edema throughout the body known as anasarca.
2 Most of the patients are normotensive but hypertension (rarely) may also occur.
3 Anemia (iron resistant microcytic hypochromic type) maybe present due to transferrin loss.
4 Dyspnea maybe present due to pleural effusion or due to diaphragmatic compression with ascites.
5 Erythrocyte sedimentation rate is increased due to increased fibrinogen & other plasma contents.
6 Some patients may notice foamy or frothy urine, due to a lowering of the surface tension by the severe proteinuria. Actual urinary complaints such as hematuria or oliguria are uncommon, though these are seen commonly in nephritic syndrome.
7 May have features of the underlying cause, such as the rash associated with systemic lupus erythematosus, or the neuropathy associated with diabetes.
8 Examination should also exclude other causes of gross edema—especially the cardiovascular and hepatic system.

Polycystic Kidney Disease

Polycystic Kidney Disease (PKD or PCKD, also known as polycystic kidney syndrome) is a cystic genetic disorder of the kidneys.There are two types of PKD: Autosomal Dominant Polycystic Kidney Disease (ADPKD) and the less-common Autosomal Recessive Polycystic Kidney Disease (ARPKD).
It occurs in humans and some other animals. PKD is characterized by the presence of multiple cysts (hence, "polycystic") typically in both kidneys; however 17% of cases initially present with observable disease in one kidney, with most cases progressing to bilateral disease in adulthood.The cysts are numerous and are fluid-filled, resulting in massive enlargement of the kidneys. The disease can also damage the liver, pancreas and, in some rare cases, the heart and brain. The two major forms of polycystic kidney disease are distinguished by their patterns of inheritance.
Polycystic Kidney Disease is the most common life-threatening genetic disease, affecting an estimated 12.5 million people worldwide.[citation needed] In half of the people with Polycystic Kidney Disease, there is no family history of the disease. In these cases, the gene coding for the disease occurs out of a spontaneous genetic mutation without either parent being a carrier of the gene.
What are type of Polycystic Kidney Disease?
Autosomal dominant
ADPKD is the most common of all the hereditary cystic kidney diseases with an incidence of 1 to 2:1,000 live births.Studies show that 10% of end-stage renal disease (ESRD) patients being treated with hemodialysis in Europe and the U.S. were initially diagnosed and treated for ADPKD.ADPKD does not appear to demonstrate a preference for any particular ethnicity.
ADPKD is characterized by progressive cyst development and bilaterally enlarged kidneys with multiple cysts. There are three genetic mutations in the PKD-1, PKD-2, and PKD3 gene with similar phenotypical presentations. Gene PKD-1 is located on chromosome 16 and codes for a protein involved in regulation of cell cycle and intracellular calcium transport in epithelial cells, and is responsible for 85% of the cases of ADPKD. A group of voltage-linked calcium channels are coded for by PKD-2 on chromosome 4. PKD3 recently appeared in research papers as a postulated 3rd gene. At this time, PKD3 has not been proven.Fewer than 10% of cases of ADPKD appear in non-ADPKD families.
Cyst formation begins in utero from any point along the nephron, although fewer than 5% of nephrons are thought to be involved. As the cysts accumulate fluid, they enlarge, separate entirely from the nephron, compress the neighboring renal parenchyma, and progressively compromise renal function.
Under the function of gene defect, epithelial cells of renal tubule turn into epithelial cells of cyst wall after phenotype change, and begin to have the function of secreting cyst fluid, which leads to continuous cysts enlargement.
Autosomal Recessive
Studies show that the incidence of ARPKD is 1:20,000 live births and is typically identified in the first few weeks after birth. Unfortunately, resulting hypoplasia results in a 30% death rate in neonates with ARPKD.In ARPKD kidneys retain their shape but are larger than the normal anatomical range with dilated collecting ducts from the medulla to the cortex.

2011年10月18日星期二

Treatment for Protein and Blood in Urine.

Proteinuria means the presence of an excess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine (bilirubinuria), retrograde ejaculation, pneumaturia (air bubbles in the urine) due to a fistula, or drugs such as pyridium.
Treatment for Protein and Blood in Urine.
Some patients with chronic kidney disease will have continuous protein and blood in urine. They are worried that it may develop into Uremia stage, so they search for treatment all around. When the protein and blood in urine had been effective treated and reduced, but after catching a cold, fever or overwork, it will appear again. Patients with IgA Nephropathy often circles like this.
Why there is protein and blood in urine?
Blood in urine is actually abnormal increase of red blood cells in urine. There is no red blood cells or little red blood cells in the urine of healthy people. If there are often red blood cells in urine, or red blood cells are over 3/HPF in microscopic test, it can be called hematuria. Renal hematuria comes from the kidneys. It is caused by the structure changes of red blood cells in urine.
Protein in urine is really a headache for patients with chronic kidney disease. The amount of protein in urine is not only related to the degree of kidney damage, but also an important index judging the progressing of the illness condition. There is only extremely trace protein in urine for healthy people and the urinalysis shows urine protein negative. However, if the kidney damage leads to changes of glomerular function and the permeability of glomerular basement membrane increases, the protein in filtrated urine will increase, which is over the reabsorption ability of the tubules thus causing protein in urine.
What’s the treatment for protein and blood in urine?
According to the above analysis, we know that the main cause of leakage of protein and red blood cells is the damage to glomerular filtrating membrane. In the past, we treated only the primary disease and did little to repair the membrane. Therefore, even the protein and blood in urine will disappear for a while, the root cause has not been solved and the glomerular filtrating membrane has not been damaged. After the effect of the medicine or due to the inducing factors, protein and blood in urine will reappear.
Micronized Chinese medicine has higher activity. While giving full play of the effect of traditional Chinese medicine, it can relink the broken molecular chains of Chinese medicine and produce new function. It can act on the damaged glomerular basement membrane, remove the immune complex and damaged tissues deposited on the basement membrane and repair it. This is to repair the cells with pathological changes, activate the DNA replication in the damaged cells, promote the change of renal structure and recover the renal function. Therefore, after repairing the root cause of the pathological changes will thoroughly disappear and the protein and blood in urine will gradually decrease and disappear. The symptoms disappear with the root cause, so it is not easy to relapse after stopping the medicine.
In treating protein and blood in urine caused by kidney disease, the key point is treating the root cause, that is repairing the damaged basement membrane.

what are Polycystic Kidney Disease and how to treat it

Polycystic Kidney Disease (PKD or PCKD, also known as polycystic kidney syndrome) is a cystic genetic disorder of the kidneys.[1] There are two types of PKD: Autosomal Dominant Polycystic Kidney Disease (ADPKD) and the less-common Autosomal Recessive Polycystic Kidney Disease (ARPKD).
It occurs in humans and some other animals. PKD is characterized by the presence of multiple cysts (hence, "polycystic") typically in both kidneys; however 17% of cases initially present with observable disease in one kidney, with most cases progressing to bilateral disease in adulthood.[2] The cysts are numerous and are fluid-filled, resulting in massive enlargement of the kidneys. The disease can also damage the liver, pancreas and, in some rare cases, the heart and brain. The two major forms of polycystic kidney disease are distinguished by their patterns of inheritance.
Polycystic Kidney Disease is the most common life-threatening genetic disease, affecting an estimated 12.5 million people worldwide.[citation needed] In half of the people with Polycystic Kidney Disease, there is no family history of the disease. In these cases, the gene coding for the disease occurs out of a spontaneous genetic mutation without either parent being a carrier of the gene.
And same time,Treat Polycystic Kidney Disease without Surgery
For patients with Polycystic Kidney Disease, their burning desire is to accept an effective treatment. Ms. Lily suffers from Polycystic Kidney Disease, in order to treat her Polycystic Kidney Disease, she came to China from beautiful Greek Island, together with her husband.
For Ms. Lily, knowing Micro-Chinese Medicine Osmotherapy began with the chatting online with Miss. Marina, a Kidney-Expert Assistant in Shijiazhuang Kidney Disease Hospital. After being told to be a patient with Polycystic Kidney Disease, Ms. Lily was eager to get some treatment information from internet. When she was searching on internet, she met Miss. Marina, and talked with her about illness condition. Miss. Marina suggested Ms. Lily should take treatments, due to back pain and high blood pressure, the common symptoms of Polycystic Kidney Disease. They changed contact information, and started to communicate via emails. It’s the first time for Ms. Lily to hear Micro-Chinese Medicine Osmotherapy, so she had many questions about Micro-Chinese Medicine Osmotherapy, such as the success rate, side effects, treatment effects, cost and so on. Miss. Marina helped her analyze her illness condition and answered all of her questions. After knowing everything clearly, Ms. Lily decided to go to China for treatments.
Admission Date: 21:00 18-8-2011
Discharge Date: 08:00 18-9-2011
Chief complaints: Multicystic Kidney Disease for 5 years.
In first testing, right kidney: 233*95 mm, left kidney: 209*97 mm. There were many cysts in the kidney. The biggest in right kidney was 53*43 mm and left kidney was 33*36 mm.
Without surgery or side effects, only after taking Micro-Chinese medicine Osmotherapy for one month, her cysts got smaller. Before she was discharged, the last medical report showed: right kidney: 226*78 mm, left kidney: 220*80 mm, the biggest cyst in right kidney was 47*35 mm and left kidney is 39*28 mm. Ms. Lily was so happily and hardly believed it’s true, she thought she was dreaming.

Treat Polycystic Kidney Disease without Surgery

For patients with Polycystic Kidney Disease, their burning desire is to accept an effective treatment. Ms. Lily suffers from Polycystic Kidney Disease, in order to treat her Polycystic Kidney Disease, she came to China from beautiful Greek Island, together with her husband.
For Ms. Lily, knowing Micro-Chinese Medicine Osmotherapy began with the chatting online with Miss. Marina, a Kidney-Expert Assistant in Shijiazhuang Kidney Disease Hospital. After being told to be a patient with Polycystic Kidney Disease, Ms. Lily was eager to get some treatment information from internet. When she was searching on internet, she met Miss. Marina, and talked with her about illness condition. Miss. Marina suggested Ms. Lily should take treatments, due to back pain and high blood pressure, the common symptoms of Polycystic Kidney Disease. They changed contact information, and started to communicate via emails. It’s the first time for Ms. Lily to hear Micro-Chinese Medicine Osmotherapy, so she had many questions about Micro-Chinese Medicine Osmotherapy, such as the success rate, side effects, treatment effects, cost and so on. Miss. Marina helped her analyze her illness condition and answered all of her questions. After knowing everything clearly, Ms. Lily decided to go to China for treatments.
Admission Date: 21:00 18-8-2011
Discharge Date: 08:00 18-9-2011
Chief complaints: Multicystic Kidney Disease for 5 years.
In first testing, right kidney: 233*95 mm, left kidney: 209*97 mm. There were many cysts in the kidney. The biggest in right kidney was 53*43 mm and left kidney was 33*36 mm.
Without surgery or side effects, only after taking Micro-Chinese medicine Osmotherapy for one month, her cysts got smaller. Before she was discharged, the last medical report showed: right kidney: 226*78 mm, left kidney: 220*80 mm, the biggest cyst in right kidney was 47*35 mm and left kidney is 39*28 mm. Ms. Lily was so happily and hardly believed it’s true, she thought she was dreaming.

To Patients with CKD: Prevention of Chronic Renal Failure

Chronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss in renal function over a period of months or years. The symptoms of worsening kidney function are unspecific, and might include feeling generally unwell and experiencing a reduced appetite. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease. Chronic kidney disease may also be identified when it leads to one of its recognized complications, such as cardiovascular disease, anemia or pericarditis.
Various Chronic Kidney Diseases will eventually develop into Chronic Renal Failure. When it happens, the structure of the kidneys is damaged, including glomerulosclerosis, renal interstitium fibrosis, tubular atrophy etc. As a result, the kidneys loss the function of excreting metabolic wastes and excess water as well as the function of secreting some hormones. Under such condition, toxins build up to high level in the body, which leads to inside circumstance imbalance and other organs injury. If this condition develops to some degree, life will be threatened. So, it is important for patients with Chronic Kidney Disease (CKD) to prevent Chronic Renal Failure. There are some measures as follows:
Limiting Protein Intake
Low-protein diets benefits patients with kidney disease. Your doctor or dietitian may recommend a moderate-protein diet. 1 gram of protein per kilogram of body weight per day is a common suggestion. In fact, high quality protein diet may be recommended, such as fish, eggs or lean meats. This will help you replace muscles and other tissues that you loss. But it is better to talk to your doctor, nurse, or dietitian about detailed information on your daily diets.
Control of Blood Pressure
High blood pressure will burden the kidneys. So patients with CKD should strictly control blood pressure. If your urine protein is larger than 1 gram, you need to keep your blood pressure at 125/75mmHg. And if your urine protein is less than 1gram, you could keep your blood pressure at 130/80mmHg. With or without high blood pressure, ACEI and ARB medicines are suggested to take, because both of them have effects of lowering blood pressure and blocking renal fibrosis. However, they may cause hyperkalemia. Hence, these should be taken under your doctor’s guide and monitoring.
Be Careful of the Factors Harmful to the Kidneys
A cold, overstrain, pregnancy and some harmful medicines may further damage the kidneys and speed up the process of developing into Chronic Renal Failure.
Proper Treatment
Treatment plays the most important role in development of Chronic Kidney Disease. A proper treatment will slow down the kidneys’ deterioration, and even recover and rebuild functions of the kidneys. On the contrary, an improper one may threaten a patient’s life. Hence, choosing a proper treatment means a lot for patients with CKD. Traditional treatments focus on patients symptoms and neglect the pathological changes in the kidneys. A relatively new treatment, called Stem Cell Transplant overthrows that wrong method. It can treat CKD effectively by focus on the renal lesions. Many patients with CKD have good condition after Stem Cell Transplant.

2011年10月15日星期六

what are renal failure

Renal failure or kidney failure (formerly called renal insufficiency) describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood. The two forms are acute (acute kidney injury) and chronic (chronic kidney disease); a number of other diseases or health problems may cause either form of renal failure to occur.
Renal failure is described as a decrease in glomerular filtration rate. Biochemically, renal failure is typically detected by an elevated serum creatinine level. Problems frequently encountered in kidney malfunction include abnormal fluid levels in the body, deranged acid levels, abnormal levels of potassium, calcium, phosphate, and (in the longer term) anemia as well as delayed healing in broken bones. Depending on the cause, hematuria (blood loss in the urine) and proteinuria (protein loss in the urine) may occur. Long-term kidney problems have significant repercussions on other diseases, such as cardiovascular disease.
Acute kidney injury
Main article: Acute kidney injury
Acute kidney injury (AKI), previously called acute renal failure (ARF), is a rapidly progressive loss of renal function, generally characterized by oliguria (decreased urine production, quantified as less than 400 mL per day in adults,[1] less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants); and fluid and electrolyte imbalance. AKI can result from a variety of causes, generally classified as prerenal, intrinsic, and postrenal. An underlying cause must be identified and treated to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes.
Chronic kidney disease
Main article: Chronic kidney disease
Chronic kidney disease (CKD) can develop slowly and, initially, show few symptoms. CKD can be the long term consequence of irreversible acute disease or part of a disease progression.
Acute-on-chronic renal failure
Acute kidney injuries can be present on top of chronic kidney disease, a condition called acute-on-chronic renal failure (AoCRF). The acute part of AoCRF may be reversible, and the goal of treatment, as with AKI, is to return the patient to baseline renal function, typically measured by serum creatinine. Like AKI, AoCRF can be difficult to distinguish from chronic kidney disease if the patient has not been monitored by a physician and no baseline (i.e., past) blood work is available for comparison.

Acute kidney failure

Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute
Last reviewed: August 31, 2010.
Acute (sudden) kidney failure is the sudden loss of the ability of the kidneys to remove waste and concentrate urine without losing electrolytes.
Causes, incidence, and risk factors
There are many possible causes of kidney damage. They include:
Acute tubular necrosis (ATN)
Autoimmune kidney disease, including:
Acute nephritic syndrome
Interstitial nephritis
Decreased blood flow due to very low blood pressure, which can result from:
Burns
Dehydration
Hemorrhage
Injury
Septic shock
Serious illness
Surgery
Disorders that cause clotting within the kidney's blood vessels:
Hemolytic-uremic syndrome
Idiopathic thrombocytopenic thrombotic purpura (ITTP)
Malignant hypertension
Transfusion reaction
Scleroderma
Infections that directly injure the kidney, such as:
Acute pyelonephritis
Septicemia
Pregnancy complications, including:
Placenta abruptio
Placenta previa
Urinary tract obstruction
Symptoms
Bloody stools
Breath odor
Bruising easily
Changes in mental status or mood
Decreased appetite
Decreased sensation, especially in the hands or feet
Fatigue
Flank pain (between the ribs and hips)
Hand tremor
High blood pressure
Metallic taste in mouth
Nausea or vomiting, may last for days
Nosebleeds
Persistent hiccups
Prolonged bleeding
Seizures
Slow, sluggish movements
Swelling - generalized (fluid retention)
Swelling of the ankle, foot, and leg
Urination changes:
Decrease in amount of urine
Excessive urination at night
Urination stops completely
Signs and tests
Many patients have generalized swelling caused by fluid retention. The doctor may hear a heart murmur, crackles in the lungs, or signs of inflammation of the lining of the heart when listening to the heart and lungs with a stethoscope.
The results of laboratory tests may change suddenly (within a few days to 2 weeks). Such tests may include:
BUN
Creatinine clearance
Serum creatinine
Serum potassium
Urinalysis
A kidney or abdominal ultrasound is the preferred test for diagnosing kidney failure, but abdominal x-ray, abdominal CT scan, or abdominal MRI can tell if there is a blockage in the urinary tract.
Blood tests may help reveal the underlying cause of kidney failure. Arterial blood gas and blood chemistries may show metabolic acidosis.
Treatment
Once the cause is found, the goal of treatment is to restore kidney function and prevent fluid and waste from building up in the body while the kidneys heal. Usually, you have to stay overnight in the hospital for treatment.
The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the buildup of toxins normally handled by the kidneys. Your diet may need to be high in carbohydrates and low in protein, salt, and potassium.
You may need antibiotics to treat or prevent infection. Diuretics ("water pills") may be used to help the kidneys lose fluid.
Calcium or glucose/insulin will be given through a vein to help avoid dangerous increases in blood potassium levels.
Dialysis may be needed, and can make you feel better. It is not always necessary, but it can save your life if your potassium levels are dangerously high. Dialysis will also be used if your mental status changes, you stop urinating, develop pericarditis, retain too much fluid, or cannot eliminate nitrogen waste products from your body.
Support Groups
The stress of having an illness can often be helped by joining a support group where members share common experiences and problems.
See: Kidney disease - support group
Expectations (prognosis)
Acute kidney failure is potentially life-threatening and may require intensive treatment. However, the kidneys usually start working again within several weeks to months after the underlying cause has been treated.
In some cases, chronic renal failure or end-stage renal disease may develop. Death is most common when kidney failure is caused by surgery, trauma, or severe infection in someone with heart disease, lung disease, or recent stroke. Old age, infection, loss of blood from the intestinal tract, and progression of kidney failure also increase the risk of death.
Complications
Chronic (long-term) kidney failure
Damage to the heart or nervous system
End-stage kidney disease
High blood pressure
Loss of blood in the intestines
Calling your health care provider
Call your health care provider if your urine output slows or stops or you have other symptoms of acute kidney failure.
Prevention
Treating disorders such as high blood pressure can help prevent acute kidney failure.

The Treating Method for Diabetic Nephropathy

Diabetic nephropathy is kidney disease or damage that occurs in people with diabetes.
Causes, incidence, and risk factors
Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter your blood and help remove wastes from your body.
In people with diabetes, the nephrons thicken and slowly become scarred over time. The kidneys begin to leak and protein (albumin) passes into the urine.
The exact cause is unknown. Poor control of blood sugar is thought to lead to kidney damage. If you also have high blood pressure, kidney damage is even more likely.
In some cases, your family history may also play a role. Not everyone with diabetes develops this kidney problem.
People with diabetes who smoke, and those with type 1 diabetes that started before age 20 have a higher risk for kidney problems.
People of African-American, Hispanic, and American Indian origin are also more likely to have kidney damage.
Diabetic Nephropathy patients should select the medicine that is easy to absorb,has less impact on the kidney and is unlikely to cause hypoglycemic reaction. Currently, the priority medicine for Diabetes Nephropathy patients is still insulin. Because an early use of insulin can delay or even prevent the development of Diabetic Nephropathy.
For fear of insulin-dependent, a considerable proportion of patients do not want to take insulin. Experts emphasize that this idea is wrong. As for Diabetic Nephropathy patients with Renal Insufficiency, because renal degradation of insulin was decreased, they should monitor blood glucose regularly and adjust the dose when taking insulin in order to avoid hypoglycemia. Besides, medical treatment has some side effects.
Targeted Micro-Chinese Medicine Osmotherapy
Active substances of Chinese Medicine can penetrate into the lesions, combining the homing effect of stem cells to repair and block islet cells and susceptibility genes.
Active substances of Chinese Medicine have vasodilator effect, and can improve the structure and function of glomerular endothelial cells and mesangial cells, activate the function of cells, improve organizational structure, extend cell survival, block insulin resistance and eventually alleviate proteinuria, microscopic hematuria and other symptoms, thus preventing renal failure.
Stem cells can effectively repair damaged islet cells and susceptibility genes. And stem cells can also differentiate into a large number of islet cells to improve tissue function gradually. With the active substances of targeted Chinese medicine blocking insulin resistance, stem cells will gradually repair islet cells and restore the function of islet cells. As long as damaged cells can be repaired, the condition will take a favourable turn.

Case Analysis: Immunotherapy for Treating Uremia

Patient: Lijun, Male, 30 years old, from Fujian province
The patient’s condition: poor spirit, appetite and sleep; severe nausea and vomiting; severe anemia; itching; backache; fatigue; light urinary color and smell; slight edema on double eyelids and both lower limbs.
Diagnosis: Uremia, renal anemia, renal hypertension.
Before stem cell transplant: hemodialysis, twice a week; before hemodialysis, serum creatinine: 1620 umol/L, urea nitrogen: 27.56 mmol/L, uric acid: 486 umol/L.
On August 3rd, after eight hours of continuous hemodialysis, cord blood stem cell transplant was done. After 10 days, review was done: before hemodialysis, creatinine: 1302 umol/L, urea nitrogen: 22.34 mmol/L, uric acid: 465 umol/L. The interval of dialysis was prolonged to 4-5 days. And the patient's condition was stable.
It can be seen that for Uremic patients, continuous hemodialysis and cord blood stem cell transplant could effectively increase the renal blood circulation and improve kidney function, so that renal detoxification capacity increased, serum creatinine, urea nitrogen decreased and the patient could achieve the purpose of prolonging the interval of the dialysis and even getting rid of it.
The experts in Shijiazhuang Kidney Disease Hospital said that after the patient was hospitalized, blood purification was given first and then Immunotherapy . Blood purification provided an non-toxic, benignant environment for stem cells to grow. Meanwhile, other medicine played an adjuvant role. Stem cells were tranfused into the patients’ body through venae and reached lesions along with blood circulation. Induced by relevant signals, stem cells can be transformed into inherent cells needed by the lesions to replace damaged cells to play a role.
Therefore, people in both experimental and clinical areas found the two major functions of Immunotherapy : repairing and rebuilding, thus further expanding renal artery and the digestive tract artery, strengthening blood perfusion of kidney and all the body; improving local microcirculation, increasing oxygen supply, enhancing metabolism, relieving the disorder state of inner environment due to anoxia and lessening symptoms of poisoning
In addition, Uremia patients need to take compound α-keto acid after the operation, which can provide protein required when stem cells expand and reproduce and can decrease urea nitrogen and glomerular high filtration, thus protecting nephrons.

2011年10月14日星期五

what are Nephrotic syndrome

Nephrotic syndrome is a type common kidney disease.It is a nonspecific disorder in which the kidneys are damaged, causing them to leak large amounts of protein(proteinuria at least 3.5 grams per day per 1.73m2 body surface area) from the blood into the urine.
Kidneys affected by nephrotic syndrome have small pores in the podocytes, large enough to permit proteinuria (and subsequently hypoalbuminemia, because some of the protein albumin has gone from the blood to the urine) but not large enough to allow cells through (hence no hematuria). By contrast, in nephritic syndrome, RBCs pass through the pores, causing hematuria.
According to NephCure, most often, Nephrotic Syndrome is defined by its primary diseases that attack the kidney’s filtering system. Some of these cases are idiopathic.
Signs and symptoms
It is characterized by proteinuria (>3.5g/day), hypoalbuminemia, hyperlipidemia and edema which is generalized & also known as anasarca or dropsy. Common among 2–6 years old boys. The edema begins in the face. Lipiduria (lipids in urine) can also occur, but is not essential for the diagnosis of nephrotic syndrome. Hyponatremia also occurs with a low fractional sodium excretion.
Hyperlipidemia is caused by two factors:
  1. Hypoproteinemia stimulates protein synthesis in the liver, resulting in the overproduction of lipoproteins.
  2. Lipid catabolism is decreased due to lower levels of lipoprotein lipase, the main enzyme involved in lipoprotein breakdown.
A few other characteristics seen in nephrotic syndrome are:
The most common sign is excess fluid in the body due to the serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravate the edema. This may take several forms:
  • Puffiness around the eyes, characteristically in the morning.
  • Pitting edema over the legs.
  • Fluid in the pleural cavity causing pleural effusion. More commonly associated with excess fluid is pulmonary edema.
  • Fluid in the peritoneal cavity causing ascites.
  • Generalized edema throughout the body known as anasarca.
Most of the patients are normotensive but hypertension (rarely) may also occur.
Anemia (iron resistant microcytic hypochromic type) maybe present due to transferrin loss.
Dyspnea maybe present due to pleural effusion or due to diaphragmatic compression with ascites.
Erythrocyte sedimentation rate is increased due to increased fibrinogen & other plasma contents.
Some patients may notice foamy or frothy urine, due to a lowering of the surface tension by the severe proteinuria. Actual urinary complaints such as hematuria or oliguria are uncommon, though these are seen commonly in nephritic syndrome.
May have features of the underlying cause, such as the rash associated with systemic lupus erythematosus, or the neuropathy associated with diabetes.
Examination should also exclude other causes of gross edema—especially the cardiovascular and hepatic system.

Do you know what are kidney failure or uremia

Renal failure or kidney failure (formerly called renal insufficiency) describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood. The two forms are acute (acute kidney injury) and chronic (chronic kidney disease); a number of other diseases or health problems may cause either form of renal failure to occur.
Renal failure is described as a decrease in glomerular filtration rate. Biochemically, renal failure is typically detected by an elevated serum creatinine level. Problems frequently encountered in kidney malfunction include abnormal fluid levels in the body, deranged acid levels, abnormal levels of potassium, calcium, phosphate, and (in the longer term) anemia as well as delayed healing in broken bones. Depending on the cause, hematuria (blood loss in the urine) and proteinuria (protein loss in the urine) may occur. Long-term kidney problems have significant repercussions on other diseases, such as cardiovascular disease.
Do you know uremia? End-stage kidney disease is uremia in some country, Eg.China.But many country people don't know uremai.There are only kidney failure or renal failure.
Uremia or uraemia (see spelling differences) is a term used to loosely describe the illness accompanying kidney failure (also called renal failure), in particular the nitrogenous waste products associated with the failure of this organ.[1]
In kidney failure, urea and other waste products, which are normally excreted into the urine, are retained in the blood. Early symptoms include anorexia and lethargy, and late symptoms can include decreased mental acuity and coma. Other symptoms include fatigue, nausea, vomiting, cold, bone pain, itch, shortness of breath, and seizures. It is usually diagnosed in kidney dialysis patients when the glomerular filtration rate, a measure of kidney function, is below 50% of normal.[2]
Azotemia is another word that refers to high levels of urea, but is used primarily when the abnormality can be measured chemically but is not yet so severe as to produce symptoms. Uremia can also result in uremic pericarditis. There are many dysfunctions caused by uremia affecting many systems of the body, such as blood (lower levels of erythropoietin), sex (lower levels of testosterone/estrogen), and bones (osteoporosis and metastatic calcifications). Uremia can also cause decreased peripheral conversion of T4 to T3, producing a functionally hypothyroid state.

What are type of kidney disease

The term “kidney disease” can refer to any type of condition that greatly reduces the functioning of the Some forms of kidney disease are acute, which means that the damage is sudden and symptoms reveal themselves very quickly.
Chronic kidney disease means that the decline in the kidney function is slow and progressive.
Many people live with chronic kidney disease for years without being aware that the kidneys are the source of their health problems, as there are few or no symptoms in the initial stages of chronic kidney disease.
Both types of kidney disease,
chronic and acute, can be due to auto-immune disorders, ingested toxins that the kidney has been forced to try to filter out, pharmaceutical medications, or infections.
Certain other diseases, such as high blood pressure and diabetes, put extra stress on the kidneys and can cause them to function below par, eventually contributing to chronic kidney disease.
One of the kidneys functions is to separate wastes, which we eliminate in our urine, from the importantmaterials that need to be put back onto our bloodstream. Proteinuria, a result of many types of kidney disease, occurs when protein, mostly albumin, leaks out into the urine causing our protein levels in our blood to become too low.
We need protein in our blood to keep fluid inside the blood vessels, and without it the fluid leaks into the tissues and blood is excreted through the urine. This is known as “nephritic syndrome”.
Chronic pyelonephritis is another common kidney disease. It is a painful condition that happens when infection finds its way into the kidneys and causes chronic inflammation. Hematuria, the presence of blood in the urine, can result from this type of kidney infection.
Kidney stones can occur when a person has a buildup of too much calcium oxalate or uric acid in their urine, and it hardens into a crystal like stones that can be very painful to pass.
Infections can occur with kidney stones as well, because the kidneys are not able to flush themselves out properly, causing a toxic environment where bacteria can readily grow.
Hypertension, or high blood pressure, and the medications used to treat it, can cause kidney problems. A blockage of one or both arteries leading to the kidneys can develop, and the kidneys respond by releasing way too much of a chemical called vasopressin which causes the blood pressure to rise remarkably.
Polycystic kidney disease is a genetic disorder where cysts begin to form in the kidney. Some of the cysts do not cause any progressive kidney failure, and others, depending on their size and location within the kidney, can greatly get in the way of the kidney performing its proper filtration.
There is one primary kidney disease which is cancerous, and that is renal cell carcinoma. The cancer will probably cause pain or bleeding in the area of the kidneys. The good news is that this type of cancer is usually highly treatable.
Some types of kidney diseases are classified as auto-immune diseases. Berger’s disease happens when the patient’s immune system has set up antibodies that act on the tissues of the capillaries in the kidney.
Berger’s disease is also known as IgA Nephropathy. Systemic lupus is another autoimmune disorder, and can cause the body to produce antibodies directed against the kidney membranes.
In a normally functioning kidney, the filtering membranes do not permit albumin and other blood proteins to be excreted in the urine. However, with systemic lupus, the filtering membranes are disrupted, resulting in protein in the urine.
As you can see, there are many types of kidney disease. But on a positive note, the large number of varied treatments available gives us a wide range of choices to restore health to our body’s filtration system.
There are many herbs and nutritional supplements available that have been shown to improve kidney health during both chronic and acute kidney disease.
Unlike the pharmaceutical drugs available these do not have any side effects and do not contribute to kidney damage while treating symptoms. Natural therapies can also treat the cause of kidney damage, offering long term protection for your kidneys.

2011年10月12日星期三

Do you know kidney

kidney
In humans the kidneys are located in the abdominal cavity, more specifically in the paravertebral gutter and lie in a retroperitoneal position at a slightly oblique angle. There are two, one on each side of the spine. The asymmetry within the abdominal cavity caused by the liver typically results in the right kidney being slightly lower than the left, and left kidney being located slightly more medial than the right.[2][3] The left kidney is approximately at the vertebral level T12 to L3,[4] and the right slightly lower. The right kidney sits just below the diaphragm and posterior to the liver, the left below the diaphragm and posterior to the spleen. Resting on top of each kidney is an adrenal gland. The upper (cranial) parts of the kidneys are partially protected by the eleventh and twelfth ribs, and each whole kidney and adrenal gland are surrounded by two layers of fat (the perirenal and pararenal fat) and the renal fascia. Each adult kidney weighs between 125 and 170 grams in males and between 115 and 155 grams in females.[5] The left kidney is typically slightly larger than the right
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid-base balance, and regulation of blood pressure (via maintaining salt and water balance). They serve the body as a natural filter of the blood, and remove wastes which are diverted to the urinary bladder. In producing urine, the kidneys excrete wastes such as urea and ammonium; the kidneys also are responsible for the reabsorption of water, glucose, and amino acids. The kidneys also produce hormones including calcitriol, erythropoietin, and the enzyme renin.
Renal physiology is the study of kidney function, while nephrology is the medical specialty concerned with kidney diseases. Diseases of the kidney are diverse, but individuals with kidney disease frequently display characteristic clinical features. Common clinical conditions involving the kidney include the nephritic and nephrotic syndromes, renal cysts, acute kidney injury, chronic kidney disease, urinary tract infection, nephrolithiasis, and urinary tract obstruction.[1] Various cancers of the kidney exist; the most common adult renal cancer is renal cell carcinoma. Cancers, cysts, and some other renal conditions can be managed with removal of the kidney, or nephrectomy. When renal function, measured by glomerular filtration rate, is persistently poor, dialysis and kidney transplantation may be treatment options. Although they are not severely harmful, kidney stones can be a pain and a nuisance. The removal of kidney stones includes sound wave treatment to break up the stones into smaller pieces, which are then passed through the urinary tract. One common symptom of kidney stones is a sharp pain in the medial/lateral segments of the lower back.

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