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

2012年7月12日星期四

Relevant knowledge of IgA nephropathy


Also did not carry out the age of renal biopsy for biopsy, IgA nephropathy, and glomerulonephritis are mixed up together, it is difficult to understand its true colors.
The body of an immunoglobulin A, that of IgA. Due to respiratory or gastrointestinal infection, and the other is not yet clear reasons, in vivo IgA or polymer increases, the to Erzhi onset of blood deposition in the glomerular mesangial, known as IgA nephropathy.Lesions in the glomeruli, a of nephritis.
The main manifestations of IgA nephropathy recurrence clearance episodes of hematuria, can of course also other similar nephritis proteinuria, edema, hypertension and even renal failure. Diagnosis of this disease only rely on glomerular IgA deposition, and thus must renal biopsy to confirm the diagnosis.
The so-called renal biopsy under local anesthesia, with B ultrasound imaging guidance, a tiny biopsy needle through the skin, reach kidney, "draw" some kidney tissue with a microscope (light microscopy, immunofluorescence microscopy and electron microscopy) examination, to establish whether this disease. Renal biopsy is actually quite safe, remove the kidney tissue is generally 10 glomerular glomerular terms of two million a 10 glomerular "loss" is negligible. Do not mind.
IgA nephropathy is quite common, as renal wear technology improves, to receive a kidney to wear the increase in the number of onset cases the ratio will be more.Generally speaking, the slow development of the majority of the disease, better prognosis, as long as adherence to treatment, often up to protect the kidneys, delaying disease progression and to maintain the purpose of stable renal function. Specific medication by a doctor selected under the condition of patients. For individuals, the key is 8 characters: self-protection, adherence to treatment.
IgA nephropathy are generally two types of performance, first class acute-speed recurrent gross hematuria, acute episodes of the naked eye hematuria onset of signs, but before this, often without a history of abnormal urine check. Common in children, their naked eye hematuria is more common in the upper respiratory tract infection (cold), also a small number of patients with onset of infection in the digestive tract, the time interval of more than 24-48 hours, gross hyperlipidemia sustainable for several hours or days, a small number of In addition to the naked eye hematuria, the patients there are some other similar acute nephritis performance such as a transient high blood pressure and serum creatinine increased after treatment, mitigation, but under normal circumstances.Such patients in the first naked eye hematuria attack, often marks the beginning of the disease, since patients may have varying degrees of urinary protein and (or) microscopic hematuria. The naked eye hematuria disappeared. About 60% of patients will re-emergence, repeatedly appeared in the respiratory tract infection. The second category is asymptomatic urinary abnormalities, persistent or intermittent microscopic hematuria, mild urinary protein, occasionally tube. Often found in the examination of urinary protein and (or) hematuria Prior to this, the urine protein and (or) blood in the urine how long is often difficult to ascertain. With the progress of the disease in some patients, there may be large amounts of urine protein (greater than 3.5 g per day) and severe hypertension and chronic renal failure.
In Western medicine are currently no specific treatment, but the following aspects can be.
The ① avoid the intrusion of the antigen: the naked eye the hematuria hair of recurrent infections, tonsillectomy and dental lesions

What are the main points of diagnosis and treatment of IgA nephropathy


So far, the disease there is no satisfactory treatment options. Of the disease associated with renal insufficiency adrenal corticosteroids with or without immunosuppressants results are not consistent. Recent data suggest that urinary protein of more than 1g / d, to impose the next day medication adrenal cortical hormone is beneficial to the improvement of urinary protein. IgA deposition of minimal change nephropathy may relieve urinary protein. Used in combination with cyclophosphamide, dipyridamole and warfarin to reduce urinary protein had no effect on glomerular filtration rate; combined use of cyclosporin A may also reduce urinary protein, and then reduce muscle liver clearance. Efficacy of phenytoin, anti-platelet drugs, the anthocyanin acid disodium diphenyl Sealand due to such drugs is uncertain. Notwithstanding the reports of urokinase may have a role to protect the glomerular filtration rate, but far from conclusive. Back and forth for tonsillitis, tonsillectomy may be useful; antibiotics in the prevention and treatment of infection may be helpful to some acute nephritic syndrome and acute renal failure for the performers. A small series of observations found that the use of fish oil preparations reduce urinary protein and increased the role of the glomerular filtration rate. Severe IgA nephropathy (glomerular filtration rate monthly decline 2 to 4ml/min), use of large doses of immune globulin intravenous infusion period, you can stop the glomerular filtration rate, improve the blood in the urine and urinary protein, but after stopping often repeated. The case of high blood pressure and severe urinary protein, glomerular filtration rate converting enzyme inhibitors can slow down the rate of decline and reduce urinary protein in severe IgA nephropathy, converting enzyme inhibitors are the preferred antihypertensive drugs. Conversion of normal blood pressure, whether effective inhibitors is unclear.
The end of advanced IgA nephropathy after renal transplantation, the transplanted kidney happen soon mesangial IgA deposition; subclinical IgA nephropathy if the donor kidney for renal mesangial IgA deposits after implantation of non-IgA nephropathy uremia often rapidly disappearing. Renal allograft associated with recurrent IgA nephropathy is not necessarily progressive renal failure in kidney transplantation, however, Shi immunosuppressive therapy including cyclosporine A also did not prevent its development. Cadaveric renal transplantation, 1 year and 3-year graft survival up to 87% and 77%, however, individual IgA antibody IgA anti-HLA antigens of renal transplant recipients, 2-year graft survival of up to 100%. reason to believe that those anti-HLA antigen antibody on the increased graft survival has played a useful role.

What should pay attention to The dietary guidelines of IgA nephropathy patients


The diet of patients with IgA nephropathy (a)
Focus on different foods on the diet of patients with IgA nephropathy, should be based on the different stages of the condition, while in drug treatment, proper nutrition, absorbed from the diet to help patients as early recovery:
Treatment of lung and stomach wind-heat toxin evil dampness type with acute exacerbation of IgA nephropathy in diet to restore
IgA nephropathy in the acute stage, depending on the clinical manifestations, Chinese medicine can be dialectically divided into the lung and stomach wind-heat toxin evil dampness, Firelight flaming hot and humid, gastrointestinal and bladder damp-heat, where the most wind-heat toxin on lung and stomach evil Fire Model common. Lung and stomach wind-heat toxin evil dampness acute exacerbation of IgA nephropathy, manifested as fever, micro sense of cold, headache, cough, sore throat, urine redness or microscopic hematuria, red tongue tip side, and thin white fur or thin yellow, floating pulse number. Should adopt the way of evacuation of wind-heat, detoxification pharynx, cooling blood to stop bleeding, such as governance, the following diet to restore, selected as appropriate for patients' friends.
(1) Silver Flower, reed, thistle each 30g, forsythia, habitat 15g, Nepeta, bellflower 10g, Semen, raw licorice, the 6g, sanchi powder 2g, red bean, rice, each 60g, sugar amount . 9 before the taste of water to cook the juice, into the red bean, rice boiled thin thick porridge, sanchi powder, sugar, seasoning can be boiled. 1 day, 2 doses.
Silver Flower (2), thistle the 30g, wild chrysanthemum, dandelion, Viola, Gynura 10g Baked rhubarb 6g, sanchi powder 2g, green beans, stems m each 60g, crystal sugar. 7 before the taste of water to cook the juice, into green beans, stems m support thin thick porridge, adding a sanchi powder, crystal sugar, stir well and then boil. 1 day, 2 doses. With sore throat will be dry and hard.
(3) Silver Flower, Forsythia the 30g, Daji, habitat, Rhizoma Imperatae each 20g, mint, Arctium Platycodon each 10g the white Yaomo 2g, Coix seed, rice, each 60g, the amount of sugar. 9 before the taste of water to cook the juice into Coix seed, rice boiled thin thick porridge, add the white Yaomo, sugar, and mix it can be boiled. 1 day, 2 doses.
The diet of patients with IgA nephropathy (b)
Firelight flaming type of acute exacerbation of IgA nephropathy in diet to restore
In the Firelight flaming acute exacerbation of IgA nephropathy patients, our hearts will be vexed, mouth sores, urine redness or microscopic hematuria, red tongue, thin yellow tongue coating, rapid pulse and other symptoms. Appropriate the Qingxin Chufan, cooling blood to stop bleeding and other therapeutic approach, the following diet to restore the formula available for patients to be used as appropriate.
A. Thistle 30g, habitat 20g, Rhizoma Imperatae 15g bamboo 12g, fried gardenia, Health hay the 10g, rice 100g sugar amount. The first six taste water to cook the juice into the rice boiled thin thick porridge, sugar seasoning. 1 day, 2 doses.
Habitat, thistle, phragmites each 30g, raw licorice 10g, sanchi powder 2g, stems m, Coix seed 60g crystal sugar. 4 before the taste of water to cook the juice into the stems m, Coix seed gruel, add rock sugar melted can. 1 day, 2 doses.
(3) Rhizoma Imperatae, Plantago the 30g, short bamboo 10g, lotus core 1g, sugar amount. The first three flavor Qu Zhi decoction while hot into the the Shengyou Lian core sugar cup, cover and bored 10 minutes. One day, on behalf of the tea, watered down so far.
The diet of patients with IgA nephropathy (c)
Spleen and Kidney Qi and Yin deficiency with chronic moved extension of IgA nephropathy, visible endoscopic hematuria or with urinary protein, fatigue, weakness, waist and knee pain, cold or dysphoria heat, spontaneous sweating or night sweats, thirst or throat pain, tongue pink edge scalloped or tongue fat, thin white or thin yellow and dry, rapid pulse and weak. Should adopt a dual-Spleen and kidney yin, stop bleeding, such as rule following diet to restore the party thirsty selected as appropriate.
(1) heterophylla, Astragalus, habitat, yam, Alisma the 15g, thistle 30g, Poria 20g, cornus, Dan the 10g, sanchi powder 1g, rice 100g sugar amount. 9 before the taste of water to cook the juice into the rice gruel, adding sanchi powder, sugar, and mix it, and then can be boiled.
(2) Astragalus, habitat 20g, Chinese yam, cornus the 15g, thistle, plantain seed 30g, Gorgon, Yinhua 12g, Eucommia, walnut, medlar the 10g, Coix seed, stems m = 60 amount of sugar. 9 before the taste of water to cook the juice into Coix seed, stem rice porridge, will become, add walnut, medlar, sugar, and mix it, and then can be cooked. 1 day, 2 doses. Spleen and Kidney Qi and Yin deficiency with urinary protein, sore throat.
(3) thistle. Yinhua the 30g, Astragalus, Rehmannia the 20g, heterophylla, white peony root in the 15g, Eclipta, fried Gardenia, Angelica 12g, Salvia 6g sanchi powder 1g, Gorgon fruit, rice, the 50g, the amount of honey. 10 before the taste of water to cook the juice, into the Gorgon, rice gruel, adding sanchi powder, honey, and mix it can be boiled. 1 day, 2 doses.
These are the recommended diet to restore in the Spleen and Kidney Qi and Yin deficiency with chronic PERSISTING patients with IgA nephropathy, IgA nephropathy patients is suitable for the kind of diet to restore his side, need to go through a professional doctor's instructions, where listed for reference only.

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