2020年11月14日星期六

what does a hemorrhoids look like,The clues of chronic kidney disease

    Chronic kidney disease (CKD) has high prevalence, low awareness, poor prognosis and high medical costs. It is another disease that seriously endangers human health after cardiovascular and cerebrovascular diseases, diabetes and malignant tumors. In recent years, the prevalence of CKD has increased year by year, and the global prevalence rate of the general population has reached 14.3%. A cross-sectional epidemiological study in China has shown that the prevalence of CKD in people over 18 years old is 10.8%. Early detection, early diagnosis and early treatment can significantly improve the prognosis of CKD patients. So by identifying which symptoms can CKD be detected early? Let us study together.

    The clues of CKD—foam urine

    Proteinuria is one of the common manifestations of CKD. It is mostly foamy urine. It can be seen that the foam in the urine increases, especially the small foam, which is not easy to dissipate. Foam may also appear in the urine of normal people, and it is easy to dissipate. If it is not easy to distinguish, a urine routine test is very simple and convenient.

    The clues of CKD-hematuria

    Hematuria refers to the sedimentation of fresh urine after centrifugation and manual microscopy. There are ≥3 red blood cells in each high-power field of view. When a liter of urine contains more than 1ml of blood, the naked eye can distinguish the color, that is, naked hematuria. It should be noted that red urine is not necessarily hematuria.

    Common interfering factors that can cause urine to appear red are:

    Food factors: beets, peppers, tomato leaves;

    Drug factors: rifampicin, phenytoin sodium, chloroquine, indomethacin, quinine, etc.;

    Blood mixing: menstrual pollution, hemorrhoid bleeding.

    In addition, gross hematuria does not necessarily come from the kidneys. For example, hemoglobinuria caused by hemolysis and myoglobinuria caused by rhabdomyolysis can be differentiated by urinary phase difference combined with other laboratory indicators.

    Causes of hematuria:

    Medical hematuria: Also called glomerular hematuria, it refers to hematuria caused by various types of primary or secondary glomerulonephritis. During urine phase contrast microscopy, deformed red blood cells can be seen.

    Surgical hematuria: refers to hematuria caused by bleeding in the urinary system (including kidney, ureter, bladder or urinary tract) caused by various reasons. Common causes include stones, tuberculosis, tumors, vascular malformations, and urinary system tumors. Most of the red blood cells in the urine were normal in shape during urinary phase contrast microscopy.

    Clues of CKD-Edema

    The causes of edema include cardiogenic, nephrogenic, hepatic, endocrine, etc. CKD edema is characterized by early morning eyelid edema, symmetry of the lower limbs, and concavity edema, which aggravates after exercise. In severe cases, there may be pleural and ascites, scrotum Edema etc.

    The clues of CKD-frequent nocturia

    Decreased renal tubular concentration function can cause frequent nocturia, polyuria, and decreased urine specific gravity. Common causes of renal tubular pathology include chronic interstitial nephritis, chronic pyelonephritis, hypertensive nephropathy, and renal tubular disease. The causes of chronic interstitial nephritis include Sjogren’s syndrome, hyperuricemia, long-term exposure to nephrotoxic drugs, and heavy metals.

    Clues of CKD-low back pain

    The etiology of low back pain is very complicated. Low back pain associated with CKD is more common in kidney stones, pyelonephritis, chronic glomerulonephritis, and perinephric abscess. Kidney stone back pain is characterized by sudden colic, which can radiate to the inner thigh through the lower abdomen, accompanied by hematuria. Acute pyelonephritis low back pain is characterized by backache, accompanied by chills, high fever, and elevated blood routine blood picture. Chronic glomerulonephritis and low back pain are often accompanied by hematuria, proteinuria, and edema. Perrenal abscess often presents waist pain, even lumps, and systemic infection.

    Clues of CKD-Hypertension

    Hypertension is divided into primary hypertension and secondary hypertension. Renal hypertension is high blood pressure caused by kidney disease and belongs to the category of secondary hypertension. It occurs after CKD and is clinically difficult to control.

    Clues of CKD-Anemia

    Anemia is a common complication of chronic renal failure. The pathological mechanism of renal anemia is complicated. The main reason is the relative lack of erythropoietin (EPO). Other factors include iron deficiency, blood loss, inflammation, and nutritional deficiency.

    The clues of CKD-nausea and vomiting

    Gastrointestinal reactions such as nausea and vomiting are not patents for gastrointestinal diseases. Patients with chronic renal failure also often have ammonia smell in the mouth. The cause is related to gastrointestinal irritation of uremic toxins and can be screened by renal function tests.

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