The 5 "gold indicators" for prognosis of kidney disease are all up to the standard and have nothing to do with uremia
Methods of rapidly detecting the prognosis of kidney disease
During the development of kidney disease, many nephrologists want to know the prognosis of their condition?
What is prognosis? Simply put, it is a way of predicting and judging the development of kidney disease. For example, a patient is diagnosed with diabetic nephropathy, and currently has more than 200 creatinine, and wants to determine whether he will develop uremia. Doctors usually make a preliminary judgment based on clinical experience and the patient's current disease development and treatment.
However, this judgment is relatively inaccurate, which is not equal to the final result. To assess the prognosis of the overall condition, the test results must also prevail. After renal function injury, the indicators that everyone pays more attention to are blood creatinine, blood uric acid, creatinine clearance, and glomerular filtration rate. The progress of these indicators is a common criterion for assessing the degree of deterioration of renal function.
In addition to these indicators, there are also some blood biochemical test indicators that are also important aspects of reflecting the progress of the disease. And some specific indicators can help prevent serious complications in advance, and at the same time help guide conditioning treatment plans.
Next, take a look at these "obscure" gold indicators:
Normal hemoglobin, low risk of uremia
The change of hemoglobin in routine blood examination is an indicator that has to be paid attention to. The role of hemoglobin in the blood is to transport oxygen and carbon dioxide to the red blood cells to ensure adequate blood circulation in the body.
If hemoglobin can continue to be maintained above 120g/L, it is fine for women to have a low level of 110g/L or more. It is more beneficial to maintain stable blood circulation in the remaining kidney cells, and can alleviate renal ischemia.
Generally, hemoglobin does not change significantly in the early and mid stages of kidney disease. In the stage of renal failure and uremia, after more than half of the kidney function is damaged, the ability to stimulate the hematopoiesis of the spinal cord will decrease, and hemoglobin will decrease accordingly.
After the decline, to prevent anemia from exacerbating the condition, it is necessary to inject erythropoietin, iron supplements or oral drugs in time to make adjustments.
No significant reduction in the number of white blood cells
The number of white blood cells in the blood routine is also an indicator that needs to be monitored in the middle and late stages of renal insufficiency.
White blood cells include three types of lymphocytes, granulocytes and monocytes, and the overall number is reduced. Some patients are often accompanied by fatigue, nausea, vomiting and other feelings that will become more and more serious. The most important thing is that the immune system will get worse and worse, resulting in fatigue after medication treatment, which is not conducive to the recovery of the disease.
If the test finds that this index is normal, it indicates that the prognosis of the disease will not be too serious, but if there is a small decrease, it needs to pay attention to adjustment. Usually take supplementary drugs that promote leukocyte production and blood-reducing drugs, and pay attention to improving immunity. Immune globulin, for patients taking hormones and immunosuppressive drugs, appropriately reduce the dose.
Serum potassium is stable below 5mmol/L
The monitoring of serum potassium indicators mainly reflects whether electrolytes are stable in the middle and late stages of nephropathy. Generally, abnormal potassium excretion is mainly related to renal function damage. After the glomerular filtration rate drops to 45, this problem needs to be paid attention to. Of course, the later the abnormal blood potassium metabolism occurs, the better the protection of renal function. It takes longer to delay the occurrence of renal failure.
After the blood potassium starts to rise, the nephrologists should not panic. If it does not exceed 6.0mmol/L, there is no obvious symptom, and the initial stage can be relieved by diet control. If it exceeds 6.0mmol/L, and there is obvious numbness of the limbs, slow heart rate or even severe arrhythmia, it must be controlled by drugs to avoid further damage to kidney function.
Carbon dioxide binding force is not less than 22mmol/
The situation of carbon dioxide mainly reflects the state of acid-base balance in the body. The critical value of carbon dioxide binding capacity is 22mmol/. Below this value, the risk of metabolic acidosis increases.
If it is as low as 12.0mmol/L, in addition to metabolic acidosis, the patient's life and health will also be threatened, and severe vomiting and systemic organ failure may occur.
Particular attention should be paid to patients including those with renal insufficiency and glomerular filtration rate lower than 45, as well as patients with diabetic nephropathy and tubular interstitial diseases, and they are more prone to acid-base imbalance.
Blood pressure level is not higher than 130/80
We have emphasized the importance of blood pressure stability for maintaining the continuous stability of renal function many times. It is mainly related to the condition of renal hypertension, that is, the problem of the living environment of kidney cells such as glomeruli. The blood pressure is stable, and the remaining kidney cells have sufficient blood oxygen supply and living space, and kidney failure naturally comes slowly. Therefore, kidney friends must try their best to stabilize their blood pressure. At present, many antihypertensive drugs have a superior effect. As long as they adhere to the medication and a low-salt diet, it is generally not difficult to control.
If at least three of these five indicators are controlled and stable, then the impact on the remaining renal function is not large, and the prognosis is relatively optimistic. Kidney friends hurriedly compare these indicators to see which state they are in now?
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