Breaking free from the feeling of powerlessness: from the despair of incurable diseases to the calmness of coexisting with diseases

Nowadays, people's work and life rhythms are accelerating, competition is intensifying, and "rolling" is everywhere. In order to pursue a richer material life, we have to run at high speed like machines, and life challenges come one after another, and psychological and physical pressures naturally follow. More and more people fall into sub-health status, and being forced to "overdraw" their bodies and emotions has become a daily routine. "Powerlessness" has become a common problem for workers.

Overloaded life, long-term stay-up late, lack of exercise, improper eating habits and other behaviors lead to decreased physical function, which in turn induces cardiovascular disease and kidney disease. According to a study published in JAMA Internal Medicine by Zhou Maigeng of the Chinese Center for Disease Control and Prevention and Academician Hou Fanfan, director of the Department of Nephrology at Nanfang Hospital, there were 82 million adult patients with chronic kidney disease (CKD) in my country from 2018 to 2019. Faced with the reality that there is no cure for the disease throughout life, the "powerlessness" of kidney disease patients seems more real and heavy.

To popularize knowledge about blind spots and prevention of kidney disease, on this year's World Kidney Day, Tencent News Yige Studio teamed up with Fan Deng, Peking University People's Hospital and Nanfang Hospital to launch the documentary "Super Consultation: Rejecting the Feeling of Powerlessness in Life", aiming to use real cases and expert insights to enable everyone to establish scientific cognition, actively deal with diseases, and feel that they are not powerless when it comes to heart and kidney health.

The invisible killer

Chronic kidney disease (CKD) is estimated to affect more than 850 million people worldwide and caused more than 3.1 million deaths in 2019. Currently the eighth leading cause of death, kidney disease is projected to become the fifth leading cause of life lost by 2040 if not addressed.

Professor Zuo Li, director of the Department of Nephrology at Peking University People's Hospital, mentioned in the program, "In the early stages of chronic kidney disease, there is no feeling or symptoms, and you really won't know unless you get checked."

Professor Zuo Li from the Department of Nephrology at Peking University People's Hospital explains how to detect chronic kidney disease

Hou Fanfan, an academician of the Chinese Academy of Sciences and director of the Nephrology Department of Nanfang Hospital, called chronic kidney disease an "invisible killer" in the program. She said, "It (chronic kidney disease) has few symptoms, and many patients have already entered the middle and late stages when they come."

Ms. Mo, who has been suffering from chronic kidney disease for more than a decade, shared her experience on the show: In 2008, she went to the gynecology department for treatment due to frequent urination and urgency. Initially, she was treated for a urinary tract infection. It was only after a follow-up examination two months later that she was diagnosed with chronic kidney disease in the nephrology department. When she heard the doctor diagnose that she might develop uremia within five years if not treated, she was scared and thought for a time that she could not be cured.

Chronic kidney disease patient Ms. Mo talks about the feeling of powerlessness at the beginning of her illness

Mr. He is also a patient who appeared in the program. Many years ago, a physical examination showed high blood creatinine, but Mr. He did not pay attention to it. It was not until his doctor friend read the report and pointed out the seriousness of the problem that he went to the hospital for examination. When he was diagnosed with IgA nephropathy, he was chilled from head to toe. He was devastated in the first few months and felt confused about the future of his family. He was worried that his parents and children would lose their support.

Mr. He, a patient with IgA nephropathy, tells about his collapse during the initial diagnosis

Comprehensive prevention and treatment measures can delay the onset of dialysis

According to Academician Hou, once the patient's condition worsens and develops into uremia, dialysis treatment is necessary, and frequent dialysis will seriously affect the normal work and life of young and middle-aged people. Based on this, Academician Hou proposed in the program: "We can take a series of comprehensive prevention and control measures to delay the time for dialysis."

She emphasized that comprehensive prevention and treatment measures can delay the progression of chronic kidney disease: "According to epidemiological surveys, the final cause of death for about 50% of dialysis patients is not the kidney itself, but cardiovascular disease, so protecting the cardiovascular and cerebrovascular systems and protecting the kidneys should be given equal importance. Even for patients in the middle and late stages of the disease, we can still use comprehensive prevention and treatment measures to change lifestyles, control risk factors, and actively protect the heart and kidneys."

Academician Hou Fanfan, Director of the Nephrology Department of Nanfang Hospital, introduced how to delay the progression of chronic kidney disease through cardiorenal protection

Professor Zuo Li also put forward a similar view: "This is the management of the entire life cycle of the kidney: primary prevention is to prevent kidney disease, secondary prevention is to delay its progression, and tertiary prevention is to prevent cardiovascular disease."

Academician Hou shared her research results in the program. According to Academician Hou, based on the long-term follow-up of patient data, it was found that there were 2,570 cases of renal function decline when they were admitted to the hospital for treatment. After comprehensive management, the proportion of patients whose condition remained stable and did not need dialysis within five years has reached 67%; in addition, the treatment burden of dialysis is very heavy for patients, and by delaying the patients from entering the dialysis stage through comprehensive prevention and treatment measures, the country can save 7 billion in treatment costs for every year.

Regarding the treatment of IgA nephropathy, Academician Hou mentioned that "IgA nephropathy is the most common glomerular disease in our country and Asia, and is caused by immune system disorders." Based on clinical research, Academician Hou's team proposed to use immunosuppression to treat it, even if the immune disorder is adjusted to a relatively low level. According to the statistics of the patient data of Academician Hou Fanfan's long-term follow-up, after 2,500 patients with IgA nephropathy received complete treatment, the proportion of patients who did not need dialysis after ten years of observation exceeded 80%. This is an encouragement for doctors and patients in the field of kidney disease.

From feeling powerless to coping with the disease

Under the medical guidance of Academician Hou, Ms. Mo began to receive comprehensive preventive and therapeutic treatment, using the upward titration method developed by Academician Hou's team. "According to the patient's response, the dosage is adjusted once a month, and the dosage is gradually increased, which is called the upward titration method." Academician Hou said that this method can enable patients to enter the terminal stage and reduce the risk of renal failure by 51%.

Academician Hou Fanfan, Director of the Nephrology Department of Nanfang Hospital, introduced the "upward titration method"

At the same time, Ms. Mo actively learned about kidney disease, and her mentality gradually changed. From the initial collapse to now fully accepting the existence of the disease and coexisting with the disease, she frankly said that "she is still lucky."

Academician Hou tells Ms. Mo about treatment suggestions

Mr. He's mentality gradually turned to optimism. According to the treatment suggestions of Academician Hou, he used drug treatment to delay the progression of chronic kidney disease, reduce the growth rate of creatinine, and stabilize the indicators. He believed that "there must be a way out when the car reaches the mountain", and doing nothing would only burden his family. Since he became ill, he insisted on going to work full time, without leaving early or absenteeism. It can be seen that the disease did not wipe out his enthusiasm for life, but made him learn to accept, grow, and be optimistic.

Pay attention to kidney disease and refuse the feeling of powerlessness in life

"Coexisting with disease is the best state of life." After entering the ward and gaining an in-depth understanding of chronic kidney disease, the program's guest Fan Deng said, "Chronic disease is a long battle; only by having a relaxed mindset, a scientific outlook on life, and the concept of life cycle management can we better face the disease." He advocated to the public: "Coexisting with disease is the best state of life."

Indeed, although humans are insignificant in the face of disease, if we can accept it calmly, face it bravely, and actively treat it, the "powerlessness" in life will be broken. The condition tends to be stable under intervention and control, and patients can work and live calmly like normal people, regain hope and happiness, and feel love again. The efforts of kidney guardians will be meaningful.

At the end of the second episode, Academician Hou said with emotion: "I think if we can devote our life's energy to doing something good for our Chinese patients and improve their prognosis, it may be the happiest thing for all of us doctors in the field of kidney disease."

Let us pay attention to World Kidney Day on March 14, pay attention to the health of ourselves and our family and friends, protect our heart and kidneys, and conduct early screening, early treatment, and early cure.