How can patients with chronic kidney disease prolong their "lifespan"? You must read these points! !

If chronic kidney disease is not well controlled, complications will occur in various systems of the body in the later stages, seriously affecting the health of patients with chronic kidney disease. At this time, in order to improve the patient's quality of life as much as possible and protect the residual renal function, efforts should be made to prevent and treat complications.

Cardiovascular disease

First of all, the most important thing to pay attention to is cardiovascular disease, which is one of the main complications of chronic kidney disease patients and the most common cause of death in chronic kidney disease patients, including hypertension, left ventricular hypertrophy, heart failure, myocardial infarction, uremic cardiomyopathy, pericardial disease, vascular calcification and atherosclerosis. The main prevention and treatment points are as follows:

1. Hypertension. The goal of hypertension control is: when urine protein is less than 1 gram/day, blood pressure should be less than 130/80 mmHg; when urine protein is greater than 1 gram/day, blood pressure should be less than 125/75 mmHg, and urine protein should be reduced to less than 1 gram/day as much as possible. However, low blood pressure should be avoided to affect kidney and cardiovascular blood perfusion. It is recommended to avoid systolic blood pressure below 110 mmHg.

Principles of blood pressure reduction: (1) Change your lifestyle, pay attention to rest, and emphasize a low-salt diet. (2) When reducing urine protein, ACEI and ARB drugs are the first choice for treating renal hypertension, but patients with high creatinine should use them with caution. (3) It can be combined with calcium ion antagonists, such as nifedipine, nicardipine, amlodipine, etc. (4) It can be combined with α/β adrenergic receptor antagonists, such as arotinolol, metoprolol, urapidil, etc. (5) Choose antihypertensive drugs under the guidance of a doctor, and pay attention to the adverse reactions of various drugs.

2. Heart failure. Heart failure is one of the most common causes of death in patients with uremia. The causes are mostly related to water and sodium retention, high blood pressure, and myocardial damage caused by uremia toxins. In acute attacks, symptoms such as dyspnea, inability to lie flat, and coughing up pink foamy sputum may occur. Once similar symptoms occur, patients should try to sit with their legs hanging down to reduce the burden on the heart, and seek medical attention in a timely manner and fully cooperate with doctors to overcome difficulties.

Renal anemia

Usually, anemia will occur in chronic kidney disease after stage 3. Many symptoms of uremia are directly related to anemia. Anemia can cause fatigue, weakness, fear of cold, decreased cognitive function, dizziness, anorexia, insomnia, depression, decreased immune function, etc. Long-term anemia can cause many cardiovascular diseases, which are often the real cause of death in patients with chronic kidney disease. Therefore, correcting anemia has always been one of the main treatments for patients with chronic kidney disease. For renal anemia, clinical treatment mainly relies on drugs, followed by other means such as dialysis and blood transfusion.

(1) Drug treatment. Under the premise of sufficient hematopoietic raw materials, erythropoietin is used. Currently, the commonly used hematopoietic raw materials are basically oral drugs, including iron, vitamin B6, vitamin B12, folic acid, etc.; some patients have poor absorption of oral iron and need to be supplemented by intravenous infusion. Patients on dialysis are best to use intravenous iron supplementation.

(2) Dialysis. Dialysis can remove metabolic waste and uremic toxins from the blood and prolong the life of red blood cells, but dialysis has little effect on improving anemia.

(3) Blood transfusion. Uremic patients have a strong tolerance to anemia, and excessive blood transfusions are dangerous, so blood transfusions are not encouraged to correct anemia. Blood transfusions can only be performed in certain specific circumstances with the doctor's consent.

In addition, abnormal mineral and bone metabolism, ion disorders and metabolic acid-base imbalance are common complications in patients with chronic kidney disease, which require early intervention and comprehensive management. This will better prolong the survival of patients with kidney disease and make their lives more quality, so that patients can "live longer".