Have you fallen into these five kidney myths? Beware of the "silent killer" chronic kidney disease if you have these symptoms!

Chronic kidney disease is known as the "silent killer" because it has an insidious onset, is painless, and generally has no obvious symptoms in the early stages. When kidney damage is mild, we may not notice it at all. Some patients may not feel uncomfortable even when they reach the uremia stage. By the time they are found out through examination, it has often developed to a serious stage.

March 9 is World Kidney Day. Let us have a comprehensive understanding of the symptoms of chronic kidney disease at each stage, the scientific methods to prevent the occurrence of chronic kidney disease, and the misunderstandings about the kidneys and kidney disease, so as to protect this "silent organ."

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What are the symptoms of chronic kidney disease?

1. Early symptoms: Patients often have no obvious symptoms in the early stage, which are easily ignored. Some patients have symptoms such as fatigue, back pain, eyelid, facial or lower limb edema, hematuria, frequent urination, increased foam in urine, and increased blood pressure. Patients with secondary kidney disease may also experience symptoms of their primary disease, such as joint pain, rash, hair loss, bone pain, etc.

2. Symptoms in the middle and late stages: As the disease progresses, the degree and range of edema in patients worsen further, and the color and volume of urine change, such as hematuria, increased foamy urine, decreased urine volume, increased nocturia, etc. Anemia, increased blood pressure, and increased blood creatinine may also occur.

3. Late symptoms: In the end-stage renal disease stage, patients may experience multi-system symptoms.

▶ Digestive system: poor appetite, nausea, vomiting, loss of appetite, etc.;

▶ Cardiovascular system: shortness of breath, wheezing after activity, inability to lie flat at night, palpitations, precordial pain, etc.;

▶ Blood system: fatigue, palpitations, pale complexion, bleeding gums, epistaxis, etc.;

▶ Respiratory system: deep breathing (Kussmaul breathing), ammonia smell in the mouth, pleural effusion, etc.;

▶ Nervous system: insomnia, sensory disorders, restless legs syndrome, impaired consciousness, convulsions, etc.;

▶ Skeletal system: bone pain, osteoporosis, etc.;

▶ Skin: pigmentation, dull complexion, skin itching, etc.;

▶ Water, electrolyte, and acid-base imbalance: hyperkalemia, hypernatremia, hypokalemia, hyponatremia, hypocalcemia, metabolic acidosis, etc.

What diseases can cause kidney damage?

1. Metabolic diseases: diabetes, hyperuricemia, gout, obesity;

2. Infectious diseases: hepatitis B virus infection, novel coronavirus infection, and other systemic or local kidney infections such as bacteria and viruses;

3. Autoimmune diseases: systemic lupus erythematosus, ANCA-associated vasculitis, Sjögren's syndrome, rheumatoid arthritis, etc.;

4. Drugs: nephrotoxic drugs such as vancomycin, aminoglycoside antibiotics, contrast agents, nonsteroidal anti-inflammatory drugs, etc.;

5. Tumors: multiple myeloma, lymphoma, various solid malignant tumors, etc.;

6. Vascular diseases: renal artery stenosis, "Nutcracker syndrome", etc.;

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After suffering from kidney disease, many people will look up relevant information on diet, taboos, etc. on the Internet, but the information on the Internet is complicated and even contains many misunderstandings. Let's take a look at the misunderstandings about kidneys and kidney disease.

01

Rumor: Drinking less water can reduce the burden on the kidneys

The truth: Kidneys are important organs for maintaining water balance in the human body. Drinking too much or too little water will affect the concentration and dilution of urine, and even affect kidney perfusion and cause disease. Therefore, healthy people and kidney patients without symptoms of oliguria and edema do not need to limit their water intake.

It is worth noting that if kidney disease patients have decreased urine volume and edema, they need to control their water intake. The "water" we are talking about here is not just drinking water, but also porridge, soup, milk and other liquids. The daily intake should be controlled at daily output + 300~500ml.

02

Rumor: People with kidney disease cannot eat soy products

The truth: Kidney patients should eat high-quality protein, mainly including meat, eggs, milk and other proteins. Soy products are mainly made from soybeans. Soy protein is a high-quality protein and can be eaten. However, it should be noted that the total amount of intake should be controlled. For patients with renal insufficiency, the total amount should not be too much. At the same time, other beans other than soy protein should be consumed as little as possible.

03

Rumor: Kidney disease patients can only eat vegetarian food

The truth: Kidney disease patients are not restricted to vegetarians. On the one hand, chronic kidney disease patients should pay attention to the types of protein they consume and choose high-quality protein, including meat, eggs, milk, soy protein, etc. On the other hand, when renal insufficiency occurs, they should pay attention to controlling protein intake. After chronic kidney disease stage 3, protein intake should be controlled at 0.8 grams per kilogram of body weight per day, and patients with end-stage renal disease should control it at 0.6 grams per kilogram of body weight per day.

04

Rumor: When urine protein in patients with nephrotic syndrome returns to normal, it means the kidney disease is cured

The truth: The return of urine protein to normal does not mean that nephrotic syndrome has been cured, but only means that it has entered the remission period and the condition is relatively stable. At this time, you must insist on taking medication under the guidance of a doctor, monitor urine volume, blood pressure, urine protein, kidney function and other indicators, and do not stop taking medication blindly to avoid recurrence of the disease.

05

Rumor: Chronic renal failure can be cured by taking medicine, without nursing care

The truth: Chronic renal failure is a common non-infectious chronic disease that cannot be cured. Once diagnosed, on the one hand, the cause should be actively sought for treatment, and on the other hand, medication should be continued and monitored. Do not blindly reduce or stop medication when clinical indicators improve. At the same time, attention should be paid to care, regular monitoring of blood pressure, blood sugar, urine volume, low-salt, low-fat, low-protein diet, attention to rest, and the development of a healthy lifestyle.

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To protect the kidneys scientifically and prevent the risk of chronic kidney disease, you should do the following:

1. Adjust your lifestyle: pay attention to rest, get enough sleep, stay in a good mood, exercise appropriately, and do not smoke or drink.

2. Control proteinuria: Patients with proteinuria should actively receive treatment under the guidance of a doctor and try to control urine protein below 300 mg/d or the lowest controllable level;

3. Avoid drug-induced kidney damage: Try to avoid the use of nephrotoxic drugs; when renal insufficiency occurs, use drugs under the guidance of a nephrologist and adjust the dosage according to the renal function; do not abuse health products, painkillers, etc. in daily life.

4. Control risk factors that lead to worsening of kidney disease, such as high blood pressure, high blood sugar, high blood lipids, and high uric acid, and delay the progression of renal function.

5. Healthy diet: low-salt, low-fat, high-quality protein diet. People with renal insufficiency should limit protein intake, and those with edema and water and sodium retention should limit fluid intake.

6. Control your weight and avoid obesity: Use scientific methods to keep your body mass index (BMI) between 18.5 and 23.9.

Note: BMI calculation formula = weight (kg) / height (m) ^ 2. For example, if the height is 1.6m and the weight is 50kg, the body mass index (BMI) = weight (50kg) / height (1.6m) ^ 2 ≈ 19.5.

Author: Ma Lijie, deputy chief physician of Nephrology Department, Beijing Chaoyang Hospital

Review｜Sun Qianmei, Chief Physician and Director of Nephrology Department, Beijing Chaoyang Hospital

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