Taipei kidneys function and diseases examination 1.Protein: Normal human urine discharges about 100-150mg/dl of protein per day. If it exceeds, it will report the urine protein (+) mark. At this time, there may be problems with the kidney. Further evaluation of physiological proteinuria is needed. Or pathological proteinuria, remember not to eat too salty, eat less and eat less~
2.Sugar: If the urine sugar is positive (+), it may be abnormal in the function of the renal tubules, unable to absorb the sugar in the urine or diabetes, and people who drink too much in the cup or drink should pay attention to it~
3. RBC: If red blood cells are detected in the urine, it may be hematuria, or urinary tract infection, stones, tumors, or kidney inflammation! Please remember to follow ~ Minsheng kao medical examiner carefully reminded ~
4.WBC: If there is a white blood cell reaction, it may be a urinary tract infection. If you have high fever, chills or severe low back pain, it may be acute pyelonephritis. More than 50% of women have no symptoms, and should also pay attention to female gynecology and male reproductive system~
5. Microalbumin: Assessment of early renal spheroid lesions. Because my grandmother is the third stage of CKD chronic rickets Therefore, I really recommend diabetes, high blood pressure, high blood fat, high uric acid four high patients to arrange screening!
6.Creatinine: urinary metabolic index
7.UACR (ua/uc): If the abnormality is high, it may be early kidney disease, and it is necessary to go to the outpatient clinic of the kidney.
8.SG: If it is too high, it may have insufficient water intake, which affects the function of the kidney to filter toxins. Please remember to drink plenty of water and use your own weight X 30 to estimate the amount of water you need for a day~
Other blood and kidney function inspectors and high-level divisions strongly recommend inspection items
1. Blood urea nitrogen (BUN): 70NTD 2. Creatinine / urinary index (CRE): 70NTD 3. Uric acid (UA): 70NTD 4. Kidney spheroid filtration (eGFR): It belongs to the American formula. The error will float away. The advantage is that it is easy to estimate. The measured value should be 24 hours of urine. It is very troublesome and therefore rarely used. 5.Aldosterone: 500NTD 6. Adrenocorticotropic hormone (ACTH): 1000NTD 7.Cystatin C: The most credible method for detecting early kidney disease is more objective than blood CRE and EGFR 1000NTD 8.Renin: Sympathetic abnormalities, common abnormalities when blood pressure is unstable: 1000NTD 9.Cortisol: Also known as stress hormone, abnormal sleep, poor mental state, poor emotional control: 500NTD 10.Na, K, Cl, Ca, P, Mg : Electrolyte trace elements Renal function abnormality test item: 600NTD
A complete set of complete analysis of kidney function testing Cost: 4000NTD
Patients with chronic kidney disease often suffer from malnutrition due to insufficient caloric intake. Patients with chronic kidney disease are prone to metabolic acidosis and inflammatory reactions due to disease, so the calorie needs to be slightly higher than the average person. 1. Source of calories: 9% from protein, <35% from fat, and others from sugar. Adequate calorie intake prevents protein breakdown in body tissues and reduces the production of nitrogenous waste. 2. The following are foods with high calorie and low protein content (more choices for chronic kidney disease): a. Vegetable oil: soybean oil, olive oil, peanut oil, etc. b. Low-nitrogen starch: winter powder, rice flour, pink rice, whitefly, white powder, corn flour, sweet potato powder, lotus root powder. c. Commercial products: glycoside, whitefly, maltodextrin (recommended 2 bowls or more).
Second, low protein diet
If kidney disease patients ingest too much protein, the wastes such as urea nitrogen after protein metabolism can not be completely excreted. If the blood urea nitrogen accumulation is too much, it will cause burnout, dizziness, weakness, nausea, anorexia, lethargy, anemia, itching and other symptoms. . 1. Source of protein: a. 1/2 to 2/3 from high physiological value proteins: chicken, duck, pig, cow, fish, egg, soy products. Others come from rice, noodles, fruits and vegetables. b. Insufficient protein intake may cause malnutrition. It is recommended that each person take about 2 to 4 meats per day (1 meat is about 3 fingers) or about 0.6 to 0.8 grams per kilogram of body weight per day. c. Eat less foods with high protein content but low utilization rate, and easily produce nitrogenous waste (urine). 2. Eat less beans: red beans, mung beans and less gluten products: gluten, noodles, baked bran. 3. Eat less nuts: seeds, peanuts, cashews, almonds.
Third, low phosphorus diet
Renal function decline because the kidneys can not adapt to the removal of excessive phosphorus, calcium and phosphorus can not balance, easy to cause parathyroidism hyperactivity, bone lesions, skin itching and other symptoms. 1. Do not eat meat and dirty: pig liver, pig heart, chicken cockroach. 2. Do not eat whole grains: grains (ten grains) rice, lotus seeds, coix seed, brown rice, whole wheat products, cereal (powder), wheat germ, chestnuts, red beans, mung beans. 3. Eat less dairy products: yogurt, cheese, yogurt, fermented milk. 4. Tips for less phosphorus: a. Use more fresh meat b. Do not broth, drink less bone soup. 5. Do not eat the following foods: health sugar, yeast powder, cocoa powder, chocolate, three-in-one milk tea, coffee, cola, SARS, Yakult, ice cream, lecithin, fish eggs/pills, and pills. 6. Eat less nuts: black beans, broad beans, peanuts, melon seeds, almonds, cashews, walnuts, pistachios, sesame seeds. 7. Eat less dairy products: fresh milk, milk powder and other commercially available nutritional products.
Fourth, low potassium diet
Potassium is an important electrolyte that maintains cell and muscle tissue function. If the potassium concentration in the blood is too high, it will affect the whole body muscle tissue. In severe cases, the heartbeat will be abnormal. However, if the potassium ion is normal and the kidney volume is greater than 1000cc, there is no need to limit potassium. 1. Do not eat low-sodium salt, delicious salt, salt-free soy sauce: These products are replaced by potassium in the salt, which is easy to cause excessive potassium intake. It can be seasoned with a small amount of salt and soy sauce. 2. Reduce the consumption of high-potassium fruits: melon, honeydew melon, kiwi, banana, tomato, rose peach; strawberry, guava, custard, durian. 3. Less potassium tips: a. The vegetables are boiled with boiling water and then fried in oil or oil. b. Avoid soup, energy soup, lettuce, sashimi. c. Boiling water is the best choice. d. Do not drink concentrated soup (eg broth, concentrated juice) e. Reduce the sauce, such as: sand tea sauce, tomato sauce, sweet sauce. 4. Reduce consumption of high-potassium beverages: vegetable juice, wheat juice, plum juice, chicken essence, ginseng essence, sports drinks, medicated soup, plum vinegar. 5. Reduce the consumption of high-potassium processed foods: ketchup, dried fruits (eg red dates, dried longan, dried persimmons, raisins).
Five, low sodium diet
The intake of sodium in food is mainly from salt, and the sodium required daily is about 5 grams of salt. Excessive sodium ions will cause water to accumulate, leading to complications such as shortness of breath, stagnation of heart failure, and high blood pressure. 1. Do not eat marinated or smoked foods: pickled vegetables (canola, sauerkraut, kimchi, dried plum, snow red), ham, sausage, smoked chicken, fish pine, dried fish, fish pine, dried fish, preserved eggs, Salted eggs, salty and salty. 2. Reduce sodium tips: a. When cooking, you can use white sugar, wine, onion, ginger, garlic, Chinese herbal medicine to increase the flavor of food. b. When eating outside, you can rinse off excess salt with hot water. c. Do not add seasonings such as pepper salt, chili sauce; do not drink soup. 3. Reduce the consumption of other processed products: noodle, chicken noodles, instant noodles, soda crackers, candied fruit. 4. Reduce canned food and sauce: pickled cucumber, meat sauce, bean curd, sand tea sauce, bean paste, tomato sauce, miso.
6. Limit water intake
In patients with chronic kidney disease, excessive water in the body can cause shortness of breath, exacerbate high blood pressure, stagnation of heart failure, and hydronephrosis. Measure your 24-hour urine output the previous day, plus 500-700 ml, which is the appropriate amount of water you drink every day. If you have vomiting, diarrhea or other body fluid loss, you should calculate these discharges. ※If you need to limit the water intake, please follow the doctor's instructions. 1. Source of water: including drinking water, soup, drink, porridge, noodles, clams and fruits, food moisture content table:
2. Tips to relieve thirst: a. Use a small teacup to reduce the amount of water or water. b. Put the water in the mouth for a while, then swallow it to have a thirst-quenching effect. c. Replace the drinking boiled water with ice. ※ Nutrition advice For patients with chronic kidney disease, it is important to get enough calories. Especially need to supplement low protein and high calorie foods. Because of the differences in the condition and lifestyle of each patient, it is difficult to develop a kidney disease nutrition manual for all patients. Based on a balanced diet, we should regularly track and conduct nutritional assessments. Please ask the dietitian to design a suitable diet plan and adjust the nutritional requirements according to the situation to avoid malnutrition. Do a good diet control to protect residual kidney function, delay the rate of kidney failure and time to enter dialysis. 1. Fasting Carambola: Carambola contains neurotoxins, w
※ Nutrition advice For patients with chronic kidney disease, it is important to get enough calories. Especially need to supplement low protein and high calorie foods. Because of the differences in the condition and lifestyle of each patient, it is difficult to develop a kidney disease nutrition manual for all patients. Based on a balanced diet, we should regularly track and conduct nutritional assessments. Please ask the dietitian to design a suitable diet plan and adjust the nutritional requirements according to the situation to avoid malnutrition. Do a good diet control to protect residual kidney function, delay the rate of kidney failure and time to enter dialysis. 1. Fasting Carambola: Carambola contains neurotoxins, which can cause uncomfortable symptoms such as persistent snoring in patients with uremia. In severe cases, convulsions and even coma may occur. 2. Ingesting appropriate amounts of vitamins and minerals: Due to chronic kidney disease, restrictions on the consumption of meat and fruits are likely to cause deficiency of vitamin B and vitamin C. 3. Cooperate with the doctor's medication instructions and supplement the appropriate amount of vitamin B and vitamin C. 4. Regular health check and tracking of renal function
Reference: Ministry of Health and Welfare Article source: Kang Jian magazine 96 kidney disease examination. Early kidney disease test. Most people have reduced kidney function but don't know it. In the mid-October, the National Institutes of Health released a new survey that pointed out that 90% of the 1.5 million patients with moderate to severe chronic kidney disease in China do not know that their kidney function has declined and delay treatment.
Even doctors are easy to ignore. A recent study published in the American Journal of Nephrology pointed out that many primary physicians are unable to correctly diagnose kidney disease. The study suggests that people should be more proactive in understanding the occurrence of such warnings and conduct regular inspections. "Early discovery is an important key to preventing or delaying slow kidney disease," said Warnock, president of the American Kidney Foundation.
The Taiwan Kidney Medicine Association also called out the "three-three screening system" to remind people with high risk groups such as diabetes, high blood pressure, proteinuria, family history of kidney disease, elderly people over 65 years old and long-term medication. Remember every three months. Check urine, blood pressure, blood creatinine and other three tests.
What checks should I do?
What kind of check should I do, layer by layer, and get out of kidney disease?
The first line of defense is routine urine examination. In addition, blood tests are performed to assess renal function. Later, your kidneys are seen through radiation and ultrasound. It is necessary to confirm the kidney by biopsy.
The first screening: routine urine examination
The kidney is the organ that produces urine in the body, and urine testing provides many clues.
◆ Way: Take the middle part of the urine, that is, skip the beginning and the end of the urination, take the middle part of the urine for inspection. Female patients should avoid the physiological period for examination. Specimens should be inspected within half an hour of collection.
◆How to interpret: From the urine test, you can interpret four indicators:
1. Protein: In normal human urine, about 100-150mg/dl of protein is discharged every day. If it exceeds, the urine protein (+) mark will be reported. At this time, there may be problems with the kidney. It is recommended to follow the clinic. .
2. Sugar: If the urine sugar is positive (+), it may be abnormal renal tubular function, unable to absorb urine sugar, or have diabetes.
3. Red blood cells: If red blood cells are detected in the urine, that is, hematuria, it may be urinary tract infection, stones, tumors, or kidney inflammation.
4. White blood cells: If there is white blood cells in the urine, it may be a urinary tract infection. If high fever, chills or severe low back pain, it may be acute pyelonephritis.
Second check, how much kidney function knows
If the urine routine examination suspects that the kidney function is different, further blood and urine tests are needed to evaluate renal function.
◆ Blood sampling: Two indexes of renal function, blood urea nitrogen (BUN) and creatinine (Creatinine), were measured, and the values were different to determine the kidney function.
1. Urea nitrogen: It is a product produced by protein metabolism. After the liver is formed, it is circulated to the kidneys and excreted by the urine. The blood concentration of urea nitrogen varies with the protein and nutritional status of the food. The normal value is 10-20 mg/dl.
2. Creatinine: a product of metabolic production of body muscle activity. The concentration of creatinine in the blood is too high, indicating that the kidney function is lower. The upper limit of normal is 1.4 mg/dl for males and 1.3 mg/dl for females.
◆ urine test:
Method: Collect 24 hours of urine plus blood sampling, check serum creatinine, calculate glomerular filtration rate (GFR, people can calculate it themselves) or creatinine clearance rate (CreatinineClearance, referred to as ccr, is used by clinicians Estimate the calculation of glomerular filtration rate).
How to interpret: The weakening of renal function is divided into five stages, and the glomerular filtration rate can judge the degree of weakening of the kidney function.
1. Must know the DIY life-saving formula GFR: can know how much kidney function.
GFR = (140 - age) × body weight (kg) / 72 × creatinine (mg / dl, can be known by blood draw), the resulting figure is the male kidney function. If it is a woman, the result must be multiplied by 0.85.
Chronic renal failure
The first stage: GFR>90ml/min/1.73m2.
The second stage: 60 ~ 89ml / min / 1.73m2.
The third stage: 30 ~ 59ml / min / 1.73m2.
The fourth stage: 15 ~ 29ml / min / 1.73m2.
The fifth stage: <15ml/min/1.73m2.
GFR is easier than the creatinine clearance rate used by clinicians (no need to collect 24-hour urine), and kidney disease is found earlier. "This is the easiest and most convenient way to learn about kidney function. Know it early and help you save your life." The American Kidney Foundation (NKF) reminded. 2. Creatinine clearance rate is currently the most widely used renal function assessment method in clinical practice. The doctor told the patient that his kidney function was still a few percent, based on the creatinine clearance rate of a few cc per minute.
The average person's creatinine clearance is 100cc per minute. If it is less than 70cc, it means that the kidney is slightly damaged. Below 30cc, entering the stage of kidney failure, the symptoms of uremia will appear one by one. Wait until less than 10cc, you need to wash the kidneys.
Generally speaking, if the blood and urine test results are normal, about 90% of them have no kidney problems. If there is abnormality, radiological examination, renal ultrasound, or kidney section will be further arranged.
Third examination, renal imaging: radiology and ultrasound examination
1. Radiological examination:
◆ General X-ray examination: an ordinary "kidney, ureter, bladder" X-ray film, you can roughly see the size, shape, location of the kidney and search for urinary calculi.
◆Intravenous pyelography (IVP): intravenous injection of developer, excreted into the urine by the kidneys, showing renal pelvis, ureter and bladder structure, to confirm urinary tract patency, can also detect urinary tract obstruction, tumor, stones Size and location; and assessment of renal papillary necrosis, urinary tract reflux, and chronic pyelonephritis.
It should be noted that when renal insufficiency has been suspected, it should be avoided as the development effect is deteriorated and the developer is nephrotoxic. And some people are allergic to the developer, which leads to urticaria or shock. It is recommended to know if you have allergies.
◆Computed Tomography (CT): It can clearly depict and assist in distinguishing organs and blood vessels, and is helpful for the diagnosis of renal tumors and renal cysts.
2. Kidney Ultrasound: It is a safe and convenient tool for kidney size, shape and renal parenchyma changes, whether there is renal edema, chronic nephritis, tumor or blisters. The examination time is about 10-20 minutes. However, because the ureter cannot be seen clearly, it cannot completely replace the X-ray examination. Fourth, pathological examination - kidney biopsy
Kidney section, also known as kidney puncture, is an important diagnostic method for early diagnosis of many chronic kidney diseases.
The method is to use an automatic spring-launching slicer to instantly acquire the tissue under the positioning of the ultrasonic waveguide, and take a few of them in more than one million kidneys of each kidney to check, so that the kidney damage is small, but the tissue can be made by this slice. Pathological examination, including microscopy, electron microscopy and immunofluorescence, to determine the diagnosis, assessment of the extent of kidney damage and prognosis, good symptomatic treatment. 1. Who should make kidney slices:
◆ Establishment and tracking of lupus erythematosus with nephritis.
◆ Track the phenomenon of rejection after kidney transplantation.
2. Who should not do kidney section: easy bleeding, kidney tumor, hydronephrosis, kidney bacterial infection and so on.
As for chronic nephritis, renal atrophy has occurred, indicating that the kidney has changed irreversibly, so most of the cases do not need to be done.
3. Kidney section complications:
Common complications include hematuria, back pain, and perirenal hematoma, which will resolve and disappear within a few days.
