Treatment of Kidney Disease

Kidney disease is a topic that troubles many male friends, mainly because male friends do not pay attention to their sex life in life. People with kidney disease will have a certain impact on your sexual life and will easily reduce your ability to excrete waste from the body. The following are different methods for treating kidney disease. Each patient should adopt different treatment methods according to his or her symptoms.

Treatment principles

Immunosuppressant therapy is the main treatment, general treatment, symptomatic treatment, and Chinese medicine treatment are auxiliary treatment.

General treatment

Patients with symptoms should rest in bed; a normal amount of high-quality protein diet (1g/kg/d) and high-calorie diet (30-50 Kcal/Kg.d) are recommended; those with obvious edema should be given a low-salt diet; eat less animal oil and foods high in cholesterol, such as egg yolks.

Symptomatic treatment

Diuresis and swelling reduction: The combination of thiazide and potassium-sparing diuretics is effective; when the effect is not good, use osmotic diuretics (such as low molecular weight dextran), albumin, and loop diuretics (such as furosemide). Indications for the use of human albumin: ① Diuresis is not ideal; ② There is a manifestation of insufficient blood volume after diuresis; ③ Progressive decline in renal function in a short period of time. Diuresis should not be too strong, which can easily lead to insufficient blood volume, thrombosis and electrolyte imbalance.

Main treatment - suppressing immune and inflammatory responses

1. Glucocorticoids: inhibit inflammatory reactions, immune reactions, secretion of aldosterone and antidiuretic hormone, affect the permeability of the glomerular basement membrane, and play a comprehensive role in diuresis and elimination of urine protein. Principles of use: sufficient initial dose (1mg/kg, 8-12 weeks); slow reduction (10%, 2-3 weeks), long maintenance (10mg/d for half a year to one year). Methods: once in the morning; side effects: infection, diabetes, osteoporosis, gastrointestinal ulcers, hypercortisol syndrome (moon face, buffalo hump), skin diseases (acne, purple lines, hirsutism) and neuropsychiatric disorders (altered consciousness, mood swings, abnormal behavior, insomnia)

2. Cytotoxic drugs: Indications: Hormone therapy is ineffective; patients are dependent on hormones; patients with recurrent or severe symptoms.

① Cyclophosphamide: Dosage (2mg/kg/d, total amount 6-8g); side effects: liver damage, hemorrhagic cystitis, bone marrow suppression, alopecia, gastrointestinal reactions, gonadal suppression, etc.

② Cyclosporine A: inhibits T helper cells and cytotoxic T cells. Dosage (3-5 mg/kg/d) to maintain the trough value of blood concentration at 100-200 ng/ml. Slowly reduce the dosage after taking the medicine for 2-3 months, and take it for about half a year. Side effects: liver and kidney toxicity, and can cause hypertension, hyperuricemia, hirsutism and gingival hyperplasia, etc.

③ Tacrolimus: Tacrolimus is a 23-membered macrocyclic ester that binds to FK506 binding protein (FKBP) in lymphocytes, inhibiting the activity of Ca2-dependent serine/threonine phosphatase-neural calcitonin, blocking the activation of T lymphocyte-specific transcription factor (NF-ATc) and the synthesis of interleukin (ILs) cytokines. Tacrolimus can inhibit the proliferation response of T and B lymphocytes. Dosage: 0.08-0.1 mg/(kg·d), maintaining serum concentration at 5-10 ng/ml. Side effects: muscle tremors, increased blood sugar, transient increase in blood creatinine, and liver function damage.

④ Mycophenolate mofetil tablets: metabolized in the body to mycophenolic acid, which is a hypoxanthine mononucleotide dehydrogenase inhibitor, inhibiting the classical synthesis pathway of guanine mononucleotide, thereby selectively inhibiting T and B lymphocyte proliferation and antibody formation. The usual dosage is 1.5-2.0g/d, taken orally in 1-2 times, for 3-6 months, and then reduced for half a year. Side effects: relatively small adverse reactions. However, when the dosage is large, the side effects will increase, such as mild gastrointestinal reactions, mainly nausea, vomiting, diarrhea, constipation and indigestion; bone marrow suppression, including anemia, leukopenia and thrombocytopenia; infection, which can cause opportunistic infections, the most common of which is cytomegalovirus infection, followed by HSV infection, herpes zoster and Candida infection.

Chinese medicine treatment

It can reduce the side effects of hormones and cytotoxic drugs; Chinese herbal immunosuppressive drugs can be used: Tripterygium wilfordii polyglycosides, Kunming Mountain Begonia tablets, Zhengqingfengtongning, etc.; increase liver albumin synthesis: Astragalus.

Through this article's introduction to the treatment of kidney disease, patients should know how to treat this common disease. Kidney disease not only affects the mood at work and various aspects of daily life, but also causes unnecessary impact on the daily conditions of patients and their families. The introduction of the article can make people more aware of the knowledge about this disease. I hope the above article can help patients with this disease and their overwhelmed family members.