To prevent or delay kidney function deteriorates2017-02-02 15:25
, preventing serious complications as the main objective. Following comprehensive treatment measures can be adopted.
1. positive control high blood pressure and reducing urine protein
Hypertension and proteinuria are accelerated Glomerulosclerosis, important factors to promote kidney function deteriorates, actively controlling hypertension and reducing urine protein are two important links. Volume dependent hypertension caused by chronic nephritis, often sodium and water retention, hypertension should limit salt (NaCl<6g/d), can be operated by thiazide diuretics, such as hydrochlorothiazide. When the Ccr<30ml/min, use of loop diuretics thiazide no effect, but generally should not be excessive and long-term use. ACEI or ARB in addition to lowering blood pressure, but also reduce proteinuria and renal function deterioration in renal protective effect, for the treatment of hypertension in chronic nephritis and/or reduce urinary protein drug of choice. Usually to achieve the objective of reducing urine protein, applied dose is often higher than the conventional antihypertensive doses. ACEI or ARB for patients with renal insufficiency to prevent high blood potassium, serum creatinine greater than 264 μ mol/l (3mg/D1), be sure to closely monitor serum creatinine, serum potassium, prevent the occurrence of side effects. In addition, combined or used β-blockers, calcium channel blockers.
2. limit the amount of protein and phosphorus in food
Renal insufficiency with azotemia patients should limit protein and phosphorus content, high quality low protein diet or adding essential amino acids or Alpha-Keto acid.
3. the glucocorticoid and cytotoxic drugs
In view of the chronic Glomerulonephritis include many kinds of diseases, and therefore drugs are applied, should be treated differently. But in patients with impaired renal function is normal or only mildly, kidney size normal, pathological types of light (such as mild mesangial proliferative Glomerulonephritis and membranous nephropathy in early stage), urinary protein more taboos can try gradually removed the invalid.
4. anticoagulation and fibrinolysis and antiplatelet drugs depolymerization
This drug can inhibit the formation of fibrin, platelet aggregation, and reduce the complement activity, but effect is not certain.
5. avoid factors that increase kidney damage
To avoid infection, fatigue, pregnancy, and nephrotoxic drugs (such as aminoglycoside antibiotics, aristolochic acid-containing Chinese medicine, and so on) can lead to worsening renal function factors.