Treatment of uremia This method can relieve uremia

Treatment of uremia

Renal replacement therapy is required for chronic renal failure. Some patients often enter the uremia stage, but it has been delayed. They do not want to receive dialysis treatment and are always worried about the toxic side effects, costs, etc. of dialysis.

Many patients also hope that traditional Chinese medicine can "cure" uremia and get rid of dialysis. In fact, dialysis is to replace the work of the kidneys. When the patient enters the uremia stage, the patient's kidneys should be damaged by more than 90%. If it is delayed and no replacement treatment is taken, the toxins will remain in the body and cause irreversible damage to other organs of the body, such as the heart, digestive system, bones, blood system, etc. However, uremia is a disease that cannot be cured by drug treatment, and there is no so-called "magic bullet" that can cure uremia. Therefore, patients with uremia should not hesitate to take renal replacement therapy, namely dialysis treatment, in a timely manner.

For patients with uremic disease who are relatively stable

The condition of these patients is relatively stable. Although they also need to start renal replacement therapy as soon as possible, there is no indication for emergency dialysis. In addition to medication and diet control, these patients need to actively prepare for dialysis. For example, medical staff can provide education on relevant content before dialysis so that patients can fully understand the necessity and limitations of renal replacement therapy, and choose a suitable dialysis method (hemodialysis or peritoneal dialysis) based on their own conditions, family environment, work situation, economic situation, etc.; patients who plan to undergo hemodialysis need to undergo fistula surgery 1 to 3 months in advance and contact a hemodialysis center for long-term dialysis treatment. Patients who are preparing for peritoneal dialysis need to have the peritoneal dialysis catheter inserted 2 to 4 weeks in advance.

Uremic emergency

Common uremic emergencies include

Hyperkalemia and uremia are prone to hyperkalemia when the kidney's ability to excrete potassium is reduced; especially when potassium is ingested, acidosis, infection, trauma, and gastrointestinal bleeding occur. Severe potassium > 6.5mmol/l (serum potassium) may cause cardiac arrest, which is life-threatening and requires immediate rescue.

① Calcium supplements are used to counteract the toxicity of high potassium to the myocardium. 10% calcium gluconate 10-20 ml is usually added with an equal amount of hypertonic glucose and slowly pushed intravenously for no less than 5 minutes. If the arrhythmia does not improve 5 minutes after the injection or if it is effective but recurs soon after, another injection can be given.

② Sodium lactate or sodium bicarbonate can promote the entry of potassium ions into cells, antagonize the inhibitory effect of potassium on the heart, and increase urinary potassium excretion.

③The combined use of glucose and insulin (4g glucose: 1U insulin) can promote the transfer of potassium into cells.

④ Potassium diuretics taken orally or injected (furosemide, torsemide, etc.) promote renal potassium excretion.

⑤ Take cation exchange resin orally to promote potassium excretion from the intestine.

⑥ If hyperkalemia is very severe (>6.5mmol/l) and the above treatment is ineffective, hemodialysis can be performed to lower blood potassium. In patients with heart failure and pulmonary edema, the kidney's function of regulating water-sodium balance is impaired or even lost, resulting in reduced urine output, which can easily lead to volume overload. In severe cases, heart failure and pulmonary edema may occur, which are life-threatening.

Its prevention and treatment measures include

① Control water intake so that the amount of water in is less than the amount of water out, and give diuretics if necessary.

②Hemodialysis ultrafiltration dehydration treatment.

③ Treatments such as cardiotonic and duct dilation. Metabolic acidosis: blood pH <7.2, carbon dioxide binding capacity <13mmol/l, and clinical manifestations of metabolic acidosis (loss of appetite, vomiting, weakness, deep breathing, etc.).

Treatment measures

① Intravenous supplementation of sodium bicarbonate, intravenous drip of 5% sodium bicarbonate solution.

②Hemodialysis corrects acid-base imbalance. When the toxin level is high, blood creatinine ≥707umol/l, urea nitrogen ≥28.6mmol/l, and uremia symptoms are obvious, emergency hemodialysis is required to remove toxins; when serious complications such as pericarditis and gastrointestinal bleeding occur. When the above situations require emergency dialysis treatment, a blood flow pathway needs to be established through central venous catheterization. First-time dialysis patients may develop dialysis imbalance syndrome, so the first dialysis time is relatively short, generally about 2 hours.

Hemodialysis and peritoneal dialysis

Hemodialysis

The patient's blood is introduced into the dialysis machine through the vascular access, where substances are exchanged with the dialysate through the dialysis membrane. The purified blood is then returned to the body to excrete waste and correct electrolyte and acid-base imbalances. If they can adhere to reasonable dialysis for a long time, many patients can survive for more than 10 to 20 years.

Since hemodialysis requires the use of a hemodialysis machine, you have to go to the hospital 2 to 3 times a week, each time for about 4 hours. The advantage is that less waste is accumulated in the body after each hemodialysis, and you have to return to the hospital for treatment at a fixed time every week. If there are changes in your condition, you can get timely treatment. The dialysis process is performed by professional medical staff, so you don't need to do it yourself.

The disadvantages are also obvious

Injections are required every time, and anemia is more serious; blood pressure will be affected before and after dialysis, which is not good for patients with cardiovascular disease and diabetes; diet needs to be strictly controlled; discomfort is more likely to occur before dialysis; dialysis time cannot be changed arbitrarily; the risk of contracting hepatitis B and hepatitis C is greatly increased.

Peritoneal dialysis

A special liquid called "peritoneal dialysis fluid" is poured into the abdominal cavity through a "peritoneal dialysis tube". At this time, one side of the peritoneum is filled with blood containing metabolic waste and excess water, and the other side is dry peritoneal dialysis fluid. The metabolic waste and excess water in the blood will pass through the peritoneum into the peritoneal dialysis fluid.

After being retained for 3-4 hours (8-10 hours at night), the peritoneal dialysis fluid containing waste is released from the abdominal cavity and new peritoneal dialysis fluid is poured in. By changing it 3-4 times a day, you can continuously excrete toxins and excess water from the body. After education and training, and after mastering the operation of peritoneal dialysis, patients and their families can perform peritoneal dialysis at home. With the help of a fully automatic peritoneal dialysis machine, dialysis can be performed during sleep every night, and you can work and study normally during the day.

Conclusion: Through the introduction above, I believe everyone has a more comprehensive understanding of the treatment methods of uremia. Uremia is still a relatively common disease in our lives. I hope the above article can help everyone. I wish you all a healthy body.