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Main measures for prevention and treatment of chronic renal

2017-01-15 09:11

For high risk population with chronic renal insufficiency, first of all to do a good job in primary prevention (primary prevention), that is to prevent the occurrence of chronic renal insufficiency. To have been suffering from early chronic renal insufficiency of the crowd, to do a good two prevention, that is delay, stop or reverse the development of renal insufficiency.

1 lifestyle adjustments: smoking cessation, weight control, salt restriction on chronic renal failure patients may have a certain benefit.

2 basic kidney disease prevention: prevention and treatment of kidney disease, including two aspects: first, the prevention and treatment of various primary renal diseases (such as a variety of glomerular, tubular interstitial, renal vascular disease, etc.); Two is to eliminate or control the risk factors for kidney damage (such as diabetes, hypertension, autoimmune diseases, etc.), which is one of the main measures of primary prevention.

3 Control hypertension actively and reasonably: first of all, the buck must be standard. The glomerular filtration rate greater than 15ml/min/1.73m2 in patients with chronic renal insufficiency, the lower blood pressure target value is less than 130/80mmHg; in uremic patients, blood pressure control in general 140/90mmHg.

4 strict control of blood glucose: diabetic blood glucose target value is fasting 5.0~7.0mmol/L, bedtime level of 6.1~8.3mmol/L, the average glycosylated hemoglobin < 6.5%~7.0%.

5 control protein urine: as far as possible to control the patient's protein in the following 0.3g/24h and the normal range, is an important link to improve the long-term prognosis of patients.

6 prevention and treatment of infection: especially to strengthen the upper respiratory tract infection, hepatitis B, hepatitis C, AIDS, tuberculosis and other aspects of the prevention and treatment.

7 maintain renal perfusion, maintain electrolyte and acid-base balance: to prevent and correct hypovolemia (hypotension, dehydration), or timely correction of severe renal artery stenosis or renal local blood supply decreased sharply; timely correction of metabolic acidosis (including renal tubular acidosis), correct electrolyte metabolism such as sodium and potassium.

8 given low protein diet and dietary therapy, and prevention of malnutrition: when the glomerular filtration rate was less than 60ml/min, can start the application of low protein, low phosphorus diet can be added amount of essential amino acids, can improve the nutritional status of patients, reduce protein hyperphosphatemia, delay the progress of renal function damage.

9 control of calcium and phosphorus metabolism: when the glomerular filtration rate was less than 60ml/min, which should be appropriate to limit phosphorus intake (< 800mg/); when the glomerular filtration rate was less than 30ml/min, in addition to the restriction of phosphorus intake, oral phosphate binders (such as calcium carbonate, calcium acetate, etc.).

10 correction of anemia: when the hemoglobin < 110g/l or red blood cell pressure of < 33%, should check the cause of anemia, if there is iron deficiency, iron treatment should be iron.

11 correct hyperuricemia and hyperlipidemia.

12 pay attention to the prevention and treatment of cardiovascular disease and other complications.

13 intestinal adsorbent, etc

14 other: avoid the use of drugs such as renal toxicity.

 

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