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Drug therapy for chronic renal failure

2016-12-26 15:43
There are many kinds of diseases now, so in the face of body disease is the need to accept the challenge, of course, for chronic renal failure will give people's physical and mental health as a great harm, so we should correct the corresponding disease, positive treatment, then the way of drug the treatment of chronic renal failure following specific to answer it?.
First, active treatment of primary disease does not use kidney damage drugs, timely removal of predisposing factors (such as infection, fever, bleeding, hypertension, etc.), often can restore the condition to the original level.
Two, delaying the treatment of chronic renal failure
Dialysis therapy (Figure 1) diet therapy protein intake should be adjusted according to the patient's renal function, generally use a low protein diet, but not to produce negative nitrogen balance principle. Due to the high quality protein, such as eggs, milk, fish, lean meat, etc.. Restriction of plant protein uptake. High heat, daily weight of not less than 125.5kJ/kg. Vitamin supplement. The amount of water should depend on the specific circumstances, the daily urine volume in more than 1000ml. No edema should not be limited to water. The salt do not have too much limitation, loss due to storage of sodium in the urine sodium loss function. The less urine should be strictly limited to phosphorus potassium containing foods. [17]
(two) essential amino acid therapy oral or intravenous essential amino acid solution, adult daily 9-23g. Where the law should not eat non essential amino acids and rich food, eating low quality protein (0.3g/kg daily weight), in order to promote the utilization of urea and non essential amino acids, and essential amino acid synthesis of human proteins, so as to achieve the purpose of reducing blood urea nitrogen.
(three) sodium expansion after the diuretic therapy to suit 3g/d (such as sodium bicarbonate, sodium and water retention in patients already, do not have to wear, and then treated with furosemide, sodium bicarbonate) to the dosage of 100mg/d, intravenous injection, the daily urine volume of about 2000ml, otherwise, the amount of daily furosemide doubled, to the amount of urine. But the total daily dose of furosemide should not exceed 1000mg, such as furosemide each more than 200mg, should be added to glucose intravenous drip.
(four) the application of vasoactive drugs 20mg dopamine, phentolamine 10mg plus 5% glucose injection 250ml by intravenous drip, drip speed 1ml/, 1 times a day, a total of 7 times. Can improve renal blood flow, urine volume increase, promote urea nitrogen excretion.
(five) oral oxidation starch 20-40g/d, can make the intestinal urea and oxidized starch combination excreted after 1-2 weeks, blood urea nitrogen can be reduced by about 30%, because of its side effects are dizziness, nausea, diarrhea, currently use DASC (albumin coating oxidized starch preparation), the preparation of slight side reaction.
(six) traditional Chinese medicine rhubarb 10g, oyster 30g, dandelion 20g, Decoction to 300ml, high retention enema 1-2 times a day, patients with diarrhea control in 3-4 times per day is appropriate, promote fecal nitrogen excretion increased.
Three, correct water, electrolyte imbalance
(a) dehydration and hyponatremia in uremic patients prone to dehydration and hyponatremia, especially long-term loss of appetite, vomiting and diarrhea, even more so, once occurred, should be added. But should pay attention to the water, sodium tolerance characteristics, should not be excessive, so as not to cause hypernatremia and water poisoning.
(two) hypokalemia and hyperkalemia in uremic patients with blood potassium is generally at a low normal value, but the use of diuretics, it is prone to hypokalemia. Should the oral potassium chloride or potassium citrate supplement, only in case of emergency, only need intravenous infusion of potassium, urine or potassium sparing diuretics, can cause hyperkalemia, the emergency treatment methods, see "acute renal failure".
Dialysis therapy (Figure 2) (three) hypocalcemia and hyperphosphatemia oral calcium gluconate and calcium lactate can improve hypocalcemia. When the low calcium tetany, intravenous glucose should be 10% or 5% calcium calcium chloride 10-20ml, corrected. Oral administration of 4% Aluminium Hydroxide Gel 15-30ml, 3-4 times a day, can inhibit the intestinal absorption of phosphorus from the phosphorus decreased. Vitamin D (especially the high activity of 1.25- (OH) 2D3) can help improve the blood calcium level and improve renal osteodystrophy. [17]
Four, symptomatic treatment of high blood pressure, should limit sodium intake, and appropriate to give antihypertensive drugs, control of hypertension. Severe anemia with iron supplementation should be, and lose a few blood by intravenous or subcutaneous injection of erythropoietin is the best general use 50u/kg, after 6-8 weeks, red cell volume increased after 30-40vol%, to maintain the volume (25u/kg), in the application process, can be due to the increase in red blood cells and the blood the viscosity increase, increased vascular resistance, elevated blood pressure, should pay attention to. Patients with renal osteodystrophy, should supplement calcium and vitamin D or 1.25 hydroxy D3 (Luo Gaiquan), such as serum calcium and parathyroid disease without improvement, such as the exploration and resection of adenomas.
Five, blood purification therapy is replaced by artificial methods to replace the function of the kidney, in order to maintain patient life. Hemodialysis and peritoneal dialysis.
Six, kidney transplantation allogenic kidney transplantation to the health of patients with uremia, is an ideal treatment for renal transplantation therapy since beginning of this century, great progress has been made in China has accumulated a lot of experience. With the development of immune rejection research, renal transplantation will become an effective treatment.
The above is the treatment of chronic kidney disease appears, we should also be prepared to understand, but also to remind people of physical problems don't be afraid, calm face also can overcome the fear of disease in the spirit of the above, but also pay attention to the positive treatment of these.
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