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2024-09-02
In China, the number of patients with chronic kidney disease is as high as 130 million, which means that on average, there is one chronic kidney disease patient in every 10 people. Han Qingfeng, a member of the Agricultural and Labor Party and director of the Department of General Medicine and Chief Physician of the Nephrology Department at Peking University Third Hospital, said, "The high incidence of chronic kidney disease is not caused by a single factor, but is accompanied by the existence of chronic diseases such as hypertension, hyperglycemia, and hyperlipidemia. Currently, 'three highs' are not only important causes of chronic kidney disease, but also play a' key role 'in the development of the disease. How do' three highs' affect kidney health? What is the key to prevention? Recently, our reporter interviewed Han Qingfeng to interpret the inseparable relationship between chronic kidney disease and the three highs. From "chronic diseases" to chronic kidney disease, in recent years, with changes in lifestyle and an aging population, the problem of "three highs" has become increasingly serious, and the incidence of chronic kidney disease has also been on the rise year by year. Han Qingfeng pointed out that behind this, the number of chronic kidney disease patients caused by simple kidney damage such as glomerulonephritis did not increase significantly, while the number of chronic kidney disease patients caused by chronic diseases such as hypertension, diabetes and atherosclerosis increased significantly. How do the three highs interact with chronic kidney disease? Han Qingfeng explained that diseases such as hypertension, diabetes and arteriosclerosis can lead to renal insufficiency and even uremia. Long term hypertension can increase the pressure on small blood vessels in the kidneys, causing arteriosclerosis and gradually thickening the inner walls of blood vessels, ultimately leading to insufficient blood supply to the kidneys; Long term hyperglycemia will damage the glomerular filtration function, which may lead to the occurrence of diabetes nephropathy; Hyperlipidemia is easy to cause renal atherosclerosis, which further aggravates the problem of insufficient renal blood supply. For example, the commonly seen ischemic kidney disease in clinical practice is usually specifically referred to as' renal artery stenosis' in traditional nephrology. However, the manifestation of this disease is insufficient blood supply to the kidneys, so the most important cause of the disease is still basic diseases such as hypertension, hyperlipidemia, and hyperglycemia Han Qingfeng said. It is worth noting that the three highs are important triggers of chronic kidney disease, and chronic kidney disease may also exacerbate the symptoms of the three highs in patients, thus forming a vicious cycle. After the decline of renal function in patients with chronic kidney disease, the retention of water and sodium in the body will aggravate hypertension; The decline of renal function will also affect the metabolism of insulin, making it difficult to control the blood sugar level, and exacerbating the risk of diabetes; Meanwhile, lipid metabolism disorders caused by kidney injury may also exacerbate lipid abnormalities. "The awareness rate, treatment rate and control rate of the three highs are inversely proportional to the incidence rate of chronic kidney disease, that is, the better the public controls the three highs, the lower the incidence of chronic kidney disease." Han Qingfeng emphasized. Regular physical examinations and systematic treatment are key to treating chronic kidney disease, as they enable patients to fully manage their three highs. After clarifying that the three highs are the fundamental causes of most chronic kidney diseases, for us, the most important thing is to provide patients with systematic treatment, including early physical examination screening, blood pressure, blood sugar, and blood lipid control in the middle and later stages, as well as lifestyle adjustments Han Qingfeng said. In his opinion, patients with hypertension for more than 10 years, type 2 diabetes patients and arteriosclerosis patients are all "high-risk groups" of chronic kidney disease, and attention should be paid to the results of routine urine tests, microalbuminuria, renal function tests and other items. In addition, even if there is no "three highs" problem, the elderly over 50 years old should also start to pay attention to kidney health. Because the risk of hypertension, diabetes, and chronic kidney disease has increased significantly, this part of the population also needs regular physical examination. However, interpreting the results of kidney function tests is difficult, and patients cannot simply draw conclusions based on the arrow markings after the indicators. Many people become overly worried after receiving examination reports due to the arrow markings on certain special indicators, suspecting that their kidney function has already been affected. However, upon careful analysis, many so-called 'abnormalities' are not actually serious, and misinterpreting laboratory results may lead to unnecessary panic, "Han Qingfeng reminded. Taking "creatinine" as an example, although it is an important indicator of "kidney injury", the creatinine value slightly deviates from the normal range, which may sometimes be related to detection errors, other non disease factors, etc., and cannot fully reflect the health status of the kidneys. If the value is "abnormal", the patient can undergo a secondary test if conditions permit. In addition, diet also plays a crucial role in "systemic therapy". Han Qingfeng pointed out that reasonable dietary management can control the "three highs", reduce the burden on the kidneys, and slow down the progression of the disease. Patients with chronic kidney disease should focus on controlling the intake of protein, sodium, potassium, and phosphorus. They can prioritize high-quality protein such as fish, poultry, eggs, and low-fat dairy products. When cooking daily, reduce the use of salt and try to use natural spices such as garlic, ginger, and lemon juice for seasoning. Mental health is also an important part of chronic disease management. Many patients with chronic kidney disease, hypertension, diabetes or cardiovascular disease often show anxiety or depression. Han Qingfeng suggests that this group of patients can relieve psychological stress through scientific exercise, keeping pets at home, planting flowers and plants on the balcony, listening to soothing music, and other methods commonly used for cognitive therapy. These methods can also help alleviate the anxiety state of patients with "multiple diseases coexisting". (New Society)
Edit:HAN ZHUOLING Responsible editor:CAICAI
Source:chinanews.com
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