Prognosis and prevention of chronic renal failure

Chronic renal failure health search is a progressive development of the disease with irreversibility, most of the poor prognosis. According to foreign reports, when Scr> 442μmol / h, progress to end-stage uremia the average time of 10.8 months, Scr higher disease development faster, shorter survival, the need for dialysis and transplantation the shorter the time.

The course and prognosis of chronic renal failure are related to two factors
First, with the underlying cause is closely related, such as chronic glomerulonephritis for 10 months, no obstructive pyelonephritis for 14 months, the worst diabetic nephropathy, only 6 months, polycystic kidney disease for 18 months.

Second, with a variety of complications and exacerbations, in a variety of comorbidities, combined with the worst prognosis of hypertension; a variety of factors such as age, diet

Infection heart failure, dehydration or treatment of misuse and so can lead to deterioration of renal function and affect the prognosis. But if the above unfavorable factors and nutritional problems, metabolic problems, anemia and other rational treatment and correction, can still make the disease part of the reverse.

In the late 1970s, some people found CRF patients in foreign countries, according to a certain trend gradually developed to the end of the period and found that the median serum creatinine level that is 1 / Scr (mg / dl) as the ordinate, the number of months Coordinates, in the absence of external factors, we can see the gradual deterioration of renal function

The degree of deterioration was linearly correlated with the progression of the disease. This view, in theory and practice in recent years by many scholars confirmed, and speculated that residual kidney units have gradually stabilized the speed of stability, and regardless of the reasons why there is a deteriorating process. Into the dialysis treatment, because the kidneys have excretion and endocrine two functions, dialysis treatment is mainly to replace the excretion function, therefore, patients should be a comprehensive observation and treatment, as far as possible after the patient dialysis, the quality of life has improved.

Prevention:
How to early prevention of chronic renal failure patients, and delay the progress of chronic renal failure Chi disease, has become a very concerned about the issue of cupping network. Three levels of prevention and follow-up measures are currently proposed.

1. Primary prevention is also known as early prevention.
Is the original kidney disease or may lead to CRF Chi the primary cause, such as chronic nephritis, pyelonephritis diabetes, high blood pressure, early screening and timely and effective treatment to prevent possible chronic renal insufficiency.

2. secondary prevention
That is, to prevent chronic renal failure continued to progress and sudden increase in patients with chronic renal failure Chi, and actively correct lipid metabolism disorders, into the high-quality low-protein diet, control of hypertension, to avoid increased factors, suitable for cold,
To avoid exogenous, infection, while paying attention to a reasonable diet and rest, in order to effectively prevent the disease progression, to promote the recovery of the disease.

3. Level 3 prevention
Is to enter the end stage of renal failure patients active treatment of health search to prevent life-threatening complications such as hyperkalemia, heart failure, severe metabolic acidosis to extend the survival of patients to China such a large population Of developing countries, should strengthen the early prevention of CRF and delay the progress of the disease, attention to the development of non-dialysis treatment, improvement and promotion. Dialysis and transplantation therapy should be used to save lives.

Follow the track
Chronic renal failure patients must be regularly followed up the frequency of treatment should be determined according to the condition, such as whether high blood pressure, heart failure and residual renal function deterioration speed. All patients in the cupping network must be treated at least once every 3 months, must visit the medical history and physical examination, and do the necessary laboratory tests, such as blood, urine, blood urea nitrogen, creatinine concentration and electrolyte, serum protein, Parathyroid hormone, ferritin, C-reactive protein, etc., according to the disease symptomatic treatment

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