Do you know what the two extremely important factors affecting renal function are?

cold,not developed. I have a patient with serum creatinine 160 and very little proteinuria. The serum creatinine 160 level has been maintained for 16 years. It rarely develops into uremia in your lifetime.The second phenomenon:

What are the factors that accelerate the deterioration of renal function?

Blood pressure, anemia, cold, uncontrolled diet, fatigue, random medication, proteinuria, hematuria, heart failure, acidosis, hyperlipidemia, hyperglycemia.

If you want to say what are the first two factors that have the most significant impact on kidney function, I believe many kidney friends are muttering to themselves.

These two factors are:Urinary protein and blood pressure

There are three criteria for clinical cure of chronic kidney disease:

1. 24-hour urinary protein < 0.5g.

2. Blood pressure < 140/90mmHg

3. The renal function is normal.

You see, the first two are urine protein and blood pressure, and whether the renal function can be stable or improved depends largely on whether the urine protein and blood pressure can reach the standard.

There are two phenomena that can explain the importance of urinary protein and blood pressure. You can try to observe or judge from yourself or your patients, and you will find that this is really the case.

The first phenomenon: the first onset of serum creatinine is very high, such as at the level of 300 to 400, but the urine protein is negative or the amount is very small, the blood pressure is normal or it is easy to control after treatment, the level of renal function of such patients can remain stable for a long time, not developed. I have a patient with serum creatinine 160 and very little proteinuria. The serum creatinine 160 level has been maintained for 16 years. It rarely develops into uremia in your lifetime.

The second phenomenon: the kidney function is normal or slightly damaged at the time of onset, but the urine protein has been at a high level and the blood pressure is not easy to be controlled. Such patients usually deteriorate renal function in about three to five years (except membranous nephropathy), and the speed is very fast. Such patients tend to have poor pathological types. Recently encountered a patient with IgA nephropathy grade 5, the onset of creatinine more than 200, 2 years time to develop uremia.

These are two highly contrastive phenomena. In patients with more urinary protein, whether it is primary glomerular disease or renal injury with specific causes (such as diabetic nephropathy), as long as the amount of urinary protein loss is relatively large and difficult to control, renal function damage is faster.

Why is that?

From two aspects:

1. The large amount of urinary protein indicates that the damage of glomerular filtration membrane is more serious, and the popular point is that the "hole" of glomerular filtration membrane is relatively large.

2. Urinary protein is not easy to be relieved, indicating that the pathological type of kidney is poor, the sensitivity to drugs is poor, and the curative effect is relatively poor.

Proteinuria is not only the result of kidney injury, but also the cause of kidney damage. The leakage of urinary protein can accelerate glomerular sclerosis, renal tubule damage and renal interstitial fibrosis.

Therefore, paying attention to urinary protein and trying to control it is to protect renal function and the recovery of renal function.necessary condition.

Blood pressure is relatively easy to control. As long as you pay attention to it and actively control your diet and medication, there are few uncontrollable blood pressure. However, urinary protein is related to pathology, whether the use of drugs is reasonable and standardized, sensitivity to drugs and other objective factors, sometimes even without human will. In spite of this, everything depends on man-made. I have worked hard to win it before I say what the result is.