Beneficial in the treatment of chronic kidney disease medicine feet

CKD+Treatment

Beneficial in the treatment of chronic kidney disease medicine feet

Reason for the high incidence of CKD Treatment in recent years, mainly lies in the rise of diabetes, hypertension, obesity patient morbidity. Therefore, to reduce the incidence of chronic kidney disease in patients with primary disease, diabetes, hypertension, obesity, should pay special attention to control the corresponding indicators. "For example, high blood pressure and diabetes, must be controlled, to control their standards, even in peacetime taking antihypertensive drugs and hypoglycemic agents, but also regular monitoring of indicators, the indicators of control within a reasonable range."

Reason for the high incidence of chronic kidney disease in recent years, mainly lies in the rise of diabetes, hypertension, obesity patient morbidity. Therefore, to reduce the incidence of chronic kidney disease in patients with primary disease, diabetes, hypertension, obesity, should pay special attention to control the corresponding indicators. "For example, high blood pressure and diabetes, must be controlled, to control their standards, even in peacetime taking antihypertensive drugs and hypoglycemic agents, but also regular monitoring of indicators, the indicators of control within a reasonable range."

Daily life in the prevention and treatment of chronic kidney disease, Wang Shaohua make three suggestions for us in an interview.

1. Chinese medicine often soak feet, do some local hot pocket medication can improve their resistance to help eliminate the disease more.

2. often do "Love kidney operation," Dodo partial kidney, and move back, Events legs, can enhance physical fitness, strengthen kidney function, to clear the veins, blood stasis effect.

3. If there is a patient suffering around diabetes, hypertension, obesity, and urge them to adhere to a lot of scientific and reasonable diet and lifestyle, the various indicators and elements within a reasonable level of control

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things related to iron metabolism of kidney disease

CKD Treatment

things related to iron metabolism of kidney disease
Over the last decade, people in the detection, understanding of iron metabolism in patients with CKD Treatment have made a lot of progress, these developments not only promote the rational use of EPO 141, reducing the dose of EPO (reduced by about 50%), but also improves the EPO effect. Research shows that the majority of CKD patients had varying degrees of iron deficiency, iron deficiency reserve and / or use of barriers hemoglobin iron deficiency or one of the main ESA generate reduced reactivity..

Functional iron deficiency" is more common manifestations of iron deficiency anemia in patients with CKD Treatment has two forms, namely "absolute deficiency" and "functional iron deficiency." Serum ferritin (SF) to reflect the status of iron stores, and transferrin saturation (TS) reflects circulating iron levels can be utilized. CKD generally recommended levels in hemodialysis patients for SF 200-500μg / L, TS levels of 30% -50% is appropriate, for reference. In recent years, some scholars believe that the reticulocyte hemoglobin content (reticulocyte hemoglobin content, CHr) and hypochromic red cell percentage (percentage of hypochromic red blood cells, PHRC,% HRC) may well reflect the state of the body's functions iron; but the domestic detection % HRC and CHr not generally experience less.

More effective ways iron Recent studies show that as a result of poor oral bioavailability of iron, so ESA therapy in hemodialysis patients to achieve target Hb targets (11-12g / dl), most of the required periodic intravenous iron. After intravenous iron after iron and transferrin-binding, can quickly supply the bone marrow; so not only can play a role in ESA's faster, and can reduce the dose of ESA (reduced by 30% -50%), thereby saving medical expenses. At present, the major clinical use intravenous iron sucrose iron (III iron hydroxide sucrose complex), iron dextran, gluconate, iron, etc., similar to the effect of its anemia, but with different iron incidence of adverse reactions vary with sucrose Rail safety

three basics in treating kidney disease anemia

 CKD anemia treatment

Anemia of chronic kidney disease (CKD) in particular, the most common dialysis patients, is also one of the major complications. In recent years, clinical studies have shown that the quality of life in patients with anemia often decrease the prevalence of cardiovascular disease and mortality increased significantly, seriously affecting the prognosis of patients with CKD.

 Treatment of anemia in patients with CKD, mainly in three aspects:
 ① supplement erythropoiesis stimulating agents (erythropoiesis-stimulating agents, ESA), such as recombinant erythropoietin (rHuEPO), darbepoetin α, etc;
 ② active iron to ensure blood supply of raw materials;
 ③ detect and correct a variety of other factors that promote or influence CKD anemia (a variety of inflammation, infection, bleeding, metabolic acidosis, carnitine deficiency, protein malnutrition, etc.).

 In general, the correct application of ESA and iron, is the foundation or basic measures CKD anemia treatment, but not all of the content, and sometimes the effect is minimal, indicating that there is still a "third party" (and other factors) involved. In recent years, ESA, iron metabolism and "other factors" in the study of many new developments are. Keep abreast of these developments, the correct guidance of CKD anemia therapy, to improve the quality of life and survival in patients with CKD, are of great significance.

 A grasp CKD anemia treatment target, correct and standardize application ESA

 Treatment of renal anemia treatment target on target, EBPG think should Hb> 110g / L, for without complications (cardiovascular disease, diabetes) patients with Hb not set an upper limit. Recently, the 2007 US K / DOQI guidelines consider Hb should be up to 110 ~ 120g / L, should not exceed 130g / L. Chinese Medical Association credits kidney disease expert consensus (2010 Revision) Hb target target for 110 ~ 120g / L. In summary, Hb target> 110g / L has become a consensus, if less than this value, the quality of life for patients is poor, prone to cardiovascular events, mortality increases. As Hb target ceiling, currently considered inappropriate> 130g / L, otherwise, the risk of adverse events threaten life may be significantly increased. The different characteristics of the old and new products currently known ESA ESA are mainly three types, of which the first two categories have been used clinically:
 ① recombinant erythropoietin (rHuEPO), the most commonly used, has been in clinical use for 20 years;
 ② long-acting ESA: including darbepoetin α (molecular weight 37,000) and continuous erythropoietin receptor agonist (continuous erythropoietin receptor activator, CERA), etc;
 ③ oral type ESA: such as hypoxia-inducible factor (hypoxia-inducible factor, HIF) stabilizers (stablizers) or HIF prolyl hydroxylase (PHD) inhibitor, FG-2216 and FG-4592, after the completion of clinical trials may market.

 ESA ESA therapy at different stages of treatment can be divided into the correction period (Hb rise for the period) and maintenance phase (Hb after standard) treatment. With rHuEPO, for example, the amount of correction of the initial period, and should be based on the patient's Hb level, Hb target, Hb growth rate and the clinical condition to decide, choose subcutaneous or intravenous administration. The initial dose is generally injected subcutaneously 50 ~ 150IU / (kg.w), to Hb rise month 10 ~ 20g / L as target. rHuEPO dosing frequency depends on CKD staging, clinical condition, effectiveness, ESA type, low frequency administration is more convenient, especially for non-hemodialysis patients. rHuEPO short half-life, should normally be administered 2-3 times a week, 1-2 times a week to maintain the period of administration.