Early treatment of polycystic kidney disease?
summary
For the treatment of polycystic kidney disease, it can be said that there are many methods at present. If the disease is serious, it is necessary to carry out surgical treatment and treat the disease correctly. But if you want to achieve good results, the key lies in the patient's cooperation and mental adjustment, as well as appropriate diet treatment and exercise health care. But it can be said that the possibility of early cure is relatively large, therefore, for polycystic kidney, early detection and early treatment should be done. Let's share with you about the early treatment of polycystic kidney disease? Experience in this area.
Early treatment of polycystic kidney disease?
At present, ACEI should be the first choice. Captopril, enalapril, cilazapril, benazepril and perindopril, which are commonly used in China, are mainly excreted by kidney, Although the latter two parts are cleared by the liver and gallbladder, they should be reduced when the GFR is less than 30ml / min. fosinopril is cleared by the liver and kidney in both directions. If the renal clearance rate decreases, the liver clearance rate increases, so that the total drug clearance rate remains relatively stable. It is clinically proved that there is no need to adjust the dose for various degrees of renal insufficiency. Although the first generation of short acting product captopril has more side effects, ACEI can inhibit angiotensin Ⅱ and activate many growth factors. Whether ACEI can inhibit the growth of cyst remains to be further studied. Other antihypertensive drugs, such as calcium channel antagonists, β Receptor blockers and vasodilators can be used, or combined with ACEI.
Second: prevention and treatment of urinary tract infection and renal calculi: effective antibiotics are selected to actively give anti infection treatment. The main purpose is to treat complicated acute pyelonephritis. A few patients are prone to urinary tract infection due to preventive medication, especially in women. If induced pyelonephritis or cyst infection, the renal pain is aggravated with fever, hematuria and pyuria are obvious, Severe cases can lead to urinary tract septicemia, therefore, active treatment must be taken. Antibiotics should be easy to enter the cyst cavity. Macrolide antibiotics, sulfamethoxazole / trimethoprim (SMZ-TMP) and quinolones are easy to enter the cyst cavity of proximal and distal tubules. Penicillins and cephalosporins are often used for cysts of proximal tubules. According to statistics, the incidence of renal calculi and renal calcification in this disease is about 20%. The reduction of urinary citrate may be the cause of easily induced calculi. Calculi can cause urinary tract obstruction, renal colic, hematuria, and aggravate renal function damage. They are also important factors of repeated infection. Drinking more water, frequent urination and urine alkalization are important measures to prevent calculi and calcification.
Third: treatment of intracapsular hemorrhage: large stones or obstruction may cause hematuria, so surgical treatment should be considered. If gross hematuria continues or massive hemorrhage, aprotinin or desmopressin acetate can be used. If necessary, renal artery embolization should be considered. Intravenous or intracapsular injection of aprotinin is the most effective for intracapsular hemorrhage of polycystic kidney, In the absence of aprotinin, batroxobin can be injected intravenously or intramuscularly as well as hemostatic drugs acting on the vascular wall. Intravenous drip of protamine sulfate is also effective.
matters needing attention
According to Hatfield's statistics, among 58 cases in group 1, 32 cases had no symptoms, and 27 cases had an average life span of more than 70 years. The other group reported that the average life span varied from 4 to 13 years after the onset of symptoms. The prognosis of patients over 50 years old was poor. Female patients did not interfere with pregnancy and childbearing process in the early stage of the disease, Polycystic kidney disease is a genetic disease. The possibility of the patient's children carrying the pathogenic gene at birth is 50%. After youth, it is advisable to do all kinds of non-invasive examinations, including family investigation and genetic diagnosis, and early detection of risk patients. As there is no effective treatment for this disease, it is very important to reduce the incidence of polycystic kidney disease, The fertility of patients with polycystic kidney disease is related to the reduction of the incidence of this disease.
