1. Give a diet low in high quality protein 0.6 g / (kg bw · day), vitamin diet, such as eggs, milk and meat and other high-quality protein. Patients should be sufficient caloric intake, usually of 30-35 kcal / (kg · day). Can be used as basic protein necessary for wheat starch plant.
2. Diet low in more proteins essential amino acids or α-keto acid treatment, treatment application note review concentration of calcium α-keto acid, hypercalcemia caution. In the absence of severe hypertension and edema, urine output> 1000 ml / day, salt of 2 to 4 grams / day.
Alternative Treatment time for uremia
When the CRF in patients with CRF 6 ~ 10ml / min (serum creatinine> 707μmol / L) and a clear clinical manifestations of uremia, no remission after treatment, the patient should be prepared mentally prepared for dialysis. Diabetic nephropathy may be appropriate in advance (CRF 10 ~ 15ml / min) arrange dialysis.
(1) Hemodialysis Patients should be made in advance to the arteriovenous fistula (general location in the forearm), fistula maturation requires at least four weeks, it is best to wait for 8-12 weeks before you start drilling. Usually three times a week hemodialysis treatment, every 4 to 6 hours. Six weeks at the start of hemodialysis, uremic symptoms gradually improved. If they can adhere to a reasonable dialysis, most quality of life significantly improved hemodialysis patients, many patients can survive for 15 to 20 years.
(2) Peritoneal dialysis therapy continuous ambulatory peritoneal dialysis (CAPD) applies filtering function and peritoneal dialysis, continuing to clear uremic toxins, simple equipment, easy, safe and efficient operation. Chronically. The medical silicone tube implanted intraperitoneally, applies this tube enter peritoneal dialysis solution, 1.5 ~ 2L increasingly 6 hours after exchange, four times a day. Effectiveness of CAPD uremic hemodialysis similar, but residual renal function and cardiovascular protection than hemodialysis, and the cost is relatively low. CAPD devices and operations have been significant improvements in recent years, peritonitis and other complications have been greatly reduced. CAPD is especially suitable for the elderly, patients with cardiovascular complications, diabetes, pediatric patients with arteriovenous fistula or for those who have difficulties.
2. Kidney transplantation
Patients should normally make a dialysis period, a stable condition and in accordance with the relevant conditions, can be considered for renal transplantation. Successful kidney return to normal renal function (including the metabolic and endocrine function), so that the patient is almost totally recovered. Living donor kidney transplant kidney may corpse or their relatives (siblings or parents for a kidney from a donor), renal transplantation is relatively better. For determination of ABO and HLA appropriate game, based on kidney donors blood group selection. Renal transplantation require long term use of immunosuppressive drugs to combat rejection of common use corticosteroids, cyclosporine, azathioprine, and (o) acetate to mofetil (MMF) drugs etc. In recent years, the efficiency of kidney transplantation improved significantly, the graft survival rate is approximately 1 year 85% 5 year survival rate is approximately 60%. HLA rather than survive longer graft.
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