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Polycystic Kidney Disease& Kidney Cysts

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PKD & Kidney Cysts

Polycystic kidney disease (PKD) is a group of disorders that result from the formation and progressive enlargement of cysts in the kidneys without dysplasia, usually leading to renal failure.

Is Your Kidney Disease Serious? Will It Become Worse? These Two Points Will Tell You

2018-12-02 07:59

Is Your Kidney Disease Serious? Will It Become Worse? These Two Points Will Tell YouThere are two aspects to consider in judging the severity of kidney disease: one is that whether the current condition is serious or not, and the other is whether it will develop seriously in the future.

Judging the severity of the disease is mainly based on the five stages of kidney disease.

In stage 1, creatinine and cystatin C are normal and glomerular filtration rate(GFR) is higher than 90. The main symptoms of the patients are proteinuria, hematuria and edema, and the main treatment is to control renal inflammation.

In stage 2, creatinine level is beyond normal range, but lower than 176. GFR is 60-89. patients have slight kidney function impairment. There are no complications. The main treatment is to control the progression of kidney disease and reduce the risk of cardiovascular disease.

In stage 3, creatinine level 186-442, GFR 30-59. Moderate kidney function impairment. Complications begin to appear. The main treatment is to slow down the progression of kidney disease, and treat complications.

In stage 4, creatinine 442-707, GFR 15-29. Severe kidney function impairment. Severe complications. The main treatment is to control various complications, and do preparation for dialysis.

In stage 5, creatinine over 707. GFR less than 15. Patients have entered uremia stage. The main treatment is dialysis or kidney transplant.

Judging the progress of the disease mainly depends on these five aspects:

1. Serum creatinine level at onset

When kidney disease is discovered, if serum creatinine is within the normal range, the prognosis is mostly good. Even if the kidney function is abnormal, as long as the serum creatinine level is lower than 265 umol/L at the time of detection, it is still possible to stay away from uremia with proper treatment.

If serum creatinine is found to have exceeded 265 umol/L, the risk of uremia is high.

2. The amount of 24h urine protein at onset

If urinary protein is less than 1 gram, illness condition is mild, and the disease progresses slowly;

1-3.5g is moderate proteinuria, and renal damage is progressive.

If the urinary protein is more than 3.5 grams, the condition is more serious, and the renal function decreases rapidly.

In addition, you should see the reaction after medication. If 24-hour urinary protein can be reduced to less than 1.0 g or even less than 0.3 g, its long-term prognosis is also good.

3. The amount of urine erythrocyte

The prognosis of patients with simple hematuria is very good, so the urinary erythrocyte (hematuria) itself can not be used as an index to judge the severity of the disease. Here it does not refer to simple hematuria: proteinuria combined with hematuria (especially gross hematuria), which is generally considered to be more serious.

4. Blood pressure

Kidney patients with normal blood pressure are easier to treat, and the progress of kidney disease is mostly controllable.

At the onset of the disease, if patients with elevated blood pressure, there may be more serious renal pathological changes, and the effect of drugs is often not ideal, so there is rapid decline in renal function.

5. Renal pathological changes

It can be seen from kidney biopsy. For example, IgA nephropathy grade 4-5 is more serious than grade 1-2; Membranous Nephropathy stage III and IV is more serious than stage I and II; the more the amount of glomerulosclerosis is, the more serious the condition is; accompanied by severe tubulointerstitial fibrosis also indicates serious condition.

Here you can quickly see if kidney disease is at risk of progressing to uremia:

Generally speaking, if the systolic blood pressure can be reduced to less than 130 and urinary protein can be reduced to less than 0.5 g after taking medicine, the condition is not too serious and the risk of uremia is very low. On the contrary, more complex comprehensive treatment should be taken.

The above is about primary kidney disease. Secondary kidney disease, such as Diabetic Nephropathy, Hypertensive Nephropathy and Lupus Nephritis are different. If you still have any questions, please leave a message below or contact online doctor.

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