Treatment of chronic nephritis need to control how the treatment of chronic nephritis?

Treatment of chronic nephritis

1. Active control of hypertension and reduce urinary protein

Hypertension and urinary protein is to accelerate glomerular sclerosis, promote the deterioration of renal function is an important factor in active control of hypertension and reduce urinary protein is two important links. Chronic nephritis often caused by sodium-water retention capacity-dependent hypertension, so patients with hypertension should be limited to salt (NaCl <6g / d); can use thiazide diuretics such as hydrochlorothiazide.

Ccr <30ml / min, thiazide ineffective use loop diuretics, but generally not too much, long-term use. ACEI or ARB in addition to reducing blood pressure, but also to reduce urinary protein and renal function deterioration of renal protection, for the treatment of chronic glomerulonephritis and / or reduce urinary protein drug of choice. Usually to achieve the purpose of reducing urinary protein, the application dose often need to be higher than the conventional antihypertensive dose. Renal insufficiency patients with ACEI or ARB to prevent hyperkalemia, serum creatinine greater than 264μmol / L (3mg / d1), be sure to closely monitor serum creatinine, potassium, to prevent side effects.

In addition to the above methods of controlling hypertension, we can also be combined with the above method of treatment, or select some of the β-blockers for treatment.

2. Limit protein and phosphorus in food intake

Renal insufficiency azotemia patients should limit the amount of protein and phosphorus intake, the use of high-quality low-protein diet or the addition of essential amino acids or α-keto acid.

3. Glucocorticoids and cytotoxic drugs

In view of chronic nephritis, including a variety of diseases, so whether the application of these drugs should be treated differently. But patients with normal renal function or only mildly damaged, normal renal volume, pathological type of light (such as mild mesangial proliferative glomerulonephritis, early membranous nephropathy, etc.), urinary protein more, if no taboos can try, invalid Were gradually removed.

4. Anticoagulation, fibrinolysis and anti-platelet depolymerization drugs

Such drugs can inhibit fibrin formation, platelet aggregation, reduce complement activity, but the effect is not sure.

5. To avoid aggravating kidney damage factors

Patients with chronic nephritis, in peacetime life, but also pay more attention to life washed, to avoid some infection or exertion of the situation, which may lead to deterioration of renal function.