Chapter 104 Kidney failure and uremia! (Please subscribe!)
Zhang Yang woke up at dawn.
He couldn't sleep well all night with things on his mind.
But at this time, he felt a little lucky. He impulsively entered the simulator last night and spent one simulation time. Fortunately, the final result was good, and two other symptoms of the patient were discovered——
Heart failure Asthma and nausea and vomiting.
Presumably these two symptoms can give doctors more reference.
Thinking of this, he got up and washed briefly. After everything was done, he looked at the time, which was 7:30 in the morning.
He was thinking about whether to go directly to the hospital, and after thinking for a while, he decided to go there near noon.
After all, early in the morning is when the doctor is busiest, and he is not so anxious about his own affairs. It is not good to mobilize a large number of people and delay the doctor's normal work.
While waiting, the time finally came to 11:30 in the morning, and Zhang Yang appeared in the office of the president of the Third People's Hospital of Chengdu.
Dean Zhou had notified the department directors of the relevant departments in advance. When Zhang Yang arrived, several chief doctors were already waiting in the office.
“Come on, let me introduce you to everyone. This is the model of the times that everyone has been talking about, Mr. Zhang Yang of Qingshan Pharmaceutical.”
“Zhang Yang, let me introduce it to you. Next, this is Director Xiao from the Department of Gastroenterology, this is Director Xu from the Department of Endocrinology, and this is Director Xu from the Department of Cardiology. Director Gao of the department, this is..."
"These are the departments I found that may be involved based on the symptoms you described."
"Oh, by the way. There is also Director Lin from the Department of Nephrology who is still in the clinic, but he will be here in a few minutes at most.”
Zhang Yang nodded, feeling warm in his heart. He could see that Dean Zhou really valued him.
After a while, he stopped being pretentious and immediately got into the topic.
He looked at several chief doctors and said:
"Dear professors, I have recently encountered a very strange disease. When I jog even a little bit, I feel tired and out of breath, accompanied by I suffered from nausea and vomiting. "
"Besides, the most special thing is that I really want to drink ice soda, but after drinking it, I feel the taste and it doesn't quench my thirst at all."
"I wonder if you, professors, have ever encountered similar symptoms in so many years of clinical practice? In other words, which disease may cause these symptoms?"
After the words fell, the four or five chief doctors present suddenly stopped. He frowned, but after a moment, Director Xiao from the Department of Gastroenterology took the lead and said:
“Mr. Zhang, normally, we often encounter problems in the Department of Gastroenterology. Patients with nausea and vomiting, but patients who particularly want to drink ice water are very rare. No matter whether they have gastric problems or enteritis, no patients report that they particularly want to drink ice water.
As for heart failure and asthma, it is not a common disease in the Department of Gastroenterology. , I think digestive system diseases can basically be ruled out."
Zhang Yang also nodded. Vomiting is a common complication and should not be the main cause.
"Our cardiology department may cause heart failure and vomiting."
Director Gao of the cardiology department said:
"Coronary heart disease, myocarditis, and valvular heart disease may all cause heart failure. Vomiting, but really want to drink I’ve never heard of ice water.”
“However, heart failure is actually very common in clinical practice. Many diseases may cause heart failure, the most common of which is kidney disease.”
"Kidney disease?" Zhang Yang's eyes were slightly startled.
"Yes, especially renal failure and even uremia can easily cause heart failure."
Director Gao continued:
"The late stages of kidney disease are generally accompanied by renal hypertension, which will have adverse effects on the heart. It has a very strong impact. If things go on like this, the overload of the heart will lead to heart failure and asthma.”
“After the kidney function is damaged, the ability to drain and excrete sodium decreases, and a large amount of toxins and sodium will stay in the body, which can also cause heart failure.”
“So... in fact, in the end The vast majority of kidney patients die not from kidney disease, but from heart failure.”
"However, I'm not sure whether kidney patients particularly want to drink ice soda. I have to ask Director Lin from the Department of Nephrology."
After the words fell, Zhang Yang nodded slightly, and Dean Zhou frowned at the side. He frowned, and then took out his cell phone to remind Director Lin who hadn't arrived yet.
He was just about to dial the number when the office door suddenly opened and a young figure walked in.
"Director Lin, you came just in time."
Dean Zhou frowned, then turned to look at Zhang Yang, and added:
"Zhang Yang, this is Director Lin Xiang of our Department of Nephrology. Despite his youth, he is a well-known expert in the field of kidney disease at home and abroad."
Zhang Yang looked around and saw that Director Lin was about forty years old. He looks like a traditional high-level intellectual wearing a pair of silver-rimmed glasses.
"Hello, Director Lin."
After a simple greeting, Zhang Yang said without hesitation:
"Recently, I encountered a strange disease. The patient I feel tired and out of breath after even a little trotting, and I also experience nausea and vomiting.”
"The strangest thing is that the patient really wants to drink ice soda, the icer the better; and after drinking it, his thirst is not quenched, and he still has a strong dry mouth."
" Have you ever encountered this kind of disease?"
Lin Xiang was slightly startled.
After a moment, he nodded and replied with almost no hesitation:
"If nothing unexpected happens, it will be uremia, and if you are lucky, it will be kidney failure."
"This situation is encountered a lot in the Department of Nephrology."
Uraemia?
Kidney failure?
Even though Zhang Yang was somewhat prepared, he didn’t expect Lin Xiang to be so sure of his words.
After a moment, he asked in surprise:
"Director Lin, in my impression, shouldn't all patients with kidney disease have edema all over the body and swollen eyelids?"
"This patient does not have edema, can he also have uremia or renal failure?"< br>
Lin Xiang nodded and explained:
"Mr. Zhang, you are right. Most patients with kidney disease will develop edema. It usually starts with swollen eyelids, and then edema of the lower limbs."
"The reason is that the water in the body cannot be excreted through urine. Go, to put it simply, I have no urine.”
"But in reality, many patients with early-stage uremia still have 1500ML of urine every day. They can excrete water, but they cannot eliminate toxins from the body."
"The only way is to wait for their kidneys Only after the complete loss of function reaches the advanced stage of uremia Edema appears. "
"So, in clinical kidney disease, edema is not a criterion for judging whether it is kidney disease, but is only a reference."
Zhang Yang suddenly understood, but...
He asked curiously:
"Is it also a main symptom of uremia or renal failure that patients particularly want to drink iced drinks?"
Lin Xiang pushed up the frames of his glasses and hummed.
“Yes, the vast majority of patients with renal failure and uremia will want to drink ice drinks, but everyone’s degree is different.”
“Well, to be precise, it’s not an ice drink , but ice water, anything ice." "This situation is not only limited to uremia patients. You must have heard of dialysis, right? Even those dialysis patients also have an abnormal desire for ice cubes and ice water. ”
"This desire will not really disappear until a kidney transplant is performed."
Zhang Yang really felt that he had learned a lot, and he became more and more curious.
“Then what is the reason for this?”
“Why do you want to drink when you see it? Even after drinking two bottles, you still feel thirsty?!”
Perhaps Lin Xiang also felt a little thirsty after explaining so much. He paused for a moment, picked up the paper cup on the coffee table and took a sip.
Then he slowly said:
“From the perspective of modern Western medicine, the concentration of toxins in uremia patients and kidney failure patients will increase, and there will be a large amount of sodium, potassium and other ions in the blood that cannot be eliminated from the body.”< br>
“These toxins will affect the osmotic pressure of the body, and after feedback to the central nervous system, the body will be considered to be dehydrated, thus The feeling of thirst stimulates the human body to actively drink water. "
"The colder the water, the more irritating it will be to the nerve center. Therefore, patients with uremia and renal failure do not like to drink ice. The human body’s nerve center is affecting them to drink ice water.”
Zhang Yang exhaled heavily, so that’s it!
No wonder when I was in the simulator, I clearly didn't like Sprite, but the host licked his lips reflexively. This was controlled by the nerve center.
Just when he was about to speak, Director Lin Xiang continued:
"From the perspective of traditional Chinese medicine, the kidneys govern water. If the kidney yin is insufficient, deficiency fire will arise."
“To put it in layman’s terms, if the kidneys are broken and cannot be regulated, the weak fire in the body will run into the stomach and lungs, and the body will become hot and dry, so the thirst will be more intense. Qiang wants to drink ice water."
"The same goes for dialysis patients. Although they are undergoing dialysis, modern technology still cannot remove all substances from the blood, and their own kidneys are also broken, so Only after a kidney transplant is completed and the kidneys return to normal can this central nervous system effect be truly eliminated.”
At this point, Zhang Yang was almost completely sure that the host in the simulator had a high probability of suffering from uremia or renal failure.
It's just that he didn't expect it.
The host's symptoms were not too serious. They were just thirsty and wanted to drink ice water, plus some asthma and vomiting after jogging.
Under normal circumstances, symptoms like this are likely to be considered as a lack of rest or a cold stomach, and they are often not taken seriously.
But the real situation is that it has reached the point of renal failure or even uremia!
"Hey, the concealment is a bit strong."
Zhang Yang sighed inwardly. At this moment, he suddenly thought of the interface during the last simulated settlement last night.
【Discovery: 75%. 】
【Effective clues found: 3/4. 】
Three clues have now been identified, namely: craving for ice drinks, heart failure and asthma, and nausea and vomiting.
So what's the last one?
After a while, Zhang Yang decided to ask Lin Xiang directly while he was here.
After thinking for a while, after sorting out the questions, he asked:
"Director Lin, thank you for your answer. I basically understand it."
"But I still have One last question, in addition to the symptoms I just asked you, do patients with kidney disease generally have any other symptoms? ”
"Yes, urine!" To Zhang Yang's surprise, Lin Xiang immediately answered in the affirmative.
“Urine?”
“That’s right!”
Lin Xiang affirmed:
“Mr. Zhang, in fact, the question you just mentioned is These symptoms are all relatively late symptoms in clinical kidney disease. Symptoms are often discovered and taken seriously, and almost all of them are renal failure or uremia upon examination. ”
"At this point, the kidneys are irreparable and the only options are dialysis or kidney transplantation."
"The real earliest symptom is urine."
"To be precise, It can be said that it is easy to judge whether there is a kidney problem through daily observation of urine.”
Zhang Yang’s expression became serious and he listened carefully.
At this moment, Lin Xiang sighed slightly, with a hint of helplessness in his tone.
"However, firstly, because the physical examination rate in our country has not increased, the detection rate of many early kidney diseases is only 15%;
Secondly, ordinary people do not know much about the popular science knowledge about kidney disease. Even if the urine There were some changes but no attention was paid to them.”
“ Therefore, kidney disease is called a 'silent disease' or a 'silent killer' in the medical community. Once discovered, it is almost likely to be renal failure, uremia, or in the best case, chronic nephritis. ”
The silent killer. ...
It turns out that the node name of the simulator comes from here.
After sighing a little, Zhang Yang brought the topic back to urine.
"Director Lin, when you just said simple judgment through urine, you mean...?"
"This is very simple. The main thing is to observe whether there is a lot of foam in the urine."< br>
Zhang Yang felt nervous and couldn't help but recall the urine when he got up this morning. It was okay, there were bubbles but not much.
Not only Zhang Yang, but also several chief doctors and Dean Zhou in the office couldn't help but recall the situation of his urine in the morning.
After a moment, everyone came back to their senses and looked at each other slightly awkwardly, with a smile appearing on their faces.
The atmosphere in the office relaxed.
Lin Xiang also noticed the change in Zhang Yang's expression and his tone became more relaxed.
"Mr. Zhang, don't worry, you will be fine at such a young age."
After that, he continued to explain:
"The main thing to see in urine is foam, because the kidneys mainly filter toxins and impurities in the human body. If the kidneys function normally, the urine will be basically full of toxins and some impurities, and not other substances."
" Once the kidneys are damaged, the filtration function will decrease. At this time, the proteins in the body will not be filtered by the kidneys and will be excreted from the body with the urine. "
"Once there is protein in the urine, the protein will be excreted. Bubbles will be formed due to the tension of the water, especially those that are cotton Pay special attention to foam that is dense and does not dissipate for a long time. This means that there is protein in the urine and there is a problem with the kidney’s filtration function.”
“If you seek medical examination at this time, it is easy to diagnose! Once kidney disease is under control, it will usually not get worse for more than ten to twenty years. "
"So, the best way to prevent kidney disease is to do a urine routine immediately after you find foam. It costs tens of dollars to do a routine urine routine. If there is no problem, then there is nothing wrong with the kidneys.”
I see.
Zhang Yang fully understood that if his guess was correct, the last clue in the simulator should be urine.
Thinking of this, he looked at Lin Xiang gratefully.
Director Lin not only told him what Jiang Chao's disease was, but even told him the last clue.
After entering the simulator, I estimate that I only need to urinate and find clues to complete the copy simulation.
What will be the reward?
(End of this chapter)