How to reduce edema caused by nephritis?

The human kidneys play a very important role in the human body. The kidneys are able to excrete metabolic products. If there is a problem with the kidneys, it will cause changes in kidney tissue, thereby reducing the person's kidney function. For patients with general kidney disease, the most obvious symptom is edema. Nephritis edema is a very common type of edema, and the harm caused by nephritis edema is generally very serious. How do patients with nephritis generally reduce swelling?

The edema caused by kidney disease usually does not disappear for no reason, and will gradually worsen if not treated. It first occurs in areas where tissues are loose, such as the eyelids and face, and is more obvious in the morning, and gradually develops to the ankles and lower limbs. In severe cases, the disease affects the whole body. The edema is soft and movable, and may be pitting or non-pitting. It is often accompanied by other manifestations of kidney disease, such as hypertension, proteinuria, hematuria, and renal function impairment, which can be easily diagnosed by clinical examination.

Treatment of renal edema

1. Diuretics can reduce swelling and promote diuresis

For renal edema, the main loop diuretics include furosemide, bumetanide and torsemide. When using these drugs, be careful to prevent the occurrence of hyponatremia, hypokalemia and hypochloremia alkali poisoning.

2. Osmotic diuresis

By transiently increasing the plasma colloidal osmotic pressure, water in the tissues can be reabsorbed into the blood. In addition, they are filtered through the glomeruli, causing a hyperosmotic state in the renal tubules, reducing the reabsorption of water and sodium and causing diuresis. Low molecular weight dextran or 706 generation plasma is usually given by intravenous drip every other day, followed by the addition of a loop diuretic to enhance the diuretic effect. However, it should be used with caution for patients with daily urine volume less than 400 ml, as it may induce osmotic nephropathy and lead to acute renal failure.

3. Increase plasma colloid osmotic pressure

Intravenous infusion of plasma or plasma albumin can increase plasma colloid osmotic pressure, promote water reabsorption in tissues and cause diuresis. The effect will be better if diuretics are used after protein infusion. Since the injected albumin will be excreted in the urine within 24 to 48 hours, it can cause glomerular hyperfiltration and tubular hypermetabolism, resulting in damage to the glomerular visceral epithelial cells and tubular epithelial cells, and promote renal interstitial fibrosis. Therefore, the indications should be strictly followed and its use can be considered for patients with severe hypoalbuminemia, severe edema and oliguria when diuresis is necessary.

The principle of diuresis for renal edema is that it should not be too fast or too strong, so as to avoid insufficient effective blood volume, aggravating the tendency of blood hyperviscosity, and inducing thrombosis and embolism complications.