A definitive diagnosis of renal insufficiency requires a comprehensive evaluation involving blood tests, urine tests, and imaging studies. Treatment includes controlling the underlying disease, adjusting diet, and medication.
1. Blood tests: Serum creatinine and blood urea nitrogen levels are important indicators for assessing kidney function. Creatinine clearance rate can be calculated using a formula and reflects the glomerular filtration rate. Electrolyte and acid-base balance tests help determine kidney regulatory function.
2. Urine examination: Routine urinalysis can detect abnormalities such as proteinuria and hematuria. 24-hour urine protein quantification assesses the degree of protein loss. Microscopic examination of urine sediment can reveal pathological components such as casts and cells.
3. Imaging examinations: Renal ultrasound can assess the size, shape, and structure of the kidneys. CT or MRI can further clarify the nature of kidney lesions. Renal arteriography can assess the condition of the renal vessels.
4. Kidney biopsy: For renal insufficiency of unknown cause, kidney biopsy can clarify the pathological diagnosis and guide the treatment plan.
5. Treatment of primary diseases: Control underlying conditions such as hypertension and diabetes. Autoimmune diseases require the use of hormones or immunosuppressants. Infectious diseases require targeted anti-infective treatment.
6. Dietary adjustments: Limit protein intake to reduce the burden on the kidneys. Control sodium intake to prevent edema and high blood pressure. Ensure adequate calorie intake to maintain nutritional status.
7. Drug treatment: Use diuretics to improve edema. Use antihypertensive drugs to control blood pressure. Use erythropoietin to correct anemia. Use active vitamin D to regulate calcium and phosphorus metabolism.
8. Replacement therapy: End-stage renal insufficiency requires dialysis or kidney transplantation. Hemodialysis and peritoneal dialysis are commonly used methods. Kidney transplantation can significantly improve quality of life.
The diagnosis and treatment of renal insufficiency requires multidisciplinary collaboration, regular follow-up to assess changes in the condition, timely adjustment of treatment plans, slowing disease progression, and improving patients' quality of life.