There are so many people undergoing kidney dialysis every year that "the Arena is full"! Doctors reveal the dawn of chronic kidney disease patients: "1 drug" helps reduce the risk of hospitalization death

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There are so many people undergoing kidney dialysis every year that "the Arena is full"! Doctors reveal the dawn of chronic kidney disease patients: "1 drug" helps reduce the risk of hospitalization death

Taiwan has the highest kidney dialysis population in the world! Are the consequences of coexisting with the three highs even worse?

Taiwan is known as the “Fruit Kingdom” and the “Gourmet Kingdom”, but its success and failure are due to its delicious food. Wrong eating habits have turned Taiwan into a “kidney dialysis kingdom”. Many Taiwanese are suffering from chronic kidney disease. bitter. Dr. Wu Maisi, chairman of the Taiwan Society of Nephrology, said that there was a 67-year-old female patient who had long-term problems with three high blood pressure. Ms. Yang, 67, had long-term problems with three high blood pressure. At first, she found proteinuria during a physical examination but did not take it seriously.

Unexpectedly, the kidney function deteriorated rapidly due to the poor control of the three highs. He was diagnosed with stage 3 chronic kidney disease. Since the diagnosis 8 years ago, he frequently visited the emergency room and was hospitalized. This year, he was hospitalized due to hematuria and severe abdominal pain. According to the doctor’s evaluation, the kidney function He was severely damaged and had to undergo kidney dialysis. Another 85-year-old woman who suffered from kidney dialysis also had diabetes and cardiovascular comorbidities. Within 2 years of diagnosis, she was repeatedly hospitalized due to worsening kidney function. When she was hospitalized again this year, she was diagnosed with stage 5 chronic kidney disease and required Undergo kidney dialysis treatment.

The number of new dialysis patients every year is so large that “the Arena is full”! Medical analysis: Chronic kidney disease should be prevented and treated from the source

The number of people with chronic kidney disease in Taiwan has exceeded 2 million, which translates to an average of about 1 in every 8 adults suffering from chronic kidney disease. The incidence and prevalence of end-stage kidney disease have also been the highest in the world for many years. Against this background, The number of new kidney dialysis patients in Taiwan every year exceeds 12,000, which is enough to “fill a small arena.”

Dr. Wu Maisi said that strengthening the prevention and treatment of chronic kidney disease, the source of kidney dialysis, is an important issue to improve the kidney health of Taiwanese people. “If the human body is compared to a big machine, the kidneys are like important parts that help the CPU to debug errors. If the kidneys are not good, the body will easily crash, and even turn this big machine, the body, into scrap metal.”

When the kidneys are damaged due to disease, causing continuous damage to kidney function for more than 3 months, it is called chronic kidney disease. At this time, kidney function is irreversible. Chairman Wu Maisi explained that the decline in renal function caused by chronic kidney disease is closely related to the three major crises of “hospitalization, dialysis, and death”. It not only easily leads to high risks such as heart failure, atherosclerosis, hypertension, and myocardial infarction. Cardiovascular disease, as kidney function deteriorates, will significantly increase the risk of hospitalization and death.

The dawn of treatment for patients with chronic kidney disease? 1 Drug expected to reduce risk of hospitalization, kidney dialysis, death

Dr. Wu Maisi said that the early symptoms of chronic kidney disease are not obvious, and nearly 60% of them are diagnosed in the late stage (stage 3-5). At this time, the kidney function has been damaged and irreversible; the decline in kidney function may accelerate the patient’s hospitalization, Problems such as kidney dialysis and death. Drugs used in the past to treat chronic kidney disease, such as angiotensin-converting enzyme inhibitors (ACEI), angiotensin type 2 receptor blockers (ARB), or Pentoxifylline, are not effective in delaying kidney disease. There are still limits to functional decline.

Fortunately, current SGLT2 inhibitors can help delay the decline of renal function and further reduce the risk of hospitalization, dialysis or death. It is expected to break the nickname of Taiwan’s dialysis kingdom and achieve the vision of chronic kidney disease care. The International Society of Kidney Medicine (KDIGO) also listed SGLT2 inhibitors as recommended drugs for the treatment of chronic kidney disease in the 2023 clinical guidelines.

“In the past few years, patients with kidney disease have gradually benefited from SGLT2 inhibitors. In fact, these are some of the results of decades of hard work and advocacy by the medical community. I believe that in the field of kidney dialysis, we will soon no longer have excretion. “World number one”!”

The glomerular filtration rate & urine protein values ​​are very important! Kidney friends must know “Two Major Kidney Function Indicators”

According to statistics, patients with chronic kidney disease may face an average of two emergency department visits per year due to deterioration of kidney function, and each hospitalization lasts up to 10 days. Moreover, 1 in 5 patients will face another emergency within one month after being hospitalized. Threats of hospitalization and even death. Therefore, for chronic kidney disease patients who are burdened with multiple pressures caused by worsening renal function, how to comprehensively evaluate renal function status through glomerular filtration rate (eGFR) and urinary albuminuria/creatinine ratio (UACR) and detect and treat early, It is the key to the prevention and treatment of kidney disease.

Dr. Zhao Jiade, a nephrologist at National Taiwan University Hospital, pointed out that delaying the deterioration of renal function to further reduce the risk of future hospitalization, dialysis and death is an important goal of chronic kidney disease. For this reason, clinical emphasis is placed on early diagnosis, regular follow-up, active treatment, and risk management. Therapeutic strategies for factor management. For example, kidney disease, diabetes, and cardiovascular disease are inseparable. About 50% of patients with heart failure and 40% of patients with diabetes will suffer from chronic kidney disease at the same time. Therefore, a multi-specialty team model should be arranged to take into account the risk of renal and cardiovascular disease. Comorbid care.

Dr. Zhao Jiade said that considering that chronic kidney disease affects more than just a single organ, taking into account both medication and lifestyle improvements, combined with weight loss, moderate low-protein diet, and blood pressure and blood sugar control, can help patients achieve more stable protection. Kidney function.

Eighty percent of high-risk groups have never received screening! Seek medical attention immediately if you experience symptoms of “water-induced fatigue”

Dr. Zhao Jiade reminded that the factors that worsen kidney function are very complex. Only 20% of patients with known risk factors for kidney disease are screened. He called on those who have three high blood pressure, obesity, smoking, long-term use of drugs without a doctor’s prescription, and advanced age ( People who are over 65 years old), have family history of kidney disease and other high-risk factors should arrange regular kidney function tests. If there are “bubbles (bubble urine), water (lower limb edema), high blood pressure (hypertension), anemia (anaemia), If you have the typical symptoms of “tiredness (tiredness)”, it is recommended to seek medical treatment as soon as possible.

In addition, the “glomerular filtration rate (eGFR)” and “urinary albuminuria/creatinine ratio (UACR)” reported in blood and urine tests during health examinations are easily ignored by the public, but they are two important factors for evaluating kidney function. As a key indicator, it is recommended that the public can refer to the chronic kidney disease risk grading table launched by the International Society of Renal Medicine, and go to the nephrology clinic for medical treatment and arrange corresponding kidney function tracking and treatment plans based on the green light of low risk to the red light of very high risk.

At present, the care of chronic kidney disease is quite complete. There are also drugs that can delay the decline of renal function, reduce albuminuria, avoid hospitalization, dialysis and the risk of death, providing new hope for treatment of chronic kidney disease patients who suffer from repeated hospitalizations.


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