Objective To evaluate the effectiveness and safety of reduced glutathione in the treatment of acute renal failure. Methods Twenty-three patients with acute renal failure were divided into the treatment group (n=10) and the control group (n=13) by simple randomisation. Patients in the treatment group received intravenous reduced glutathione 1200 mg daily. Patients in the control group were not treated with reduced glutathione. The therapeutic course for both groups was 4 weeks. Serum creatinine and urea nitrogen were determined before treatment as well as at the end of each of the 4 weeks. Proximal and distal renal tubular functions were evaluated at the end of the treatment. The time when clinical symptoms were improved was recorded and adverse drug reactions were monitored. Results The durations of nausea and vomiting as well as the oliguria stage were shorter in the treatment group than in the control group. The serum creatinine level in the treatment group decreased more markedly than that in the control group. At the end of the treatment, the renal tubular function was better in the treatment group than in the control group. Conclusion Reduced glutathione contributes to the early recovery of renal function in patients with acute renal failure. However, more high-quality and large-scale randomized controlled trials are needed.
Objective By means of evidence-based clinical practice, to find more effective treatment for a hepatitis B related nephritis patient with renal failure. Methods The following databases as Up to Date (May 2011), The Cochrane Library (Issue 5, 2011), PubMed (1978 to 2011) and CNKI (1978 to 2011) were searched to identify systematic reviews and randomized controlled trials (RCTs) of treating hepatitis B related nephritis with glucocorticoid, immunosuppressor or antiviral therapies, and the quality of collected clinical evidence was evaluated by using GRADEpro software. Results The glucocorticoid or combined immunosuppressors was not recommended for existing adverse effects and not acting on the remission of hepatitis B related nephritis and reduction of proteinuria. However, the antiviral therapy used alone was recommended for acting on the remission of hepatitis B related nephritis and the reduction of proteinuria. In view of adverse effects and expensive price of interferon, the nucleoside analogue antiviral agent was suggested. Considering the renal toxicity of adefovir and tenofovir, and possible drug-resistance of lamivudine, the entecavir (0.5 mg qd) was finally selected with patient’s agreement, and the supporting therapies such as lowering blood pressure, and protecting the kidney and liver were adopted continually. After one month treatment, 24-hour urinary protein got reduced, serum albumin got increased, kidney function got stable, and hepatitis B virus DNA quantity got reduced. Conclusion For treating hepatitis B related nephritis with kidney failure, entacavir can reduce 24-hour urinary protein, raise serum albumin, stabilize kidney function and reduce hepatitis B virus DNA in a short term, but its long-term efficacy still requires further studies.
目的:探讨住院患者急性肾功能衰竭(ARF)的临床病因方法:回顾性分析139例ARF患者的临床资料,探讨其病因、肾衰类型及危险因素。结果:139例ARF患者中,肾前性90例,肾性37例,肾后性12例。其中,60岁以上的老年人73例,占52.5%。引起ARF的根本病因中,感染、心衰及创伤为引起ARF的主要病因。结论:注意有效血容量不足的症状及体征、及时扩容及控制感染可以减少ARF的发生。同时,60岁以上老年人仍是高危人群,应重在预防。
【摘要】 目的 总结急性肾功能衰竭（acute renal failure， ARF）的病因特点、治疗情况与预后的关系。 方法 回顾性分析2007年8月-2008年4月77例ARF的临床资料，总结各种因素与患者预后的关系。 结果 肾性因素是最主要的致病病因，占77.92%，其中以药物和中毒居多。老年患者、少尿型患者或合并多脏器功能衰竭患者病死率较高，分别为25.93%，29.55%，83.33%。 结论 ARF应早期诊断，积极给予综合治疗，包括肾脏替代治疗，老年ARF患者易出现多脏器功能衰竭、合并感染等，应放宽透析指征，并注意去除高危因素以提高存活率。【Abstract】 Objective To explore the clinical features, treatment, and prognosis of acute renal failure (ARF). Methods The clinical data of 77 patients with ARF from Auguest 2007 to April 2008 were retrospectively analyzed. Results Renal factor was the most important cause of ARF, accounting for 77.92%. The mortalities of elderly patients, oliguric patients and with multiple organ failure were 25.93%, 29.55%, and 83.33%, respectively. Conclusion Patients with ARF should be diagnosed as early as possible and given comprehensive treatments, including renal replacement therapy; the elderly patients with multiple organ failure and infection should be relaxed dialysis indications. We should pay attention to the removal of risk factors to improve the survival rate.
目的:探讨腹膜透析相关性腹膜炎的治疗。方法:回顾性分析的89例腹膜透析相关性腹膜炎患者,初期使用头孢菌素和或氨基糖甙类抗生素治疗,严重者使用头孢唑林和头孢他啶治疗。结果:89例腹膜炎患者透析液培养阳性33例(37.1%),其中19例1～4d治愈(21.3%),56例4～14 d治愈(62.9%),复发11例(12.4%),2例因尿毒症而全身衰竭死亡(2.2%)。结论:虽然腹膜透析相关性腹膜炎的发病率有降低趋势,但其仍然是腹膜透析最常见并发症之一,我们在强调对腹膜炎治疗的同时,更要强调对腹膜炎的预防。
Chronic kidney diease has a high incidence. It is a major disease that seriously endangers human health. The integrated management of chronic kidney disease, through etiological treatment of chronic kidney disease, delaying the deterioration of renal function, and the combination of hemodialysis, peritoneal dialysis and kidney transplantation for end-stage kidney disease treatment, is a scientific and effective full-course management of chronic kidney disease. The integrated management of chronic kidney disease is the key to reduce the mortality and disability rates. At the same time, it is a more important and far-reaching task to emphasize early popularization of science, screening, prevention and intervention to reduce the incidence of kidney disease.
【摘要】 目的 探讨开展优质护理服务对早期慢性肾功能衰竭患者治疗的影响。 方法 将2009年9月-2010年6月收治的80名早期慢性肾功能衰竭患者，随机分成对照组和试验组，每组各40例。试验组实施优质护理服务，对照组按常规护理，半年后采用自测健康评定量表（SRHMS V1.0）对患者进行问卷调查，从而了解和评判优质服务对早期慢性肾功能衰竭患者治疗的影响及效果。 结果 试验组在器官功能、日常生活功能、生理健康子量表总分3个维度，在负向情绪、正向情绪、认知功能、心理健康子量表总分4个维度，在角色活动、社会健康子量表总分2个维度与对照组比较，差异均有统计学意义（Plt;0.05），在社会支持和社会资源方面与对照组的差异无统计学意义（Pgt;0.05）。 结论 开展优质护理服务能明显提高患者治疗疾病的信心，对有效控制患者病情发展有一定的影响与作用。【Abstract】 Objective To investigate the impact of quality care on early chronic renal failure patients. Methods Eighty patients in early stages of chronic renal failure in our department between September 2009 and June 2010 were randomly divided into the control group and the experimental group with 40 patients in each group. Quality and Conventional care were implemented on the two groups respectively. Six months later, self-rated health measurement scale (SRHMS V1.0) was used to analyze the impact of quality care on the patients. Results The results of the measurement showed that there were significant differences between the two groups in organ function, daily life function, physiologic health, negative emotion, positive emotion, cognitive ability, psychological health, role activity and social health (Plt;0.05). There were no significant differences between them in social support and social resources. Conclusion Carrying out high-quality care can significantly improve the active treatment confidence of the patients and can effectively control the development of the disease.