Be careful: anemia, behind the mask of kidney disease

Be careful: anemia, behind the mask of kidney disease

Be careful: anemia, behind the mask of kidney disease 

When the expert outpatient service, I met a 32-year old quarry workers xiao wu, half a year to feel fatigue, loss of appetite, diarrhea, complexion is bad, the local hospital diagnosis of nutritional anemia in mines. The patients in the doctor's advice vitamin B12, folic acid and iron after 3 months, there is no better off. 

Detailed inquiry history, when he was young, often catch a cold, hard work and love to drink a little wine at ordinary times, the body a little discomfort is also not too care about, but past symptoms worse. I gave him on examination found that patients was and eye mucous membrane pale; Abnormal laboratory tests routine urine, urine protein 2 "+", urea nitrogen, creatinine, exception; Ultrasound examination revealed bilateral renal have substantial damage. I told the patient that he does not have a iron deficiency anemia caused or what nutrition deficiency, but the result of chronic nephritis, renal insufficiency, is called on medicine "renal anemia. I gave him some medication, and use the RBC auxin subcutaneous injection treatment, after 2 months, his dramatically improve symptoms of anemia. 

Clinically, like xiao wu is main performance of patients with anemia, there are quite a number of misdiagnosed. Because it is generally believed that anemia is caused by malnutrition nutritional anemia, some doctors with folic acid, iron and blood enriching oral liquid, etc. Can have a lot of times, the primary disease symptoms can be hidden, mild, such as the patients, childhood often catch a cold, may be due to a cold repeatedly concurrent light or virus infection aslar-pacific perspective glomerulonephritis, but due to the symptoms of light and didn't care. After a long process, progression to chronic renal insufficiency, and led to the digestive tract as the main symptoms of renal anemia. 

Chronic nephritis occurs when the kidneys or acute and chronic renal insufficiency lesion, erythropoietin levels will drop, patient's ability to produce red blood cells also decreases, so the patient will be showing symptoms of anemia. Combined with no obvious kidney patient medical history, some of the patients are often mistaken for iron deficiency anemia, refractory anemia, aplastic anemia, etc., thus delays in diagnosis and treatment. 

Renal anemia is caused by a variety of reasons cause kidney damage, cause renal insufficiency, renal function decline, reducing discharge metabolites, kept increasing. These toxins can inhibit erythropoietin production on one hand, on the other hand, inhibit the activity of erythropoietin, causing damage to the red cell membrane, shorten the life. At the same time because of the renal insufficiency and long-term anorexia, diarrhea, caused the lack of iron, folic acid, vitamin B12, eventually lead to renal anemia. 

Therefore, remind everybody to raise awareness of anemia, to know the anemia is common symptoms of kidney disease, suspected patients, even in normal circumstances of urine, also should make routine urine examination. Once urine have proteinuria and hematuria, and accompanied by abnormal blood pressure at the same time, often have the possibility of renal anemia, when must continue to do routine blood, kidney and kidney to wait B check, this can be confirmed soon. 

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