Zhou Xun is the chief physician of the Department of Nephrology.
According to the spokesperson of the National Health Commission, acute respiratory diseases in China have been on the rise recently. Surveillance showed that the causative agents of this wave of respiratory tract infections were mainly influenza viruses, but also rhinovirus, Mycoplasma pneumoniae, respiratory syncytial virus and adenovirus. During the respiratory disease season, multiple pathogens coexist, and the main pathogens circulating in different age groups will also be different. In general, children aged 1-4 years, in addition to influenza virus, have rhinovirus;Children aged 5-14 years are mostly influenza virus, mycoplasma and adenovirusPeople aged 15-59 are mainly influenza virus, rhinovirus and new coronavirusThe elderly over 60 years old will be infected with all kinds of pathogens, as well as human metapneumovirus and common coronavirus.
However, for our group of patients with kidney disease, due to the widespread poor immune function, various pathogens such as influenza virus, rhinovirus, Mycoplasma pneumoniae, respiratory syncytial virus, adenovirus, new coronavirus and common coronavirus may be infected, and a small number of kidney friends may also have two or more pathogens superimposed infection. Despite this, the vast majority of infected people present with mild symptoms of upper respiratory tract infection. Therefore, even if chronic kidney disease is combined with such acute respiratory infections, there is no need for kidney patients to panic.
So, in the face of menacing acute respiratory diseases, how should patients with kidney disease cope?
1.All kidney patients must take personal protection
Regardless of the pathogen of acute respiratory illness, the main route of infection is droplet and contact transmission. Therefore, personal protection is still the most effective measure. Our friends with kidney disease should reduce crowd gathering areas as much as possible, wash hands frequently, ventilate more, wear masks and maintain a safe social distance.
2.Develop good Xi habits and physical exercise
In normal times, kidney friends should develop good living Xi, such as regular work and rest, reasonable diet, moderate exercise, etc. Regarding exercise, kidney patients can choose the appropriate exercise method and moderate exercise intensity according to their physical condition, such as brisk walking, jogging, yoga, tai chi, swimming and dancing, etc., and insist on half an hour to one hour a day or at least three days a week, so as to achieve the purpose of enhancing physical fitness and disease resistance.
3.Most infected people only need symptomatic treatment or antibiotics
Most patients with acute respiratory tract infection are mild, only showing symptoms of upper respiratory tract infection, such as itchy throat and sore throat, cough with less phlegm, fever and headache, nasal congestion and runny nose and poor appetite. Patients with mild symptoms are mainly symptomatic support**, such as throat lozenges, cough suppressants, antipyretics, and cold capsules, with the addition of non-nephrotoxic antibiotics if necessary.
4.Most infected people do not need to stop taking drugs for pronephropathy
Since most patients with acute respiratory tract infection are mild, all the original drugs of patients with kidney disease do not need to make major adjustments and changes, and the original regimen can be continued, such as the original hormone dosage can remain unchanged, the original immunosuppressant does not need to be stopped, the original antihypertensive drugs do not need to be increased or reduced, and the original Chinese patent medicine and other auxiliary drugs can also be stopped. However, if the original planned drug adjustment (eg, corticosteroid or immunosuppressant taper) is scheduled, it is often necessary to postpone the adjustment.
5.Patients with severe infection may need to adjust their medications for kidney disease
A small number of patients with acute respiratory infection can develop severe conditions, which can be divided into two conditions: one is that the acute respiratory infection itself is not serious, but causes kidney disease** or exacerbation, such as nephrotic syndrome** or rapid increase in serum creatinine in chronic renal insufficiency;On the other hand, the concurrent acute respiratory illness is not mild in itself, but even severe or critical. This belongs to the "serious infection", in these cases, patients need to adjust kidney disease-related drugs, usually still need to actively ** acute respiratory diseases first, while paying attention to the basic drugs for kidney disease, non-mild infections should reduce the dosage of hormones or stop immunosuppressants, kidney disease ** after the acute respiratory infection control improves, and then re-* kidney disease. All of these medications should be decided by a specialist in the hospital.
Winter respiratory tract infection hotspotsThe article is original by Zhou Xun and shall not be authorized **.