Must I Do Double Kidney Color Doppler Ultrasonography2019-05-05 15:30
Acute renal failure, if found in a timely manner after regular dialysis, often can return to normal life, to achieve the cure of the disease. For chronic kidney disease, it is easy to develop End Stage Renal Disease.
So, how does the clinician judge the acute or Chronic Kidney Disease?
For this problem, some people may say: to see whether the kidney is bigger, if the double kidney color Doppler ultrasound examination shows that the kidney is bigger, can determine that there is no risk of chronic renal failure in kidney disease. But is that really the case?
Here I have to mention a very important examination item in nephrology: kidney color Doppler ultrasound.
Normally, normal adults have a range of kidney size: 10-12 cm long, 5-7 cm wide and 3-5 cm thick. Doctors will be alert if they find that the kidney size of the patient is not within the normal range.
In nephrology, the size of the kidney is not within the normal range, which mainly involves two aspects:
1. Reduction of both kidneys
When kidney color Doppler ultrasonography showed that the kidneys of patients were significantly reduced and the kidney structure was disordered, it was mostly attributed to the progress of chronic renal function, and the course of nephropathy was generally very long.
Clinically, bilateral kidney shrinkage and atrophy often occur in patients with chronic renal insufficiency or uremia stage, and bilateral kidney atrophy is also one of the signals predicting patients to prepare for dialysis.
2. Enlargement of both kidneys
The enlargement of both kidneys is also an abnormal pathological phenomenon of nephropathy, which is mainly related to acute renal failure or acute renal injury. Nephrotic emergencies resulting from this need to be hospitalized for diagnosis and treatment.
Clinically, double kidney color Doppler ultrasound shows enlarged kidneys, which may be related to the following diseases:
(1) Urgent nephritis: the condition is very dangerous, need to identify the cause of disease, targeted treatment;
(2) Acute glomerulonephritis: more common in children, the possibility of cure is high;
(3) Acute interstitial nephritis: often associated with drug and toxicant-induced kidney damage, the etiology needs to be clarified;
(4) Renal amyloidosis: It is rare in clinic and difficult to treat.
(5) Early stage of diabetic nephropathy: most of them occur in middle-aged and elderly people, and early prevention and control is the most important.
(6) Lupus nephritis active stage: female patients are more, disease risk coefficient is high;
(7) Polycystic kidney disease: polygenetic attributes, the late need for long-term dialysis;
(8) ANCA-associated vasculitis with renal damage: relatively rare, in recent years began to increase;
In addition, often mentioned hydronephrosis (associated with stones and cysts), kidney abscess (associated with bacterial infections) and other conditions, may also occur double kidney enlargement phenomenon.
These kidney diseases are mostly in the acute progression or active stage of the disease. They need hormones and/or immunosuppressive drugs to treat them. Some need dialysis to protect the kidney unit and prevent the deterioration of renal function. Once the treatment is not timely, the prognosis is very complex, some will develop into chronic renal failure, uremia, and eventually face the dilemma of long-term dialysis.
If the kidney is enlarged due to the discharge of the above-mentioned diseases, and the diagnosis of primary nephrotic syndrome is caused by bilateral kidney enlargement, there is no obvious abnormality in renal function. At this time, timely use of hormones and Kidney-Protecting drugs to standardize treatment, the prognosis is generally good.
All in all, the kidneys are not big enough, nor small enough. Whether nephropathy is going to uremia or not, we should not neglect double kidney color Doppler ultrasound, a non-invasive examination of the kidney!
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