Hong Guanyu, Vice President of National Taiwan University Hospital, delivered a public welfare speech to "Hong Junpei Culture and Education Foundation".

Hong Guanyu, Vice President of National Taiwan University Hospital, delivered a public welfare speech to "Hong Junpei Culture and Education Foundation".

(Taiwan Business Daily News) Taiwan has the highest density of kidney dialysis in the world. Recently, a series of food safety issues have aroused public concern. Taiwan Business Daily News and Hong Junpei Culture and Education Foundation on May 11 invited Professor Hong Guanyu, vice president of National Taiwan University Hospital, to give a lecture on "kidney health and happy life," hoping to improve people's knowledge of protecting the kidney.

Many people are afraid of suffering from kidney disease, but they do not know how to detect signs of kidney disease early. Hong Guanyu said that because there are no obvious symptoms at the initial stage of kidney disease, it is not easy for the public to detect, and therefore, only medical examination can see a clue at the initial stage. It is suggested that people should have regular health check-ups, which is conducive to early detection and early prevention and treatment of kidney disease. In addition, understanding albuminuria, hematuria, nocturia or polyuria is helpful for early prevention and treatment of nephropathy.

Hong Guanyu, Vice President of National Taiwan University Hospital, delivered a public speech: kidney Health and Happy Life

1. Albuminuria: if only a single proteinuria does not have clinical significance, the focus is on the persistence of proteinuria, the amount of proteinuria, and the source of proteinuria, whether it is caused by glomerulopathy or renal tubular problems, or even caused by the production of too much protein in the body that exceeds the limit of renal tubular absorption. In the outpatient clinic, there are often patients who seek medical examination because of the discharge of bubble urine when urinating. The examination results do not necessarily have albuminuria, but patients with proteinuria usually have more bubbles and more proteinuria.

two。 Hematuria: unless the urine is obviously bleeding, otherwise if it is some micro-hematuria, it is not easy to find out without urine screening. In addition, only one hematuria does not have clinical significance, but if the patient has persistent hematuria, it must be followed up to find out the cause of hematuria.

3. Nocturnal urination or polyuria: there are many reasons for nocturnal urination or polyuria, but when renal tubule function is abnormal, concentrated urine function is often poor, which can also cause nocturia or polyuria, so examination and regular follow-up treatment must be carried out.

There are often some high-risk groups of kidney disease, including diabetes, hypertension, gout, people with familial kidney disease, people over the age of 65, patients with albuminuria, and drug abusers. These high-risk groups had better conduct regular urine screening and renal function tests, so that they can be detected and followed up as soon as possible.

Hong Guanyu stressed that the early symptoms of kidney disease include albuminuria, hematuria, nocturnal urination or polyuria. Generally speaking, unless urine screening is carried out, these symptoms can easily be ignored, leading to the progression of stage 4 or 5 chronic kidney disease. At this stage, the patient will have edema, anemia, nausea, vomiting, hypertension, poor appetite, itchy skin, pulmonary edema and other symptoms. I'm afraid the condition has deteriorated to a serious level.

Chinese people like to eat salt, and each person eats an average of 15 grams of salt a day, three times the amount recommended by the World Health Organization. Hong Guanyu said that salt contains many electrolytes that the body needs, such as muscle contraction, which requires electrolytes to work. Electrolytes produce electric waves in the body, such as the common ECG waves. When the heart contracts, it needs three different electrolytes: sodium ion, potassium ion and calcium ion to complete the contraction. Many sports drinks on the market emphasize electrolytes. Chen Baichen, a medical doctor, explains that when sweating, not only water is excreted, but also electrolytes are excreted from the body. When electrolytes are insufficient, the muscles become weak, just like gastroenteritis. After a lot of water, the limbs become weak or even unable to stand up, so it is very important to maintain the electrolyte balance in the body when you need to replenish the lost electrolytes after exercise.

Hong Guanyu said that it is generally believed that salt has a germicidal function and will be sprinkled on pickled food because salt sprinkles on the food will dehydrate, making it impossible for bacteria to survive, but when a hole in the mouth is put on the wound, it will not only not be dehydrated, but will also sting; but if the wound is smeared with saline, it will be more comfortable because it contains the same electrolytes as the body. There are many kinds of salt, especially when eating steak with high-grade, beautiful color rose salt or rock salt, these salts contain minerals, but not everyone needs these minerals In particular, refined salt does not contain iodine, and long-term iodine deficiency will cause hypothyroidism. In addition to thickening the neck, it will also cause internal obesity, that is, the so-called puffiness, especially the thyroid gland is closely related to the growth of children. If thyroid function is low, it may not grow tall. more serious may affect intellectual development.

Kidney patients need to pay special attention to salt intake. Refined salt contains more than 99.5% sodium chloride. Consuming too much sodium will increase the burden on the kidneys and raise blood pressure. Therefore, some people design "low sodium salt" which is suitable for patients with hypertension. The composition of sodium is about half, and it is replaced by potassium ion, but poor renal function will reduce the metabolic ability of potassium ion, so kidney patients are not suitable to eat low sodium salt.

The potassium ion in the diet is easily absorbed in the small intestine. In general, the main way of potassium loss in the human body is urine excretion, 80-90% is excreted by the kidney through urine, and a small part (10-20%) is excreted through feces. Usually, the kidney has a regulatory effect on potassium ion, so as to maintain the potassium concentration within the normal range, so as to make the myocardium active and an indicator of electrolyte balance. In addition, the acid-base balance of human blood also has an effect on potassium ions.

Hypokalemia is called hypokalemia when the concentration of potassium ion in human plasma is less than 3.5 mEq/L. The common reasons are decreased uptake, excessive loss, such as diarrhea, vomiting and the transfer of potassium ions from extracellular fluid to intracellular fluid. When hypokalemia occurs in the human body, it will affect the cardiovascular, central nervous system, digestion, urinary and muscle system of the human body. With the severity of hypokalemia, postural hypotension, weak pulse, severe ECG changes, myocardial injury, cardiac arrest and so on may occur in the cardiovascular system. The central nervous system will have burnout, lethargy, confusion, sensory abnormalities, DTR weakening, severe and even coma. Anorexia, nausea, vomiting, worsening of intestinal peristalsis, constipation and severe paralytic intestinal obstruction will occur in the digestive system. Urinary system will have kidney concentration can reduce, urine dilution, polyuria, severe thirst. The muscle system will have weakness, delayed paralysis, respiratory muscle weakness, respiratory arrest and so on.

On the contrary, if the concentration of potassium ion in human plasma is higher than 5.5 mEq/L, it is called hyperkalemia, which is often caused by excessive uptake, decreased excretion or the transfer of potassium ions from intracellular to extracellular fluid. Generally speaking, patients with renal failure are prone to hyperkalemia. When hyperkalemia occurs in the human body, there will be a decrease in blood pressure, arrhythmia, changes in electrogram, severe ventricular fibrillation and cardiac arrest. Neuromuscular symptoms are muscle tremors, spasms, sensory abnormalities in the early stage, and muscle weakness, flaccid paralysis and respiratory arrest in the late stage. In addition, there will be nausea, vomiting, increased intestinal peristalsis, diarrhea, abdominal colic and other symptoms of the digestive system and oliguria, anuria and other symptoms of the urinary system.

In general, if the human kidney function is normal, excessive daily intake of potassium ions can usually be excreted by the kidneys, therefore, proper intake of potassium ions will not cause a burden on the human body. However, in patients with chronic kidney failure, due to the decreased function of the kidneys to excrete potassium, RDA recommends a daily upper limit of 99 mg and recommends reducing the intake of foods high in potassium, and fruits with low potassium content such as water pear, watermelon, pineapple, lotus flower, mangosteen, peach, mango and so on.

▲ newspaper and Hong Junpei Culture and Education Foundation invited Professor Hong Guanyu, Vice President of National Taiwan University Hospital, to give a lecture on "healthy and Happy Kidney Life" on May 11, hoping to improve people's knowledge of kidney protection.

Hong Guanyu, Vice President of National Taiwan University Hospital

Professor Hong Guanyu, Associate Dean of National Taiwan University Hospital, graduated from the Department of Medicine, National Taiwan University School of Medicine. He graduated from EMBA (Finance and Finance Group), PhD, Institute of Clinical Medicine, National Taiwan University, and Master of Management, National Taiwan University. He has served as director and vice president of the teaching department of Banqiao Yadong Memorial Hospital, director and chairman of the Education Committee of Taiwan Kidney Medicine Association, director of Taiwan Medical Nutrition Association, supervisor of Taiwan Hospital quality Association, director of Taiwan Hypertension Society, executive director of Taiwan Arteriosclerosis and Vascular Disease Medical Association, medical consultation and consultation committee of the Ministry of Health and Welfare, health quality policy advisory committee, total consultation representative of health insurance hospital, Member of the Medical Review Council of Taipei Municipal Health Bureau, Deputy Secretary-General of Taiwan Internal Medicine Association, Deputy Director of Internal Medicine Department of National Taiwan University Hospital, Medical Secretary of National Taiwan University Hospital, Director of quality Management Center, Director of Comprehensive diagnosis Department, Chief Editor of Taiwan Nephrology Association Journal, Chief Editor of Medical quality Journal, editorial Board of SCI Journal, etc. He is currently vice president of National Taiwan University Hospital; he has won the Taiwan Revitalization Medicine Award, twice awarded the Taiwan University Hospital Medical Teaching Special Outstanding personnel Award, the Taiwan Internal Medicine Association Best Research Paper Award (the highest Research Award of the Taiwan Society of Nephrology), Professor Chen Wanyu's Outstanding thesis Award (the highest Research Award of the Taiwan Society of Nephrology), the third Taiwan Kidney Medicine Association Research Award, twice awarded the National Taiwan University Hospital textbook Award and other honors.

Hong Junpei Culture and Education Foundation 103 commonweal speech