1. 1, total calorie control: in order to maintain or reach the ideal weight, gout patients should make their own weight lower than the ideal weight 10% ~ 15%. To achieve the latter, the key point is to control the total calorie intake every day. The total diet should be about 65,438+00% lower than the normal diet. Don't eat too many snacks, don't eat too much, and be full at every meal.
1.2, low-protein diet: gout patients should be given 0.4 ~ 0.5g protein/male, and the daily total protein should be controlled at about 40g, and the intake of fish and beans should be appropriately restricted. Every day 1 cup of milk plus 2 eggs or 2 lean pigs can meet the body's demand for protein, but not too much.
2. Diagnosis of gouty nephropathy
The serum uric acid of patients with uric acid nephropathy was significantly higher than that of urea nitrogen and creatinine, and the serum uric acid/creatinine ratio was >: 2.5 (calculated by mg/dl). Gouty nephropathy arthritis is obvious and frequent. Even if the primary glomerular disease has hyperuricemia, arthritis rarely occurs, which may be due to its small response to uric acid. Uric acid nephropathy has a long history, usually only renal tubular function is obviously damaged; However, glomerular function was slightly damaged and renal function decreased slowly. Tophi only appears in patients with primary gout. Birefringent uric acid crystals can be seen in renal biopsy tissue under polarizing microscope, which can establish the diagnosis of uric acid nephropathy.
3. Pathological causes of gouty kidney.
Genetic factors, enzyme gene mutation, such as hypoxanthine-guanine phosphoribosyltransferase deficiency. Acquired factors, abnormal bone marrow hyperplasia, high purine intake, obesity and hypertriglyceridemia, high fructose content in diet, high alcohol content in drinks and exercise. Uric acid excretion decreased. Genetic factors, uric acid excretion or decreased excretion fraction.
What are the early symptoms of gouty nephropathy?
1, the clinical manifestations of gouty kidney may have obvious hypertension and azotemia in the early stage, and 25% patients will have mixed urinary tract infection during the course. Generally speaking, gouty kidney often occurs unconsciously, and the progress is very slow. It often takes 10~20 years for renal failure to occur. There are also about 20% patients complicated with uric acid stones, which can cause renal colic, hematuria or urinary excretion of uric acid stones.
2. Mid-stage gouty nephropathy: Patients entering this stage have obvious changes in urine routine, proteinuria becomes persistent, and red blood cells or casts can be found. Patients may have mild edema and hypoproteinemia. Some patients may have symptoms such as hypertension, backache, fatigue, dizziness and headache.
3. Late gouty nephropathy: edema, hypertension, hypoproteinemia, etc. It is obvious that anemia may occur. The most prominent manifestations are the aggravation of renal insufficiency, the gradual decrease of urine volume, and the progressive increase of urea nitrogen and creatinine, especially in azotemia. Finally, it developed into uremia and renal failure, and it could only be maintained by artificial kidneys. Gout and kidney disease are completely different diseases, but the causes of the two diseases are similar, either because of the pathological changes of some organs or because of long-term bad living habits.
Treatment prescription of gouty nephropathy
1, carrot juice. Take 500 grams of carrots, wash them and add water to juice them. Carrots are slightly warm and can resist gout. Radish is good for joints. Radish "conducts the atmosphere, eliminates pathogenic heat and facilitates defecation". In addition, radish can also prevent cancer, lower blood pressure, help digestion, relieve cough and phlegm, and relieve asthma.
2. Green celery juice. Take 500 grams of fresh celery, wash it, add some water and juice it. Celery is sweet and pungent, cool in nature, and has the effects of clearing away heat, relieving annoyance, calming the liver, promoting diuresis and reducing swelling.