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Management of cardiorenal syndrome in patients with chronic kidney disease

Chinese Journal of Practical Internal Medicine.2001;0(02):-.

Chronic kidney disease(CKD)coexisting with cardiorenal syndrome(CRS)can be frequently seen in clinic,especially in older patients.The guidelines for clinical management of the condition include:typing of CRS according to reasons for cardiac and renal function impairment and symptoms,accurate understanding of the disease aggravation,correction of anaemia,fluid overload or sodium retention and diuretic resistant.Angiotensin-converting enzyme inhibitors,?-blockers and cardiac glycoside are safe and effective for those patients,but they should be used with caution and the patients need to be monitored closely.The long term effect for CRS needs to be studied by more and prospective clinical trials.

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Cardiovascular disease caused by chronic kidney disease

Yipu CHEN

Chinese Journal of Practical Internal Medicine.2001;0(02):-.

Chronic kidney disease(CKD)is a high risk factor of cardiovascular disease(CVD).This paper introduces the coronary atherosclerotic heart disease,uremic myocardiopathy,uremic cardiopericarditis,stroke and peripheral arterial disease in patients with CKD.

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Strategies for treatment of anemia in patients with chronic kidney disease

Xuefeng SUN

Chinese Journal of Practical Internal Medicine.2001;0(02):-.

The paper reviews the causes of the anemia in patients with chronic kidney disease(CKD)and focuses on the diagnosis.Meanwhile,we also systematically introduce the treatment strategies for patients with anemia and CKD,especially for the reasonable clinical application of erythropoiesis-stimulating agents(ESAs)and iron.The problems in diagnosis and treatment of anemia in CKD patients are also proposed.The objective of this paper is to standardize the clinical diagnosis and treatment of anemia in CKD patients,so as to promote the treatment of CKD in grassroot hospitals.

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Strategy for treatment of hypertension in patients with chronic kidney diseases

Shanyan LIN

Chinese Journal of Practical Internal Medicine.2001;0(02):-.

Hypertension control is the most important and effective treatment for chronic kidney diseases.Compared with hypertension patients without kidney diseases,it requires a stricter blood pressure control in those with kidney diseases.The treatment principles are:(i)To lower the blood pressure is the top priority;and(ii)the impacts of various antihypertensive drugs on individual patients.The antihypertensive drugs should be chosen taking into consideration of the following factors:the extent of hypertension,whether the hypertension occurs abruptly or permanently,the heart and renal functions and any significant metabolic disorders.Among the existing drugs,diuretic is usually hampered by renal dysfunction;ACEI/ARB seems to be more effective on patients with proteinuria,but it should be used with caution in patients with severe renal insufficiency;CCB is effective and can quickly lower blood pressure,therefore it is an essential drug for hypertension treatment;?-blocker is not considered as a main drug for hypertension with kidney diseases.Combination use of anti-hypertensive drug is common to many CKD with hypertension,among them ACEI/ARB+diuretic,ACEI/ARG+CCB are the most common combinations.ACEI+ARB exhibit a better proteinuria reduction effect;however it is not indicated in patients with severe cardiovascular lesion.Hypertension treatment should take into consideration of individual differences and should be adjusted according to individual responses.Salt intake control also plays an important role in the successful treatment of hypertension with kidney diseases.

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Diabetes and osteoporosis

Qi PAN ; Lixin GUO

Chinese Journal of Practical Internal Medicine.2001;0(10):-.

Diabetic Osteoporosis is a general metabolic bone disease having fracture tendency because of osteopenia in unit volume,microstructural changes of bone tissue,decreased bone strength and increased friability,which is one of important complications of diabetes mellitus in skeletal system.Studies on bone involvement in patients with diabetes mellitus have generated conflicting results,largely because of the pathogenetic complexity of the condition.There are many factors,including advantageous and disadvantageous factors,influence the probability of osteoporotic fractures in diabetics.Adequate glycemic control,and calcium and vitamin D intakes,and the prevention and treatment of diabetic complications are key elements in the elimination of osteoporosis in diabetes mellitus.Patients with osteoporosis and diabetes should be offered the same pharmacological treatments as non-diabetics.

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Summary of clinical application of macrolide antibiotics during 25 years and its development in common diseases

Azuma ARATA

Chinese Journal of Practical Internal Medicine.2001;0(10):-.

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Optimal time of the use of non-invasive positive pressure ventilation on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

Yan JIA ; Wanzhen YAO ; Lina SUN ; Baona GUO

Chinese Journal of Practical Internal Medicine.2001;0(10):-.

Objective To evaluate the optimal time of the use of non-invasive positive pressure ventilation on the patients with acute exacerbation of COPD(AECOPD).Methods 131 patients were divided at random conventional therapy group(control group)and conventional therapy plus NIPPV group,the patients of NIPPV group were again divided into PaCO2≥9.31 kPa,7.98～

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Evaluation of Guideline for Treatment of Non-Hodgkin's Lymphoma in NCCN 2009

Jun MA

Chinese Journal of Practical Internal Medicine.2001;0(10):-.

Non-H Lymphoma(NHL)is a heterogenous group of lymphoma which originates from B lymphocytes,T lymphocytes and Natural Killer cells.Every year,many very famous specialists of Hematology in the world come together to update the guideline of NHL for National comprehensive Cancer Network(NCCN).The guideline updated by NCCN is obtained good evaluation by clinical doctors in the world.This article makes a brief comment for the category,diagnosis and treatment of all subtypes NHL in V.I.2009 compared with V.I.2008.

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The diagnosis and therapy of pheochromacytoma

Guang NING

Chinese Journal of Practical Internal Medicine.2001;0(10):-.

The definition of pheochromacytoma is the tumor derived from the adrenal chromaffin cell excessive producing catecholamines.Until now,the urine and plasma metanephrines(MNs) determined by HPLC-ED is considered as the first choice for the biochemical diagnosis of pheochromacytoma.According to the clinical pathway,the location of pheochromocytoma is determined by imaging methods including CT,MRI and PET,however,123I-MIBG is a more specific method for location of the tumor.The candidate genes screening including RET,VHL,SDHD,SDHB and NF1 have been recommended.The surgery to remove the tumor is the first choice for curing of pheochromacytoma.

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The evaluation of cognitive function in patients with obstructive sleep apnea hypopnea syndrome by expansive scale of dementia

Bing WEI ; Xiuhong NIE ; Lianguo ZHANG ; Kui REN

Chinese Journal of Practical Internal Medicine.2001;0(10):-.

Objective To asscess cognitive changes of patients with Obstructive Sleep Apnea-Hypopnea Syndrome(OSAHS)by the Expansive Scale of Dementia(ESD),and to compare ESD to Mini Mental Status Examenation(MMSE)in cognitive function.Methods 90 OSAHS patients were investigated in our study.All patients were divided into three groups,according to apnea-hypopnea index(AHI),including mild group,moderate group and severe group.The cognitive function was evaluated by MMSE and ESD.Results The parameters,including AHI,Longest apnea time(LAT)and percentage of time spend when oxygen saturation lower than 0.9(SLT 90%) in severe OSAHS group were significantly higher than those in mild and moderate groups(P0.05).The total score of MMSE and subtest scores of MMSE in memory,attention,calculation and short-and long-term memory were significantly lower in severe OSAHS group than those in mild and moderate groups(P0.05).Conclusion There was the obvious decrease in cognitive function in patients with severe OSAHS,especially in leaning,memory,calculation and constructive function.Both ESD and MMSE could be used to evaluate the cognitive function in OSAHS patients,especially ESD.

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