Zhou Xun Chief physician of Nephrology
Urine protein 1+ or 2+ and urinary occult blood 3+ can be either abnormal urine tests found during medical treatment due to other reasons or abnormal urine tests found during health examinations. No matter what the situation is found, it is considered that it may be a kidney disease. You need to go to the nephrology department for further relevant laboratory tests to clarify the diagnosis, and then give corresponding treatment. This is not the focus of the kidney first. What the kidney first wants to say is patients who have been clearly diagnosed with kidney disease. If urine test still has urine protein or urine occult blood , what will the patient's condition be? We still have many kidney friends who are completely confused about .
The author found that after a period of treatment, many of our kidney disease patients still have 1+ or 2+ urine protein. They will worry about their condition and don’t know what will happen in the future. Will it develop? Will it progress to chronic renal failure or even uremia ?
Similarly, the author also found that many of our kidney patients have 3+ urine occult blood (urinary occult blood) after a period of treatment. They are also worried about their condition and always think that they have not been cured yet, and are afraid that they will develop, and even afraid that they will develop in the direction of uremia.
This is what the kidney first wants to say: the urine protein of kidney disease patients also has 1+ or 2+ and 3+ urine occult blood. Which situation is more worrying?
Before answering such questions, kidney friends should first understand what the meaning of urine protein 1+ or 2+ and urine occult blood 3+?
is different from urine protein 3+: If urine protein 1+ or 2+ is often found, it mostly indicates that the patient's urine protein is not a large amount of proteinuria, but a small amount of proteinuria or medium amount of proteinuria; if urine protein 1+ or 2+ occasionally occurs, and the urine protein is negative or 1+ is more often indicates that the patient's urine protein may be in the normal range or only a very small amount of proteinuria.
is different from urine erythrocyte exceeding the standard: if there is only urinary occult blood (or urinary occult blood) 3+ (there is no urinary erythrocyte exceeding the normal range and no proteinuria), it is only potential bleeding, not blood in the urine in the true sense. The occult blood or occult blood 3+ in the test report are mostly automatically displayed by the computer during routine urine tests, which can only indicate that the urine contains certain components of red blood cells (mainly the iron-related components in red blood cells).
Therefore, in patients with nephropathy, urine protein 1+ or 2+, and it is often the case, and it fails to lower it or turn negative, which mostly indicates that a small amount of proteinuria or medium amount of proteinuria is continuously leaked in the urine of nephropathy patients. That is to say, the patient's 24-hour urine protein quantitative is likely to have been more than 0.3 grams, or about 1.0 grams, or even about 2.0 grams (usually not more than 3.5 grams of large amounts of proteinuria). Such high urine protein is due to protein leaked after nephron injury in patients with glomerulonephritis or tubular interstitial nephritis. At the same time, it in turn causes greater damage to nephron . Only by reducing urinary protein to normal or to a reasonable range can it reduce its damage and impact on the kidneys. Generally, reducing the 24-hour urine protein of patients with kidney disease to no more than 0.5 grams is considered a relatively safe range. Otherwise, it will promote the progressive progress of chronic kidney disease . What is worrying is that it may lead patients to develop in the direction of chronic renal failure and uremia.
Since this is the case, it needs to be treated with medicine. Protein-lowering drugs can be selected according to the specific condition. For patients with glomerulonephritis, first distinguish between primary or secondary. Chronic nephritis and IgA nephritis are primary glomerulonephritis, and allergic purpura nephritis and lupus nephritis are secondary glomerulonephritis. If there are no contraindications for use, both sartan and priligy can have a protein-lowering effect. For urine proteins relatively high (24-hour urine protein quantification ≥1.0 grams), on the basis of using sartan or pril, you can also add drugs such as glucocorticoid and immunosuppressant .In short, urine protein should be lowered as much as possible so that people can truly not worry that it will also harm the kidneys and promote the progression of chronic kidney disease.
Let’s talk about the problem of only urinary occult blood 3+ or urinary occult blood 3+. As mentioned earlier, it is only potential urinary bleeding, not real urinary blood 3+. Patients with kidney disease may experience urinary occult blood or urinary occult blood 3+ during the recovery period of kidney disease or normal people.
Since this is the case, it will not harm the kidneys and people's bodies, that is, it will not cause harm to kidney function, and there is no need to add any medicine to this. Traditional Chinese medicine or Chinese medicine is not needed, and there is no need to use excessive treatment including hormones, triptycodon polygon tablets and immunosuppressants. Therefore, patients do not have to worry about urinary occult blood or urinary occult blood 3+.
was first published simultaneously with the WeChat public account of the same name "Kidney First". The article was original by Zhou Xun and may not be reproduced without authorization.
