肾脏病已上升为全球十大死因之一。大家对肾病的严峻形势不了解，慢性肾病可防可治，早期治疗效果好，可很多人发现时已经错过了最佳治疗时机。大马人要如何早发现、早预防？肾脏科医生说出心里话，和大家聊聊如何远离肾脏疾病。
肾病的残酷真相
肾脏疾病是无法完全治愈的。更令人担忧的是，四分之三的透析患者在等待合适肾移植的过程中死亡。那些有幸接受移植手术的人，往往会因排斥或移植失败而不得不重新接受透析治疗。
早防早治是关键
“根据一份关于全球肾病护理能力的详细报告（Kidney Health Atlas 2017）指出，全世界有十分之一的人患有肾脏疾病。因此，Columbia Asia 吧生分院的内科顾问医生、肾脏科医生Dr. T Kalaiselvam Thevandran提醒你：唯有早预防、早发现，才是避免加重慢性肾病（CKD）的首要关键。”
怀疑肾有问题怎么办？
肾病是一个“无声杀手”，早期几乎是没有明显不舒服的症状，等到出现不舒服时大多已经是很严重了。因此，早发现、早治疗尤为重要，就可以得到有效的控制及延缓病情。每年最好进行一次健康体检测一测“肾功能”，这一项检查起到至关重要的作用，因为它可检测出任何人、任何阶段的肾脏疾病。格外要注意“肾功能检查”的验尿、血肌酐、GFR肾小球滤过率方面的检查结果，及时了解肾功能状况，争取有问题可以早诊早治疗。
尿常规更是不可忽视，因其检查到尿红细胞、尿蛋白变化，也有助于判断肾功能受损的病因。GFR肾小球滤过率是指肾脏每分钟滤过的血浆量，滤过率越高，表示肾脏功能越好。它是判断肾功能的“权威指标”。测定尿液或血浆中理想的滤过标志物如菊粉、肌酐，而血肌酐是检测肾功能的最常用指标。
Dr. T Kalaiselvam Thevandran医生特别提醒，身患有糖尿病、高血压、肾结石、肾病家族史、尿液异常及老年人这几类人，属于高风险群，应考虑定期做肾病相关检查。例如急性肾病患者每天检查一次以上；如果病况稳定，也可以每月或每年定期检查。
谁是肾病的高风险族群？
- 高血压患者
- 糖尿病患者
- 肾病家族史
- 肥胖
- 50岁以上年长者
- 基因（在非洲、西班牙、土著和亚洲基因人机率较高）
如何诊断出肾病患者？
要确诊为慢性肾病，eGFR值必须低于60mL/min/1.72m2持续三个月以上，或有其他肾脏损害征兆，如蛋白尿、肾脏活检结果异常等。
什么原因导致肾脏衰竭？
根据马来西亚的数据显示，糖尿病、高血压、肾小球疾病、多囊肾病、阻塞性肾病是肾衰竭的主要导因。
急性肾功能衰竭是什么意思？
指肾功能受到急性破坏，导致体内血液中的废物可能会积聚至危险水平。
肾脏健康与糖尿病之间有何关系？
糖尿病，即当血液中的葡萄糖过多时，肾脏可能无法重新吸收血液，导致出现尿糖的情况。若糖尿病控制不佳，可能导致糖尿病肾病，甚至是末期肾病变（ESRD），最后仅能采用肾脏替代治疗。迄今，糖尿病肾病已成为马来西亚末期肾病变的最常见因素，高达 65%。
如果是慢性肾病，透析是唯一的选择吗？
不是。肾脏替代疗法包括血液透析、腹膜透析和肾移植。不过，对于那些不适合透析治疗或移植手术的人来说，保守治疗也是另一种选择。
肾病可以逆转吗？
这取决于肾病或急性肾病的受损程度，很多情况下可能有机会完全恢复；但对于慢性肾病，它是不可治愈的，甚至更大可能会进一步恶化。
哪些生活习惯的改变可以逆转肾衰竭？
以下举例出4种健康生活习惯，可以延缓慢性肾病的恶化：
- 戒烟
- 减轻体重
- 少盐饮食
- 减少摄取蛋白质食物
如何预防肾病？
预防肾病的8项黄金法则：
- 保持健康和活跃
- 稳定控制血糖指数
- 定期监测血压
- 健康饮食、控制体重
- 保持水分充足
- 不吸烟
- 勿定期服用非处方药
- 定期检查肾脏功能
这篇文章首次刊登在《健康时尚杂志/GoodHealth Magazine》
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