I Can See Health

   Chapter 163 Contrast Nephropathy! (Add more rewards for "Xi Rushui")

  Lu Chen met Wang Jun's gaze.

"I?"

   "Yes, didn't you just say that you are considering acute renal failure?" Wang Jun smiled, "There must be a reason for renal failure, right?"

  Lu Chen glanced at Sun Guoguo, who was beside him, and found that she nodded to him.

   Getting Sun Guoguo's signal, Lu Chen stood up.

   In the doctor's office, most people's eyes were on him.

   Even those classmates who were working were watching Lu Chen from the corner of their eyes.

  I saw Lu Chen said slowly: "Although the patient's renal function has not yet yielded results, but according to the urine output, the patient has no urine within 24 hours, and the diagnosis of acute renal failure is basically clear."

   "The diagnosis is clear, what about the cause of acute renal failure?" Wang Jun continued.

  Lu Chen was silent for a long time.

   Seeing that Lu Chen didn't speak, everyone looked at him silently, waiting for his speech.

   At this moment, all possible factors for acute renal failure immediately appeared in Lu Chen's mind.

  The human body is a very interesting organism, and each organ does not operate independently.

  Blood circulation connects various organs. Once an organ becomes diseased, it is likely to affect other organs and tissues.

   For example, there is a problem with the heart, there is heart failure, not enough blood is pumped out, and not enough blood is flowing through other organs.

   Heart failure may lead to kidney failure.

  If the kidneys are not good, it will in turn have toxic side effects on the heart.

  In clinical practice, it is often said that the heart and the kidney are not separated, and this is the truth.

   Therefore, in the field of cardiology, if there is renal failure, the first thing to consider is the renal failure caused by heart failure.

   However, Lu Chen found that there was something strange about this patient.

  Clinically, to determine whether a patient has heart failure, the most important thing is whether there are symptoms of chest tightness and dyspnea, and then combine the laboratory indicators.

   And this patient named Yang Song, before stent surgery, only had symptoms of chest pain and no symptoms of chest tightness.

   That is to say, before the stent surgery, he did not have heart failure.

   Could it be that after the stent operation, his heart is worse? Heart failure?

   This is a bit counterintuitive.

   The patient is very young, and a stent was placed in time after the onset of the disease. Logically speaking, there should be no heart failure!

  If it wasn't because of heart failure, what could be the reason for him?

   "By the way, he is anuria after surgery!"

   Lu Chen's eyes suddenly lit up.

   Before and after surgery, there is a difference between having surgery or not.

   In other words, the patient's renal failure must be related to a certain factor in the operation!

   And heart stent surgery is an angiography operation, so a contrast agent is bound to be used!

   At this moment, Lu Chenmao suddenly opened up.

   "In general, acute renal failure, there are three major categories of factors."

  Lu Chen spoke, and everyone focused on him.

   "respectively pre-renal factors, renal factors, and post-renal factors."

   "The patient had no urinary tract obstruction, and post-renal factors were excluded; the patient had no major blood loss, no heart failure, and pre-renal factors were also excluded."

   "The only thing left is the renal factor. The patient denies any previous renal disease, and the renal function was normal before surgery, so now there is only one possibility left."

  Lu Chen paused, looked around, and said slowly, "Contrast nephropathy!"

   As soon as he finished speaking, there were whispers in the doctor's office.

   "Why not consider renal failure caused by heart failure?"

   "I think this patient is very young and in good condition before surgery. The probability of heart failure after surgery is low."

   "Contrast nephropathy? Why didn't I think of this?"

   "I have never encountered such a situation in clinical practice!"

   Contrast nephropathy, which refers to a sudden decline in renal function caused by contrast media.

Commonly used contrast agents are generally hyperosmotic, with an iodine content of up to 37%. In the body, they are filtered by the glomerulus without being absorbed by the renal tubules. When dehydration occurs, the concentration of the drug in the kidney increases, which can cause kidney damage and Acute renal failure occurs.

   Cheng Peng glanced at Lu Chen in surprise, and couldn't help muttering in his heart, "It's really amazing, it's indeed Lu Chen!"

   He just heard from the teacher that the contrast agent may cause damage to the kidneys.

   However, it is very rare to actually encounter contrast agents that lead to renal failure.

  Wang Jun looked up and down at Lu Chen.

   This student is not easy.

   For these old clinicians, it is normal to think of the diagnosis of contrast agent nephropathy.

   But for a fledgling student, it is quite difficult to think of contrast agent nephropathy!

   The most important thing is that Lu Chen showed his entire diagnosis and treatment ideas in front of everyone.

   Step by step analysis and exclusion, and finally came to the diagnosis of contrast nephropathy.

   In other words, no matter what the cause of renal failure, Lu Chen could draw conclusions through his own clinical thinking and final analysis.

   "Guoguo, you taught this student?" Wang Jun smiled and looked at Sun Guoguo beside him.

   "Mr. Wang, Lu Chen is a graduate student of Mr. Li Yao this year and has just entered the department." Sun Guoguo smiled.

   "You just entered the department?" Wang Jun was even more surprised.

   He was still a freshman in the first year of research.

   So young, but the clinical mindset is already mature.

"Student Lu Chen, your analysis is very good. I am also considering the possibility of contrast agent nephropathy." Wang Jun read the patient's doctor's order, "When the patient's urgent blood results come out, evaluate the renal function. Persistent anuria, which is likely to require emergency dialysis."

  Dialysis, in short, is the removal of blood from a patient’s body.

   The metabolic waste and excess water are removed by the machine, and then the blood is returned to the human body.

  Cheng Peng glanced at Lu Chen again.

   He remembered that Lu Chen had also said before that the patient was likely to need emergency dialysis.

   "Others, there is no special treatment for the time being. Wait for your superior doctor to return, and then communicate with the patient's family about the condition."

   "Furthermore, after the urgent renal function test results come out, continue to ask our department for consultation."

  Wang Jun wrote the consultation opinion on the computer.

   "Guoguo, then I'll go first."

  Sun Guoguo smiled and sent Wang Jun out of the doctor's office.

   "Mr. Wang, bye bye."

   Finally sent Wang Jun away, and the sense of oppression he brought to the crowd disappeared.

  Lu Chen and Cheng Peng looked at each other and smiled, and both breathed a sigh of relief.

"Junior brother, Mr. Wang was my teacher in the kidney at the beginning. I know that he rarely praises others." Sun Guoguo said to Lu Chen, "Your analysis today won his heart. "

   "Actually, all this knowledge is in the book." Lu Chen smiled modestly.

   "The knowledge in the book is dead. If you use it, it is your knowledge." Sun Guoguo laughed, "Do you still need to hold a medical book to see a patient?"

   Just then, Xia Gang ran into the doctor's office out of breath.

   "Fat man, hurry up! Urgently check the kidney function! Then ask the nephrology department for emergency consultation!"

   Thank you for the reward of Roaring Dragon Breath, I owe one more update, and I will update it tomorrow.

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   (end of this chapter)