It's a bit dangerous, but I think it's a disease that can show symptoms all over the body."

Wu Jiang Weileng: "What disease can cause a chain reaction throughout the whole body?"

Wu Jiang muttered while thinking.

"Edema, dark urine, anemia, gastrointestinal symptoms, and high blood pressure......

Suddenly, I heard Lin Yi slowly speak:

"I suspect he had nephritis in the early stages, but it dragged on for a long time and caused kidney failure."

"Huh?! Kidney failure? Such a young lad? No way! I see he's only 24 years old on his ID card."

Wu Jiang looked surprised, he couldn't believe it.

Kidney failure for such a young lad??

"That's right, it's not just kidney failure, it's already having early symptoms of uremia."

Hearing this, the more Wu Jiang thought about it, the more he felt that it was possible.

The urine he said was darker than brown and close to hematuria!

There is also edema, renal failure, and early symptoms of uremia.

There are also high blood pressure, anemia, and even bone disease.

These are kidney failure, that is, systemic reactions caused by a kidney strike!

"Oh, when I heard you say that, I think it's kidney failure!"

While the two were thinking, the last patient with a stomach ulcer walked in with a checklist:

"Doctor, my results are out, this is a gastroscopy result, this is a blow test."

Lin Yi took the inspection and looked at it.

There are two gastric maps on the gastroscope list, and two small depressed ulcers appear in each of the folded stomach curves.

Carbon-13 breath test, 30-minute DOB value > 23.0.

Carbon-13 above 4.0 is considered positive.

So this person is a Helicobacter pylori infected gastritis, and then slowly develops into a stomach ulcer.

Helicobacter pylori is not incurable, combined with antibiotic medication, the symptoms will be relieved a lot after half a month.

Also take stomach acid-suppressing medications.

Helicobacter pylori accelerates the secretion of stomach acid, which is why it causes ulcers.

Stick to taking medicine and take care of your stomach, and the ulcer can still be cured.

Lin Yi instructed the patient while prescribing the examination list:

"Go back and take medicine on time, wait a month after a course of treatment and then come back for a recheck, in addition, this disease will be contagious, if you have it, your family will probably have it, remember to bring your family to check it out, and remember to use chopsticks when you go back to eat."

The patient nodded and left the room with the slip.

By the time noon was about to go to lunch, the young man with kidney failure had not returned.

This made Lin Yi a little faintly worried.

From Lin Yi's point of view, this person is indeed kidney failure.

It is also chronic renal failure, and the right kidney is more severe than the left kidney.

I don't know how this young man was so able to endure it in the early days?!

I didn't come to the hospital until there was a very serious hematuria.

Ay!

The more I thought about it, the more I felt sorry.

This lad...... It's not easy to treat!

So Lin Linyi and the two went out to eat,

As soon as I walked out of the consultation room and came to the corridor, I suddenly heard an exclamation:

"Come to the doctor! Help, someone's fainted!"

Lin Yi and Wu Jiang glanced at each other.

The voice......

How is it a little familiar?

It's like the voice of the girl in the morning clinic.

I didn't bother to eat lunch right away.

Lin Yi and Wu Jiang hurriedly ran to the front.

As a result, it turned out to be the guy with kidney failure and the girl who came to the hospital with him.

The guy is falling to the ground with his eyes closed!

The girl was also crouching on the ground and shouting, "Woo...... Doctor, come and see! He's fainted!"

Lin Yi rushed forward with a brisk step.

I found that the young man's carotid pulse disappeared, and he couldn't call it.

Sudden ventricular arrest!

That is, sudden death!

Gotta rush to the rescue!

Lin Yi was doing cardiopulmonary rejuvenation

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Su said to Wu Jiang:

"Hurry up and push the cart over to the rescue room! This man is ventricular arrest!"

When Wu Jiang heard this, he hurriedly borrowed a flat car from the B-ultrasound room next to him.

The two lifted the guy onto the flat car, and Lin Yi ran with the flat car while pressing.

"Quick! Let's get it! Excuse me!"

When the family members passing by saw this situation, they also consciously gave way one after another.

On the other side, the doctor on duty in the emergency room heard the sound of hurried footsteps and the sound of wheels of the flat car.

When I looked out, I saw that it was Dr. Lin and Dr. Wu who were pushing the patient to the emergency room.

The staff on duty consciously pushed the rescue medicine cart over.

"Oxygen, ECG monitoring, intravenous access are all on!"

"One for adrenaline, one for lobelin and one for dexamethasone!"

Lin Yi immediately commanded after entering the rescue room.

"Okay!"

As soon as Lin Yi spoke, the two nurses in the rescue room immediately took action.

When the medicine was injected, the heart rate and breathing increased significantly.

But the heart compressions can't stop yet.

You have to hold on until the guy regains his own heartbeat and breathing.

"Add another lidocaine!"

"Okay."

Six minutes later, the rescue was successful.

The guy's heart was beating on its own.

Lin Yi also breathed a sigh of relief.

Kidney failure does cause sudden death.

And the cause of sudden death is high blood potassium.

The kidneys have two main functions, one is the filtering function and the other is the endocrine function.

The urinary system of the kidneys is like a sieve of the human body.

After the blood passes through the kidneys, the metabolic waste products in it, such as urea nitrogen, creatinine, uric acid, etc., will be excreted with the urine.

Proteins, fats, and other substances remain in the body.

Sift out the bad ones and leave the useful ones behind, so that it is a normal kidney filtration function.

However, when the kidneys fail, the filtration function is impaired, and creatinine, uric acid and urea nitrogen cannot be excreted, and the long-term accumulation of these things will cause acidosis, edema, elevated blood uric acid, and electrolyte imbalances.

Among them, the accumulation of potassium ions and the inability to excrete them will cause high blood potassium.

(High potassium in the blood can easily cause arrhythmias, leading to sudden death.) ）

Then there is the endocrine function.

When the kidneys are damaged, they secrete a substance called renin.

Originally, renin is secreted normally, and it will not cause harm to the human body under normal circumstances.

But once the kidneys are damaged, the blood flow to the kidneys is reduced, and the renal endocrine nerves are dysregulated, and renin will be secreted in large quantities uncontrollably.

When renin is high, blood pressure will also increase, so it becomes renal hypertension.

(This patient was young and had high blood pressure.) ）

In addition to this, the kidneys secrete erythropoietin under normal conditions.

Once the kidneys are damaged, erythropoietin decreases, and erythropoiesis disorders lead to anemia, which is known as renal anemia.

(The cause of this patient's anemia.) ）

In addition, the kidneys also have an important endocrine function, which is to activate vitamin D3.

Most of the body's vitamin D3 is synthesized through ultraviolet radiation.

(Food contains very little D3, so it's better to spend a lot of time in the sun.) ）

After vitamin D3 is produced, it undergoes the first round of activation through the liver.

After the second round of activation by the kidney, the vitamin D3 after kidney activation is truly biologically active.

In order to participate in the body's metabolism, enhance immunity, and promote calcium absorption.

When the kidneys are damaged, active vitamin D is deficient, calcium is malabsorbed.

As a result, various bone diseases, osteoporosis, and so on will appear.

These are a series of reactions in the body that occur after kidney failure.

The patient now has a sudden ventricular arrest, which means that the level of potassium in the blood is exceeded.

The first treatment is to get rid of potassium as soon as possible!

However, the kidneys have been damaged and potassium ions cannot be excreted in the urine, so dialysis is the only option.

And uremia is kidney

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A general term for the symptoms of late stage of failure.

Hemodialysis is the process of filtering harmful substances that cannot be excreted by the kidneys in the blood and then re-infusing them into the body.

"Lin Yi, how could this person suddenly die? Is it really an electrolyte imbalance caused by kidney failure?"

Lin Yi nodded:

"Taken together, several symptoms are indeed very similar to kidney failure, which should be sudden death caused by high potassium after electrolyte imbalance."

After finishing speaking, Lin Yi turned his head to look at his family and asked:

"Did he pee just now? Did you take a urine test?"

The girl cried and shook her head:

"No...... No, I can't pee...... Just a few drops."

"You're his wife, aren't you? Let me make it clear to you first, although we have pulled him back from the ghost gate, the situation is still not optimistic."

After the girl glanced at Lin Yi, she kept shedding tears.

While crying, he begged Lin Yi to save people.

Just then, the patient's blood test results came out.

complete blood count:

White blood cells: 16x10?? /L（(4.0-10.0)x10?? /L）

Red blood cell count: 2.510?? 12（3.5-5.510?? 12）

Hemoglobin measurement: 98 g/L (130-170 g/L for normal men)

After a row of blood routines, it can be basically confirmed that it is anemia.

Hemoglobin measurement is the main basis for confirming whether a patient is anemic.

A normal man with more than 130 is considered normal, less than 120-90 is considered mild anemia, 90-60 is considered moderate anemia, and 30 is considered severe anemia.

Kidney Function:

Serum creatinine value: 588 μl/L (50-120 μl/L)

Glomerular filtration rate: 20/n (90-120/n)

Looking at these two results, it is basically possible to determine the degree of kidney damage and whether it is uremia.

(Urea nitrogen and uric acid values are unstable and are easily affected by other factors, so the diagnosis of uremia is basically based on creatinine and glomerular filtration rate.) ）

The glomerular filtration rate of a normal person is 90-120 per minute.

This guy is actually 20 years old!

Less than 15/n is considered end-stage renal disease, and only hemodialysis is required to sustain life.

Electrolyte:

Potassium ion: 6.8ol/L. （3.5-5.5ol/L）

Sodium: 152ol/L. （135-145ol/L）

Chloride ion: 103.3ol/L. （98-107ol/L）

Calcium: 2.0ol/L. （2.10-2.55ol/L）

Potassium, sodium, and calcium are reduced, which is an electrolyte disorder.

Wu Jiang glanced at the checklist and said:

"Potassium is 6.8! Coupled with the glomerular filtration rate is so low, potassium will definitely not be excreted! How do you get it? Gotta go to dialysis, or this boy will be in danger."

The girl next to her cried again and asked:

"Doctor, what's wrong with him? What kind of illness is he? Is it serious?"

Lin Yi glanced at the girl and said helplessly:

"The initial diagnosis is severe kidney damage, that is, kidney failure, inflammation, and most likely in the uremia stage."

"What...... What? Urine...... Uremia?!"

Uremia is a disease that even those who don't study medicine have heard of.

With such a serious disease, you can't live without a kidney replacement!

Thinking about it, the girl began to cry heartbreakingly.

Crying while lying on the guy's body.

Still muttering in his mouth:

"Woo...... Wake up, woo...... Don't you die...... What should I do if you die......

Lin Yi hurriedly helped her up and comforted her:

"Don't get excited, he's been rescued now. The next first treatment is to get a dialysis treatment as soon as possible.

Otherwise, if there are too many harmful substances in the body and cannot be discharged, it will only get more and more serious, and the same situation will occur just now.

In this way, you go to the payment office to admit to the hospital first,

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We'll arrange for dialysis right away."

The girl snorted and asked:

"Doctor, what about this...... How much do you have to pay for that?"

"Does he have health insurance?" Dialysis is generally more than 500, and if you have medical insurance, you can reimburse it."

"Yes, yes, there is medical insurance."

"Then you don't have to worry, you may pay more than 100 yuan for medical insurance."

Hearing Lin Yi say this, the girl was much more relieved.

Hurriedly took his ID card and went to the hospital.

Soon, Lin Yi also notified the doctor from the nephrology department to come down for a consultation.

The doctors who came were two people, one named Wang Guang and the other Song Feng.

"This is the patient's checklist, blood routine, liver and kidney function, hyperthyroidism and electrolytes, all indicators are abnormal, the preliminary diagnosis of severe renal impairment, does not rule out uremia symptoms."

Lin Yi handed the checklist to Wang Guang.

Behind him, Song Feng quietly glanced at Lin Yi and hurriedly lowered his head.

The gap is getting bigger and bigger, how can Song Feng be embarrassed to compare with others again......

It's better to be a little transparent!

As he spoke, the patient's color ultrasound and CT results also came out.

CT showed no obvious pathological changes in the lungs.

However, there is a problem with color ultrasound, the size of both kidneys is smaller than normal, and the cortex and medulla are not decomposed and thinned, and the reflective intensity of the whole kidney is enhanced.

Lin Yi handed the list to Wang Guang:

"I'm just missing a urine test now, but this guy can't pee, but just looking at the existing test list, I can confirm that he has kidney failure."

Wang Guang nodded while looking at the results:

"Song Feng, you go and inform them, let them quickly take the dialysis machine to the emergency department, do dialysis once, and then send it to the department for hospitalization after the electrolytes are restored."

"Okay!"

Song Feng immediately ran to make a phone call after answering.

Soon, the bedside dialysis machine and the family members who went to pay the bill came.

Wang Guang looked at the girl and asked:

"You're a family member, aren't you? His wife, right? Come here and sign it, he's critically ill now, you have to sign a critical illness notice."

When the girl heard this, the tears fell down again, and after hesitating for a while, she said:

"I can sign it, but ...... But I'm not his wife, I'm a girlfriend, and we're not married."

"What?" Lin Yi was stunned, then he asked if it was his wife just now, but she didn't deny it.

Wang Guang hurriedly urged her to say:

"So, you hurry up and call his family, he is now in a serious condition, do you know about kidney failure? Chronic renal failure and symptoms of uremia have developed.

You must stabilize the condition quickly, otherwise it will be very dangerous.

He is critically ill, and we are sure to go down.

Our hospital also needs a family member who can take responsibility to sign, so you should inform his parents immediately."

The girl asked with a puzzled face:

"I'm his girlfriend, I can call the shots and take risks, so you can let me sign it!"

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