Department of Nephrology, West China Hospital, Chengdu, Sichuan Province.
Doctor Tang picked up the water glass on the table and took a big gulp. The cold tea entered his mouth, making his chaotic mind instantly feel clear.
He looked up at the clock on the wall and found that more than two hours had passed since he sat down.
"I'll get off work in two hours." He muttered, pressed the call button on the table, and quietly waited for the next patient to arrive.
As the mechanical electronic call sounded, the door was pushed open, and a middle-aged woman walked in with a timid girl.
"Please sit down. Are you feeling uncomfortable?"
As Dr. Tang spoke, he glanced around and saw that the middle-aged woman had rough skin and simple clothes. The girl must be her daughter. Although she was young, her face was haggard and her eyes were dull. She must be the patient.
After the girl sat down, the middle-aged woman immediately handed over a test sheet with a flattering smile on her face.
"Doctor, look at my daughter. She is young, has not had a good appetite, and is not feeling well. The child's father keeps saying that it is fine and thinks she is pretentious, but I am always worried, so I took the child all the way to the provincial capital for medical treatment. Well, it shouldn’t be a big problem.”
Dr. Tang showed a kind smile and looked at the test sheet with ease.
"Let me take a look at the test results first. You did it this morning - huh?"
His voice suddenly rose in pitch, and he sat upright, staring at the test form without saying a word.
After a while, a solemn look appeared on his face, and his eyes became stern.
"The creatinine is over 700, and the normal value should not exceed 114umol/L. The girl is thin and thin, and most of them are around 70-80. Your kidney failure is already very serious, and it may be uremia."
"The B-ultrasound also showed a certain degree of atrophy in both kidneys and glomerular sclerosis..." As he spoke, he glanced at the patient's 18-year-old age and couldn't help but shake his head.
The middle-aged woman was frightened and confused: "Doctor, this, this, I don't know. The child has always been fine."
She hugged her daughter and couldn't help but burst into tears: "My life is so miserable, wuwuwu, how could you get uremia when you are fine~"
Dr. Tang sighed and reassured: "In short, kidney failure cannot be cured. I hope it is not late-stage uremia. In any case, we must find out the cause first, and then perform dialysis as soon as possible."
"Dialysis?" The middle-aged woman suddenly burst into tears: "Then if it is uremia, how long can the child live?"
"Don't cry yet!" Dr. Tang said sternly: "This disease is usually suffered by the elderly in their fifties and sixties. It is rare among young people, let alone 18-year-old patients. There must be a special reason. If you think about it, Let’s talk about the development of this disease from beginning to end.”
The middle-aged woman wiped away her tears and fell into memories.
Dr. Tang concentrated his attention, peeled off the cocoon, and began a detective-like interrogation process to find the original disease.
Fortunately, this parent really loved his daughter and remembered many details clearly. After asking, he could easily find out the real culprit.
It turned out that after the little girl started menstruating at the age of 12, she felt excruciating pain every time she had menstruation. Her mother took her daughter to a miracle doctor in the village, who said that dysmenorrhea was caused by poor Qi and blood. After explaining, she asked for a doctor. Secret recipe.
This secret recipe is said to be specially designed to regulate the body and replenish qi and blood. As long as you drink it for a long time, you will naturally no longer have dysmenorrhea after conditioning.
As if the mother had found a treasure, she gave her daughter two bowls of secret recipe decoction every day since she was 12 years old. She drank it continuously until a month ago, every day for 6 years.
"Then show me the prescription." Doctor Tang frowned.
The middle-aged woman shook her head: "There is no prescription. I have to get medicine regularly."
"Uh," Doctor Tang couldn't help but hold his forehead, speechless for a moment.
He suddenly felt the anger of hating iron and steel: "It's just a bowl of herbal decoction with unknown ingredients and unknown efficacy. You let your daughter drink it every day, every month, for 6 years in a row, without seeing a doctor." ?”
“As a result, I now have kidney failure from drinking???”
The middle-aged woman suddenly burst into tears: "There is nothing I can do. My family is in a rural area. I am too poor. My daughter has not been with me since she was a child. I only started to take care of my daughter when she was older. I don't know anything and I don't have the money to see a doctor."
"The child's father said it was fine and blamed me for making such a fuss. I finally raised 3,000 yuan from my relatives before I came to a big hospital for treatment. Woohoo!"
"Doctor, is this dialysis very expensive? I only have more than 2,000 yuan now, and I have to leave 300 yuan for travel expenses. Do you think it is enough?"
"Alas~" Doctor Tang sighed, not knowing what to say.
He also knew that rural women knew nothing and worked outside all year round, so it was no longer easy for them to raise their daughters.
After all, this mother still cares about her daughter. She will find a solution when her daughter is not feeling well, and she also spends a lot of time making decoction every day.
It is foolish to take your daughter to eat the secret recipe, but how can you bear to criticize her harshly?
Dr. Tang had never heard of the rural area where they were located, which showed how remote it was. Apart from the rural health center, the only people there could only go to for treatment were the so-called miracle doctors.
At least this mother cares about her daughter's dysmenorrhea and her inability to eat. She will also run around raising money, and even if she quarrels with her family, she will take her to a big hospital for treatment.
Compared to many who are indifferent to their children, they are already very caring parents.
As for the child's father, he is also ignorant, but he really can't criticize him.
Counting the old man, there are five or six people in the family, farming in the valley, and the whole family depends on him for food, so their life must be difficult.
In his world, keeping the whole family fed would probably take all the effort.
After thinking about it, I don't know who to blame for this girl's tragic life.
If the girl is really diagnosed with uremia, the family will not be able to pay much money at all. Even the 3,000 yuan for this medical treatment was borrowed. I am afraid that it will not even cover the cost of intubation and ostomy.
Even raising funds can allow her to undergo dialysis 10 times? 20 times?
You must know that a uremic patient needs dialysis two or three times a week for more than ten years. How can there be so much charity to allow her to continue doing it.
As for kidney transplantation, it all depends on fate.
Dr. Tang felt a sense of powerlessness in his heart. Even though he had been practicing medicine for many years, he still felt sad to see such a young flower being broken off by someone's own hands and shrinking in front of him.
In particular, no one can blame this situation, because it is not easy for anyone.
This is the case in the real world. When someone is harmed, there may not necessarily be a corresponding perpetrator.
We can only blame the world for being too unpredictable and suffering too much in life.
Doctor Tang sighed again. In just half an hour, he had sighed more than he had in a whole year.
"Uraemia is generally called the silent killer because it develops slowly from early-stage kidney disease. Over a long period of time, the body slowly adapts to it and there are no obvious symptoms at all."
"Only when toxins accumulate to a certain extent, will it cause loss of appetite. It's like all the organs in the body are soaked in toxins, and the same is true for the gastrointestinal tract, so there will be a loss of appetite."
"Let's do this. I'll make a list for you first, get a puncture, and then be hospitalized. I hope it's early and you can still be saved."
The middle-aged woman cried and kept repeating the same sentence over and over: her family was poor and she had no money for dialysis. Even if she was diagnosed, she could only be discharged from the hospital with tears in her eyes.
The daughter sat aside, her expression always numb, and she didn't say a word. Her dark eyes no longer had the agility that belonged to her age, as if she had been drained of all her strength by the disease.
"Hey, let's do this. I'll give you a chance to try the drug in clinical trials," Dr. Tang said, feeling a little distressed and worried: "Sanqing Group has a new drug for the treatment of chronic kidney disease, which has just entered the third phase of clinical trials."
"Uraemia is actually the end stage of renal failure. If your daughter's statistics are not particularly bad, she will probably be in the fourth or fifth stage. She is still young, her body is more resilient than the old men, and she does not have any underlying diseases. She is very Good test subjects.”
"This drug mainly increases the filtration capacity of the glomerulus, which is helpful for the recovery of kidney function. Sanqing's drugs are generally relatively safe and do not have messy side effects."
"The most important thing is that it also gives you money. For the first phase of the experiment, you can get at least several thousand in fees. You can use this money to provide dialysis for your daughter. Free food and accommodation during the experiment. In short, it can alleviate some of your difficulties."
"Do you agree?"
"Great! I agree." The middle-aged woman nodded repeatedly, and a smile suddenly bloomed on her tear-stained face.
"Okay, after you finish the puncture, come to me and sign the consent form."
Doctor Tang sent the patient away, couldn't help but sigh again, and then continued to call the next one.
The next patient was a boy who had just entered high school. He came to see a doctor because he had oliguria and foamy urine. He was suspected of having proteinuria.
The test results showed that creatinine was slightly elevated, and renal puncture revealed that more than half of the glomeruli were sclerotic, and the renal interstitium was in a mess.
Doctor Tang was shocked again.
After careful interrogation, it was discovered that the boy had no family history, no diabetes, or even any underlying diseases. He also loved playing basketball and sports.
However, one thing that makes him very different from other children is that because the conditions at home are so good, his grandparents are keen to give him various supplements.
"My precious grandson has been eating a pound of walnuts, half a pound of red dates, 4 eggs, 2 cups of milk, 2 bowls of ginseng soup, and 5 spoons of black sesame seeds every day for more than ten years."
The child's grandfather said proudly: "I still have to drink the golden partner, Life No. 1, every day. This is not over. I also drink turtle soup once a month and eat the placenta once every six months."
"We eat wild boar, wild venison, wild rabbit and other game from time to time, and we eat seafood every night."
Doctor Tang was stunned for a moment, and his whole body fell into a sluggish state. It took him a long time to react.
After more than ten years of working as a doctor, this was the first time he saw such a weird parent, and he almost burst out with swear words.
No wonder teenagers are showing symptoms of kidney failure at such a young age.
I really suffered a lot from ignorant and fearless parents.
He took a deep breath and said with a serious expression: "The child has a large amount of protein in his urine. You should not eat more of these high-protein foods in the future. Otherwise, the more you eat, the faster the disease will progress. If you don't control it well, you will soon die." It will progress to uremia and require dialysis..."
Before he finished speaking, he was interrupted by his grandfather.
The old man sneered at his words and snorted coldly: "You, a doctor, know what nonsense you are talking about. The child is so young and sick again. He needs to strengthen his nutrition. How can he eat less?"
"Besides, it's not too much to eat. I'm an old man and I'm too weak to take advantage of it. He's so young. The more he eats, the better, and the better his health will be."
Doctor Tang asked unceremoniously: "Then how could the child get sick?"
The old man was stunned by the question, but he still said stubbornly: "I have to ask your doctor."
After saying that, he turned around and shouted at the child's father: "I'm just saying that Huaxi is famous, but its medical skills are not very good. Take your child to Haishi for medical treatment quickly, don't delay the child."
The child's father seemed to be very well-mannered. He kept a smile on his face and did not talk to him. Instead, he asked Dr. Tang repeatedly.
"Is the child's kidney disease caused by taking supplements? Doctor, can you be sure? If you are sure, I will definitely give the child less food."
"This..." Doctor Tang was at a loss for words. As a rigorous doctor, although he was very sure that these high-protein supplements had spoiled the child, he could not directly draw a conclusion. After all, the doctor had to bear responsibility for every word he said. legal liability.
He could only repeat: "These supplements must be excreted by the kidneys after being eaten. Since you already have symptoms of kidney failure, you must not take them anymore. In the future, you must eat a low-protein diet to let the kidneys take a breath. Don't take them anymore." It’s such a heavy burden.”
The child's father nodded, knowing what he was thinking, and turned around and said, "Dad, just listen to the doctor, eat less in the future, and arrange hospitalization first. If dialysis is needed, we can also take care of it."
Dr. Tang was quite satisfied with the parent's attitude. He felt moved and said, "I think the child is still young. As long as he doesn't continue to take supplements, there is still a possibility of recovery."
"By the way, Sanqing has a new drug for the treatment of chronic kidney disease. It is in clinical trials. The drug is very effective. You can give it a try. Maybe you can recover as soon as possible and avoid dialysis."
The child's father was instantly overjoyed: "That's great, thank you doctor, please hurry up and make arrangements."
Doctor Tang smiled slightly and warned: "Then you must listen to the doctor's advice and never take any messy supplements again."
As he spoke, he shook his head with great emotion: "Hey, more and more young people are suffering from uremia now, because they often drink drinks, take supplements, and drink messy decoctions, which damage their kidneys. ”
"Among the patients I saw this week, there were several who suffered from chronic kidney disease in their teens, all for the same reason. The disease enters through the mouth. You parents, you must pay attention to it in the future."
The patient's parents nodded in agreement, and even the old man shut his mouth and no longer insisted on his theory of supplements.
After sending the high school students away, Dr. Tang saw a few more middle-aged and elderly patients before ending the outpatient clinic.
In the following period, as he said, more and more young people came to see the nephrology department.
Moreover, when many people are diagnosed, they have already reached the mid-to-late stage and developed uremia.
This depends on the onset characteristics of chronic renal failure. It is characterized by an insidious onset. There may be no symptoms in stages 1-3 of chronic kidney disease. Some patients who are careless or skinny may not even have obvious discomfort in stage 5. You can call it a silent killer.
There is an inappropriate metaphor: a dog that doesn't bark bites people, making it difficult for people to guard against it.
To identify it early, there is a very simple and economical method: urine routine + renal function test + renal B-ultrasound.
According to the low price of a tertiary hospital: 7+20+80=107 yuan, once a year, no matter what kind of kidney disease, it can definitely be screened out early.
Unfortunately, many people do not have this awareness.
Because chronic kidney disease has another characteristic, it develops slowly. Therefore, even if many people check it every year, even if the indicators are abnormal, the difference is not big. They are not uncomfortable and are unwilling to treat them. They even suspect that the doctor is deliberately scaring them, and then warm water Boil the frog and procrastinate beyond control.
By the time chronic kidney disease gradually develops into uremia, it is already too late!
When Dr. Tang sees young patients with kidney disease, he will recommend them to participate in clinical trials of Sanqing’s new drugs.
Because young people are very sick because they eat too much, causing damage to their kidney function. If treated early, they are more likely to recover.
Unlike middle-aged and elderly people who have chronic underlying diseases, even if there is a kidney problem, high blood pressure, diabetes, etc. must be treated first before it can get better.
In comparison, young people experience faster results and are suitable for participating in clinical trials.
Facts have also proven this. After two courses of treatment, the conditions of the young patients who participated in the trial improved and were getting better every day.
