I Can See Health

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Lu Chen met Wang Jun's gaze.

"I?"

"Yes, didn't you just say you were considering acute renal failure?" Wang Jun smiled, "There has to be a reason for renal failure, right?"

Lu Chen glanced at Sun Guoguo on the side and found that she nodded to him.

After receiving Sun Guoguo's signal, Lu Chen stood up.

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

Even those classmates who were working were observing Lu Chen with their peripheral vision.

Lu Chen said slowly: "Although the patient's urgent renal function test has not yet produced results, judging from the urine output, the patient has had no urine within 24 hours, and the diagnosis of acute renal failure is basically clear."

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

Lu Chen was silent for a long time.

Seeing that Lu Chen was silent, everyone looked at him silently, waiting for his speech.

At this time, 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, if there is a heart problem or heart failure, the blood ejected is not enough and the blood flowing through other organs is not enough.

Heart failure may lead to kidney failure.

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

It is often said clinically that the heart and kidneys are not separated. This is the truth.

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

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

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

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

In other words, he did not have heart failure before the stent surgery.

Could it be that after the stent surgery, his heart condition got worse? Heart failure?

This is somewhat unreasonable.

The patient was very young, and the stent was placed promptly after the onset of the disease. Logically speaking, he should not have heart failure!

If it wasn't because of heart failure, what would be his cause?

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

Lu Chen's eyes suddenly lit up.

The difference between pre-operative and postoperative is whether surgery is performed or not.

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

And cardiac stent surgery is a contrast-enhanced surgery, so contrast agents are bound to be used!

At this moment, Lu Chen had an enlightenment.

"Generally speaking, there are three major categories of factors for acute renal failure."

Lu Chen spoke, and everyone focused on him.

"They are prerenal factors, renal factors, and postrenal factors respectively."

"The patient has no urinary tract obstruction, and post-renal factors are ruled out; the patient has no massive blood loss, and there is no heart failure, and pre-renal factors are also ruled out."

"The only remaining factor is renal. The patient denies any previous kidney 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, whispers broke out in the doctor's office.

“Why not consider kidney failure due to heart failure?”

"I think this patient is very young, and his condition before surgery is not bad. The probability of developing 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 refers to a sudden decline in kidney function caused by contrast agents.

Commonly used contrast agents are generally hypertonic and contain up to 37% iodine. They are filtered by the glomeruli in their original form in the body without being absorbed by the renal tubules. The concentration of the drug in the kidney increases during dehydration, which can cause kidney damage. Acute renal failure occurs.

Cheng Peng on the side looked at Lu Chen in surprise, and couldn't help but murmured in his heart: "It's really amazing, it's Lu Chen as expected!"

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

However, it is extremely rare for contrast agents to actually lead to renal failure.

Wang Jun looked Lu Chen up and down.

This student is not simple.

For experienced clinical doctors like them, it is normal to think of the diagnosis of contrast-induced nephropathy.

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

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

After step-by-step analysis and elimination, the diagnosis of contrast-induced nephropathy was finally made.

In other words, no matter what the cause of kidney failure is, Lu Chen can draw a conclusion through his own clinical thinking and final analysis.

"Guoguo, did you teach this student?" Wang Jun smiled and looked at Sun Guoguo standing aside.

"Teacher Wang, Lu Chen is Teacher Li Yao's graduate student this year and has just entered the department." Sun Guoguo smiled.

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

He is actually a freshman in the first year of graduate school.

He is so young, but his clinical thinking mode is already very mature.

"Student Lu Chen, your analysis is very good. I am currently considering the possibility of contrast-induced nephropathy." Wang Jun looked over the patient's medical instructions, "Waiting for the patient's urgent blood test results to come out, evaluate the kidney function. If the patient If you have persistent anuria, you may need emergency dialysis.”

Dialysis, simply put, is the removal of blood from the patient's body.

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

Cheng Peng glanced at Lu Chen again.

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

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

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

Wang Jun finished writing the consultation opinions on the computer.

"Guoguo, I'll leave first."

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

"Teacher Wang, goodbye."

Wang Jun was finally sent away, and the sense of oppression he brought to everyone disappeared.

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

"Junior brother, Teacher Wang was my teacher in the kidney, and I know that he seldom praises others." Sun Guoguo said to Lu Chen, "Your analysis today has won his heart. "

"Actually, all this knowledge is available in books." Lu Chen smiled modestly.

"The knowledge in the book is useless. If you use it, it will be your knowledge." Sun Guoguo said with a smile, "Do you still want to treat patients with an internal medicine book?"

At this moment, Xia Gang ran into the doctor's office out of breath.

"Fat man, hurry up! Check your kidney function urgently! Then ask for emergency consultation from the nephrology department!"

For the convenience of reading next time, you can click "Collect" below to record the reading record of this time (Chapter 163: Contrast Nephropathy! (Additional update for "Xishu Shui" Ten Thousand Rewards)), and you can see it next time you open the bookshelf!

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