These 4 golden nursing rules, lupus nephritis patients have to know!

Lupus nephritis is the most common secondary chronic glomerular disease in China, and it is also a serious complication of systemic lupus erythematosus, clinical statistics show that about 40%~60% of SLE patients will develop lupus nephritis [1].

The severity of renal lesions is an important factor directly affecting the prognosis of systemic lupus erythematosus, and renal impairment and progressive renal failure are one of the leading causes of death in SLE [2].

In addition to active treatment, daily care is also very important for patients with lupus nephritis, and just the right care can make the treatment of lupus nephritis twice as effective! Next, Kopujun will teach butterfly friends to take care of them!

Rule 1: Standardize medication and take care of it

Lupus nephritis is currently treated with glucocorticoids and immunosuppressants, but both therapies have some side effects
.
Some butterfly friends will ask, how to break the side effects of these drugs?

Next, let's talk about the care of the side effects of immunosuppressants that butterfly friends currently use more!

Mycophenolate mofetil

Mycophenolate mofetil can effectively reduce the production of antibodies and the deposition of circulating immune complexes, thereby alleviating kidney damage [3].

However, high-dose mycophenolate mofetil can be combined with various bacterial, viral and fungal infections during treatment, resulting in pneumonia, lymphadenitis and erysipelas
.
Therefore, butterfly friends should pay attention to the treatment of this drug, if there is an infection, sensitive antibiotics should be added under the guidance of a doctor, and mycophenolate mofetil should be reduced or discontinued in severe cases [4].

Tacrolimus

Relevant clinical practice has confirmed that tacrolimus can effectively treat some patients with severe lupus nephritis with few
adverse reactions.
However, the occurrence of
side effects of the drug is not excluded.
Common adverse effects of tacrolimus include infection, allergies, hematologic symptoms such as anemia, leukopenia, thrombocytopenia, leukocytosis, and neurologic symptoms such as seizures, impaired consciousness, paresthesias, and obdullness [5].

However, butterfly friends do not have to worry too much, most of the adverse drug reactions caused by tacrolimus are reversible, and can be improved
after lowering the dose.

In addition, when using tacrolimus, butterfly friends should also pay attention to regularly measuring blood drug concentrations and related physiological and biochemical indicators, and should seek medical attention
in time in case of adverse reactions.
Doctors should adjust the dose or type of drug and give aggressive symptomatic treatment to improve prognosis and reduce the incidence of irreversible side effects [6].

Cyclosporine

Studies have confirmed that cyclosporine can significantly reduce proteinuria levels and slow the progression of kidney injury [3].

The most common adverse reactions of fucyclosporine are decreased glomerular filtration rate, hypertension, diarrhea, headache, and anemia [7].

The main side effect is hypertension, and clinical trials have shown that the symptoms related to drug withdrawal are reduced, and blood pressure returns to normal after taking antihypertensive drugs [8].

Therefore, if there is an adverse reaction, butterfly friends should seek medical attention in time and stop the drug
if necessary.

Cyclophosphamide

When treated with cyclophosphamide pulse therapy, there will be gastrointestinal reactions, leukopenia, liver and kidney function impairment and other adverse reactions
.
Butterfly friends should pay attention to regular blood routine examination and review liver and kidney function in the process of treatment, when the white blood cell < 3×109/L, be sure to inform the doctor in time and suspend the medication [9].

Rule 2: Preventing infection is the top priority

Above we said that drug side effects can cause infection, and infection is the main cause of death in lupus nephritis patients [10], so preventing infection is also an important step in the care of butterfly friends, and Kopujun will talk about how we should prevent infection in normal times
.

Once infection occurs during the treatment of butterfly friend, antibiotics should be used promptly
.
When nursing at home, we must always prevent colds, pay attention to cold and warmth, and avoid bacterial virus infection caused by colds; If butterfly friends are accidentally infected, they should seek medical attention in time and follow the doctor's advice to take cold medicines with low renal toxicity, such as vitamin C silver warp tablets, double jaundice oral liquid, banlan root powder, etc.
[4].

Rule 3: Eat reasonably to promote recovery

The right diet can promote the recovery of the disease, and reasonable choice of diet can also be an important step in daily care.
Kepujun summarized the red and black list of the diet of lupus nephritis patients for everyone [11], come and see if you eat right?

Red list appropriate intake of high protein

Patients with systemic lupus erythematosus with kidney damage often lose a large amount of protein from the urine, which can cause hypoproteinemia, so adequate high-quality protein
supplementation is essential.
Butterfly friends can usually drink more milk, especially colostrum, the protein content in bovine colostrum is much higher than that of normal milk, its protein content can reach 4-8 times that of normal milk [12], in addition, colostrum contains 23 kinds of minerals, of which the content of calcium is higher; The mineral content of phosphorus, sodium, zinc, iron, manganese and other minerals is also significantly higher than that of ordinary milk [13].

In addition to drinking milk, animal protein is also high-quality protein, such as fish, meat, chicken, duck, etc.
, butterfly friends can eat more appropriately, but high-protein foods that damage kidney function should also be controlled intake
.
Diet

Patients who take glucocorticoids for a long time are easy to cause steroid diabetes and Cushing syndrome, so butterfly friends should properly control the amount of meals and eat less foods
with high sugar content.

Low salt

Patients who use glucocorticoids or have kidney damage are likely to cause water and sodium retention and edema, so choosing a low-salt diet is more conducive to the discharge of water and sodium
.

If there is edema, heart failure butterfly friends should limit salt intake, daily consumption of 2~4 grams is appropriate; Patients with severe edema should be controlled below 2 grams per day, salted fish and various pickles should be contraindicated, and the amount of sodium salt should be gradually increased after the edema subsides [12].

Kepujun tested, the beer bottle cap is flat full, about 4 grams of salt, 2 grams of salt is about half a bottle cap, butterfly friends can limit salt intake according to this standard
.

Low fat

Most patients with lupus nephritis have little activity and poor digestive function, so they should eat light and easily digestible foods and should not eat greasy foods
with a lot of fat.

Calcium and vitamins

In order to prevent osteoporosis caused by taking glucocorticoids, butterfly friends can usually supplement more calcium, and eat more vitamin-rich vegetables and fruits, which is also conducive to calcium absorption
.

The black list is best not to eat

1.
Spicy and irritating food

Such as tobacco, alcohol, peppers, raw onions, garlic and other foods;

2.
Foods
that induce allergies from fish and shrimp.

Both of the above foods can cause lupus nephritis to recur or worsen symptoms, so butterfly friends with nephritis are best not to eat
.

3 foods with photosensitive effects

Such as figs, purple vetch, rape, yellow mud snails and celery, butterfly friends can eat at night, and try to do a good job of sun
protection after eating.

4.
Some foods that have the potential to induce SLE occur

Such as mushrooms, shiitake mushrooms and certain food dyes and tobacco, also try not to eat or eat less
.