0:40 I am the host of the "Money's Health Line" program, Qian Zi. Did you know that more than 90,000 people in Taiwan undergo kidney dialysis every year? We, Taiwan, are the "Kingdom of Kidney Dialysis". This has been going on for 20-30 years, at least because I was running the news more than 20 years ago. How did it create such a notoriety? How to wash? We have invited Dr. Jiang Shoushan, a famous nephrology doctor, for you today. Welcome, doctors. Hello everyone! Doctor, the question I just asked is what many people want to know: why? Taiwan's medicine is very advanced and the health insurance is so good. But why does the reputation of "Kingdom of Kidney Dialysis" stick to us? Is there something wrong with our lifestyle? Or is there something wrong with the medical system? I think the most important thing is probably... some of our medical indicators are set incorrectly,
1:26 which we will mention later, but our people's own medication habits are terrible. According to statistics from the Pharmaceutical Industry Association, Taiwanese people take 7.2 times more medicine than Americans. Think about it, have you really found a medicine without side effects? Probably difficult! Then you take 7.2 times the medicines of Americans, not to mention that they are bigger than us, so you calculated back that we may take 8 or 9 times the medicines. If you take too many medicines, your kidneys will be easily affected. This is a certain problem. Then I want to ask about vitamins like this - are these also considered medicines? -No, it doesn’t count! What I'm talking about is the statistics of the Pharmacists Association, so it talks about the medicines that are actually distributed . For example, chronic diseases - heart disease, diabetes - for various chronic diseases , medicines taken every day are good. Well
2:12 , this is bad. The other side is that there are more people coming in for kidney dialysis. This part is bad. Of course, the other thing that leads to more uremia patients is good. What is good? The mortality rate of our kidney dialysis patients is very low, but this low rate has both good and bad qualities . How can we say this? The quality of our dialysis is one of the best in the world. When we compare the mortality rate with that of the United States, our mortality rate is only about 1/2 to 1/3 of that . That means the quality of our dialysis is very good ! And if Hong Kong, a relatively large country with peritoneal dialysis , has a lot of peritoneal dialysis - because it gives priority to peritoneal dialysis - then our mortality rate is only half that of peritoneal dialysis, so it becomes a big bucket . The water flow is very large and the faucet is very small . There is another way out
2:57 called kidney transplantation . However, kidney transplantation in Taiwan is very rare, about 200 cases a year. Because the kidney source is now very scarce. In fact, it is ridiculous to talk about this thing. Compared with 30 years ago, we had more kidney transplants, so why are there fewer kidney transplants? Why? Because everyone rides motorcycles and wears helmets, we have fewer brain-dead patients. I understand, I understand, so there are fewer healthy kidneys. Because this is an important reason for brain death. Car accident deaths . Now, because everyone rides motorcycles and wears helmets, the whole thing is cut in half. Now it is a big problem. Your queue of people who need kidney transplants may be 8000-9000 people. 200 transplants a year, then you have to wait for decades before you can get one, right? So this part The kidney transplant is used as an outlet for dialysis
3:42 so that he does not need dialysis. The road is basically blocked until half of a small hole is blocked. The blockage is very big . So if dialysis is a big bucket, so many people join it every year because we take a lot of medicine and other factors. However, there are very few people leaving this big bucket. Because the quality of our kidney dialysis is very good , the notoriety of Taiwan, the "Kingdom of Kidney Dialysis" , is firmly attached to us . So what should we do? A good way is to try not to jump into this big reservoir. Yes, this is the most important thing. Well , let’s talk about this in several aspects. The first question is that we cannot deny that the largest shareholder of kidney dialysis in Taiwan is called Diabetes, because half of the kidney dialysis patients in Taiwan are from A single disease is called diabetes. What we all focus on in controlling this disease now is the number of diabetes.
4:29 For example, if I want to control my fasting blood sugar below 110, I will be very happy. If I control my glycated hemoglobin below 6.2-6.5, I will feel that I am successful . The words are beautiful , yes , but let me tell you a practical example. When I was seeing a patient in the public insurance, a patient was transferred from the metabolic department. This patient had been treated by the public insurance for 17.5 years and had a thick medical record because he had very regular examinations . When you come back for a consultation and get medicine, you can say that he has not stopped taking medicine for almost a day. Then you look at his numbers and see his fasting blood sugar. I have seen a very beautiful data, which has never exceeded 115. The glycated hemoglobin does not exceed 6.5.
5:15 Then he was found by the last doctor that he needs kidney dialysis ! So now there is a big problem that everyone pays attention to. The root cause of diabetes is insulin resistance. No one cares about it. For the entire medical community , in fact, diabetes has gradually transitioned from simply treating symptoms and controlling digital control in the past to controlling impedance and even eradicating the road of controlling impedance. However, we have always stayed in this ancient era . We have always stayed in the need to control digital control beautifully . There is a contradiction in the middle. Sometimes your control of numbers is the opposite of your control of the disease. Let me give you two examples. Many hospitals will call diabetic patients and tell them that in order to prevent your blood sugar from soaring too high after a meal,
6:01 you need to eat "smaller meals more often". This means that you eat a little at a time, so your blood sugar will not be too high after a meal, right? But this method is actually very bad. This method will extremely increase your insulin. Continuous secretion will create more resistance. Nowadays, new treatment methods include Duke University in the United States , which has a metabolism clinic that specializes in using fasting to control patients, including using "168" or "one meal a day" , etc. What is the point? The emphasis on "larger meals and smaller meals" is exactly the opposite of your "smaller meals and frequent meals". But you have to know that the reason why it is very famous in the United States is because it has about 60% chance of removing the patient's medicine. If you go back there, 60% of the people
6:46 will basically get a state similar to a radical cure , that is, the patient can not take medicine for a long time and maintain a very good blood sugar condition without complications. So your clinical suggestions are sometimes the opposite of controlling the disease . You are just trying to control your numbers . This is a big problem in Taiwan! But if we already know this problem, why don't our relevant units convert this concept? It takes a while, doesn't it? It takes time because a lot of things are researched and written into textbooks. It will take about 5 years. OK, if the research has a conclusion , for example, it may take hundreds of studies before I can do a large-scale review and comparison. Then I will finally conclude in the review analysis that this is really better than that. If you really do all the research, it will take
7:33 about 10 years to do a review. So you basically have the treatment method officially recommended in textbooks or the Department of Health . In fact, it will probably be 15 years behind the times . So far away, so we may still be in a relatively backward stage. Yes, let’s take another example of diabetes. We know that Taiwan’s fruit is very sweet. Yaoshoutian, right? Yaoshoutian is really sweet. So you take a look at the diabetes health education in various hospitals . The teacher told the patient that you should not eat too much fruit as it will increase blood sugar. You can only eat two fists a day , that's two servings of fruit , and eat non-sweet ones - guava - yes, yes - try to eat non-sweet ones - tomatoes, right ? But what is the fact? The fact is just the opposite of what you imagined !? For healthy people, we found that eating whole fruits never increases diabetes.
8:19 Not only does it not increase diabetes, it also reduces the risk of diabetes, no matter how sweet it is? For the second case of diabetic patients, someone collaborated with the other side to do a long-term follow-up of 490,000 people. It was found that if diabetic patients eat more fruit, it will reduce all the complications of diabetes, including reducing retinopathy, which is the main reason why adults are currently blind . It reduces nephropathy , which is the main reason for kidney dialysis - yes - right? Third, it reduces nerve disease, right? Fourth, it reduces cardiovascular disease in diabetic patients. In fact, most diabetic patients will die from cardiovascular disease, including myocardial infarction or stroke , except for kidney dialysis . If you eat more fruits, you will reduce the four major complications.
9:06 So I wrote a book to ask everyone a question: Since you have no complications, do you need to care about blood sugar? Is that right? But today we are not. Today all our health education is that you should be very concerned about blood sugar , so you are not allowed to eat more fruits, especially sweet fruits. But do you know that it is ironic to say that some sweet fruits are very helpful for blood sugar control ? Why? For example , grapes are very sweet, right? Especially grapes and raisins in Taiwan are sweeter, right? They are concentrated. As a result, grapes and raisins can be dosed . The higher the dose, the more suppressed the glycated hemoglobin is. The more you eat , the lower the glycated hemoglobin will be , which means the glucose curve will be suppressed . Many people are confused about what I wrote in the book and said, "No, I obviously ate sweet fruit.
9:52 I tested it two hours later and it was higher. No, you are too short-sighted. Why?" Because what you care about is after two hours. In fact, eating grapes will have a peak after two hours , but it will lower the blood sugar of the next two meals. We have to pursue long-term research on blood sugar of the next two meals. In fact, in the study, we will find a significant decrease. So you look too short, so you will feel that you care about how many grapes I eat . In fact, in the study, which fruits can lower blood sugar? Are the grapes and raisins I just talked about good with their skins on? Apples with their skins must be on their skins, right? Do you have to peel the guava that is easy to peel ? What about that seed over there? It doesn’t matter that the seeds can be eaten, but the guava needs to be peeled, because someone directly conducted a random allocation study on people
10:39 . One group of people were asked to eat guava with the skin , which is the normal way we eat. The other group peeled off the skin and found that only eating peeled guava can reduce blood sugar and blood lipids . Of course, both groups are helpful in reducing weight, but the ones that really help blood sugar still need to peel off the skin, such as mango, dragon fruit, and avocado . These are very famous fruits that can lower your glycated hemoglobin. Although some of them are really sweet, dragon fruit is not unsweet . In fact, dragon fruit is also quite sweet. Yes . Some varieties are super sweet. Yes . Taiwan's mangoes are actually quite sweet. Yes , especially when they are in abundance. Yes. So if you look at the entire research data, you will find that it is good for you. But our diabetic patients are afraid to eat it! In order to be filial to their parents, many of our children will warn their mothers
11:25 , "Mom, don't eat that!" "You can't eat that!" "You can't eat it!" "That's too sweet!" "Eat that one" "Your diabetes will be out of control!" In fact, it's exactly the opposite of the conclusion of the research . What Dr. Jiang told us today is really a complete subversion of our past concepts , so it also brings some new opinions. The doctor just said that living habits are very important . Not drinking enough water is also a very important reason for kidney disease . Modern people may not drink enough water and may drink the wrong drink! Doctors can tell us about the benefits of water to the kidneys. It is easy for you to know intuitively. For example, unfortunately, if you go to the Sahara Desert and your camel runs away , you may be picked up after 7 days . Why do you need to start kidney dialysis ? Because you may not be able to drink water within 7 days . Without water, the kidneys cannot detoxify,
12:10 so insufficient water can cause acute renal failure. This is a very superficial idea , but what everyone ignores is that chronic dehydration can cause chronic kidney fibrosis, kidney atrophy, and kidney dialysis. Let me tell you an example of a patient. One day, I was doing rounds because our doctors have to be on duty. Some patients are indeed not your old patients. You admit them yourself. The emergency room helps you admit patients from your nephrology department on the day you are on duty. Then I am the chief physician. The doctor reported that this old man was 72 years old and he now had uremia and needed kidney dialysis. After carefully examining the patient, I asked the patient, "Are you not even thirsty?" The patient said, "No, I drink water!" Do you know that I only did one thing? I gave him 7.5 liters of saline solution within two days , and on the fourth day,
12:55 the patient's kidney function was normal and he was discharged. It only took four days before and after he was discharged from uremia to normal, so he didn't drink enough water at all , and the most important thing was that he wasn't thirsty. Why? There are many more patients who are not thirsty than you think. There are several reasons for not being thirsty. The first is old age. Old people often do not remember to drink water because their sense of thirst has gradually dulled or even lost. If they do not feel thirsty, they will not drink . A worse problem is that patients in the nephrology department are less likely to be thirsty! Why? The patient in the nephrology department was also found to have a poor appetite. Most of the receptors in the throat that sense water have been lost, so he will not feel thirsty . If you don't drink water, it will cause chronic kidney fibrosis,
13:40 chronic kidney atrophy , and eventually uremia. And because you drink too little water, you will be more susceptible to infection and stones , and you will be prone to constipation . What does constipation have to do with nephrology? Yes, constipated nephrology patients will not excrete potassium , so they may be constipated because their potassium ions are too high and they need kidney dialysis. So drinking less water will have a very big impact on nephrology patients. To put it bluntly, I only see 30 patients in one outpatient clinic. Half of the patients will be urged by me to drink more. He drank water and even scolded him to drink more water. I told the patient that if he didn't drink enough water, he shouldn't come to see me next time. But how do you judge whether he drank enough water ? Because all patients will tell you "Yes, I drank it!" It's a very simple question. Look at it. I am also in my 60s. You have made your skin light. Pinch it easily
14:27 and then let it go. I am not pulling it up and popping it away. I am pinching it flat and letting it go. It will disappear immediately. If you pinch it flat and let it go, you will see a swoosh. This movement and a slow rebound movement means that the water content of your skin is insufficient. It means that the water content of your whole body is insufficient. Doctor, come and pinch me and take a look . Don't pinch the place where the skin is tight. Let's pinch the loosest part of the skin . Pinch it at this position and let go. You are a little worse than me - but you are not bad anymore - I am still worse than you. Pinch yourself, right? You can't even see the trace . But there are some old people whose skin is loose, aren't they? It won't be loose, but you shouldn't be able to see it in this position . I have a very simple question. My patient only needs to be asked by me. If he drinks enough water next month,
15:13 come and see him. Hold it down and let go, and it will bounce back immediately, just like me. If he doesn't drink enough water , you can actually feel it by touching his armpits with your tongue to see if there is any wetness . But isn't wetness in the armpits just a sign of sweating? Everyone should have a slightly wet feeling in their armpits. That is to say, if you put your hands on your armpits, you should feel a little wet. If you don’t feel anything, it’s over. You must be dehydrated. But Dr. Jiang, we must also have it in this air-conditioned room !? It must be there! Because there are apocrine glands here , it will feel a little wet anyway , and human fingers are very sensitive to this humidity. Legend has it that a good Western pastry baker can feel
15:58 the change of about 1/10000 of the humidity in the dough. So you will know if you touch it. Do the old man, old lady or yourself in your family have enough water? If the water is not enough, just like a while ago, someone had a kidney stone and was hospitalized and went to the hospital to get rid of the stone. This is very common caused by lack of water. This happened to my own family members. He has never had stones in his life because that is my brother. He is the chairman of the Structural Technicians Union. During the epidemic for more than two years, I went to a meeting. The authorities did not dare to provide drinking water at that meeting because if you drink water, you will open the mask, so there is no water to drink. Frankly speaking, my brother is also a bit lazy. People don’t give him water and he doesn’t bring water. In the past two years alone, he had been holding back a stone.
16:43 One day, he found that it was a little uncomfortable to urinate, and when he checked, he had hematuria . When he took a picture, he saw a stone , which means he had a stone . And he had never had a stone in his life. He just drank less water when he went out during the epidemic, and he immediately developed a stone. And I know that the reason why some elderly people drink less water is because they are afraid of going to the toilet. For example, it may be troublesome to find a toilet outside , so they hold back and stop drinking. Well , then this is a big problem. If you go out, you will urinate frequently. Do you think about this? To deal with it, you shouldn't reduce your drinking water because of frequent urination . What's worse is that our nephrology patients , especially after the third stage, will enter a state of "salt loss nephropathy" before they even enter the third stage. In the second stage , they
17:29 can't retain water or salt, so they will excrete water without restriction until their kidneys are broken. So for these people, I tell the patients that there is no way. Your kidneys will be in this state during the recovery period, so you have to drink to win! You are not allowed to lose your kidney! I force them to drink water a day. Some patients may be asked to drink up to 3,000 or 3,500. If they are in a "salt loss" state , the water you drink must be faster than the water it loses . Let it stay in your body . But why is this water lost? At this stage of kidney failure, it will cause "salt loss" , that is, it will leak salt, and when the salt is leaked, it will take away the water. OK , and there is another problem . Many people think that if I drink tea, I have enough water.
18:15 Is it okay to drink beer? So actually, I’m sorry, but who are these five things that can only be flushed down the drain and won’t bring any benefit to your kidneys ? Beer, beer, 500cc, beer can urinate. 800cc , this is research-proven strong tea, coffee barley water, red bean water, barley water, red bean water!? Corn silk, these are all the same . Corn water is right for us girls to eliminate edema because it has its own diuretic effect. Those that can have its own diuretic effect are only It can help our patient flush his sewer, but it can't be left in the body , but it can't be used as a deposit. It's just a passing god of wealth. Once you make money, you spend it immediately. This is probably the concept , and you take more money away , so you may not earn half a cent from it . So many people suffer from kidney failure
19:00 because they drink less water . Salt is also a problem. The Ministry of Health and Welfare also recommended that we all not consume more than 2,300 milligrams of salt. However, later studies found that this is not right. Why do you track these problematic patients for a long time? The subjects include normal people , including patients with heart failure, people with high blood pressure, and people with kidney disease. You found that his kidneys deteriorated faster if he ate less salt. Contrary to what we thought, because in early studies, many people filled out questionnaires and asked you questions such as whether your food was salty or not. Many patients wrote random questions in the questionnaires , especially some questionnaires were unreasonably designed. They even asked people to review what did you eat in the past week ? It calculates your salt intake based on the type and amount of food
19:46 you eat. This is a standard research practice. But have you ever thought about a question? Do you really remember what you had for lunch three days ago? I have to think about it, I tell you it is very difficult , very difficult, because this is something you do every day, unless you happen to have an appointment with your friends for afternoon tea in a big hotel that day, you will remember that meal , or it was my birthday meal - I remember - yes , but most of us will forget every meal in our daily life . Recall that this research is very inaccurate because you can honestly say it is blatant nonsense - just write it down - just like ChatGPT , it is an upright nonsense and hand it over . But later research found that this problem was a big problem and the research was inaccurate. Then I stopped doing this and what did I do next? I collect patients’ daily urine because the amount of salt in
20:32 daily urine is equal to the amount you eat . It’s very smart. Later research found that people who don’t eat less salt have kidneys that deteriorate faster . People who eat less salt have kidneys that deteriorate faster! Yes , there is a very popular diabetes in Europe and the United States called type 1 diabetes . It ’s considered a minority in Taiwan , around 4%. In the United States, 20% of very young elementary school students may develop diabetes before they even enter elementary school. After 15 years, most of the kidneys of such people will be broken because it is an immune-type disease. In the end, the kidneys will be broken. As a result, if you divide the amount of salt these people eat into 10 levels, you will find that in order, the kidneys that eat less salt will die faster! Dr. Jiang, your behavior today has completely overturned some of our past imaginations and experiences . Yes, everyone said
21:18 this when I was a child. In fact, it is still like this to this day. "Mother soup is heavy on salt!" "If you eat heavy salt, your kidneys will be broken!" "If you eat too much salt, your kidneys will be broken!" This is the concept of transmission , but it cannot stand the test of research. Did you know that we eat less salt ? It's really funny when you think about it. 15% of our hypertensive population has salt-dependent hypertension , which means that people whose blood pressure rises when they eat too much salt should theoretically eat less salt, right ? Because they will have high blood pressure if they eat salt, right? But don't forget it. This accounts for only 15% of the total population with hypertension . How much of the total population does hypertension account for? 10%, right? So the total population, total adult population, children are not included in the total adult population. What is the amount of salt that needs to be controlled? What is 10% times 15%? 1.5% , only 1.5% need to control salt!?
22:05 Let me ask you, the other 98.5%, why are you joining in the fun with others? But we all thought that was the case! Yes , and have you ever thought about whether there are any disadvantages to avoiding salt? Except for 1.5% of the people who avoid salt , what price will all the people who avoid salt pay? First, it increases the secretion of four types of vascular poisons, including renin secretion, angiotensin II secretion , epinephrine, and norepinephrine secretion. These four are all vascular poisons, because our treatment of blood pressure mainly focuses on these things to restrain it. Then what do you not know? People who eat less salt have higher insulin resistance and higher blood sugar, which is harder to control. So people who eat less salt have more difficulty controlling their blood lipids and are more likely to gain weight? It’s not that blood lipids will be high , so think about it, I pay such a high price
22:51 for 1.5% of people and the other 98% of people. Of course... that’s a wrong concept, right. So doctor, do you mean we need to take in more salt? In large-scale studies, the lowest point of its death curve is 4500 mg of sodium, which is equivalent to nearly 10 grams of salt. Let me tell you, go back and do the math and see if all of you can't eat this amount. You must eat more than 10 grams to be considered qualified? That is to say, the lowest point of death rate is... How many grams are there? You shouldn’t be able to eat that little salt spoon I told you. Each one is about 1 gram. So if you eat 10 spoons a day, your mortality rate will be the lowest. If you don’t eat it with your family, you have to eat 10 spoons alone . That’s a lot! Yes, it is absolutely beyond your imagination.
23:39 We are all educated to eat less salt. The result is actually paying a greater price. What's worse is that if you pay attention to the line between salt intake and mortality, make the vertical axis of this curve. If the salt intake is less than 4500, the buttocks will rise, which means the mortality rate will rise quickly. But if you eat more than 4500 salt, In fact, when the amount of milligrams is doubled , it is still unable to escape the statistical error range and has no impact on the mortality rate . Therefore, in the past, everyone told us to eat less salt, eat light food , and not too much salt. This concept may be changed from today on . That’s right, because academic research has found that it is completely untenable! From now on, when our
24:25 mother cooks, will she have to risk her life to drop the salt? And let me tell you, there is another big problem with eating less salt . Many elderly people feel that food has no taste because they eat less salt. The more they eat, the more malnourished they become! Because the food feels bland and tasteless to him, he eats very little. It is a big taboo for the elderly to eat less! You see, Japan’s statistics on Renrui are that a girl over 100 years old is considered fat if her BMI is 26 ! Yes, 26.1, right? Don’t you say that 20-24 is a normal BMI? If it’s over 24, you’re slightly fat, right? It’s good. Renrui is 26, so people are all fat. The only way to survive is to eat more. Then think about it, if you call him this salt from beginning to end. You are not allowed to eat the salt, you are not allowed to eat
25:11 the flavorful ones, you are not allowed to eat the spicy ones, you are not allowed to eat them, etc. Because you add a lot of salt to a lot of chili sauce , right? You are not allowed to eat anything. As a result, the old man’s appetite becomes smaller and the whole person becomes thinner and thinner. The old man who is too thin actually dies faster! Because he does not take in enough nutrients, he will suffer from several problems due to lack of nutrients. He has insufficient resistance and will die quickly when he encounters a serious illness! This is a problem I already know. Do you know what I am most afraid of encountering? When I meet a patient, for example, if he is admitted to the intensive care unit, I will go to see the patient. Let me tell you , I only need to see the patient whose BMI is less than 22. No matter what the reason is, I will immediately call the family member to sign a critical illness notice for him. He will feel very strange. Why did he sign the critical illness notice immediately if he was not admitted to the intensive care unit just now? My father and my mother have not changed. I can’t tell you. According to statistics, if you are admitted to the intensive care unit at this weight, the chance of surviving is less than 5%.
25:58 If you are 95% dead, of course it is critical! If you don’t have enough weight, you’ll be critically ill! You don’t have to think about it and do you know how important nutrition is to people? Let me tell you a true story. One day, I had a colleague who admitted a girl with hyperthyroidism who was only in her 30s and was very thin. Of course, she also had kidney problems , so she consulted the nephrology department. So I went to see him. Of course, I checked him out and gave him some advice . Two days later, the resident doctor who took care of the female patient came over to me and told me that I was on rounds and came over to talk about "Director Jiang. " "Please go see him again." Then I'll help look at the patient. After looking at the patient, I asked, "What does Director Hong think?" The resident doctor said,
26:43 "Director Hong said this patient is very dangerous!" I was thinking in my mind, "Don't talk nonsense!" If it's not dangerous after rescuing three times, of course it is! That's not what I'm asking. What I'm asking is what Director Hong's judgment is about him? It's okay. The resident doctor can't answer it anyway. I looked at the patient carefully, looked through the medical records , and asked the resident doctor, "After the patient was admitted to the intensive care unit, " he had gastrointestinal bleeding. "You just fasted him, right?" " It's been 7 days since he fasted. " "What did this patient get fed?" The resident doctor said, "Ah, I didn't." "We have been." "He hasn't resumed eating and drinking yet," I said, "This patient will starve to death for you!" After I asked him to start force- feeding, the patient was discharged from the intensive care unit on the third day and was discharged a week later. So the three cardiac arrests he had in the intensive care unit were actually exhausted!
27:31 There is no nutrition and it is burned out because people with hyperthyroidism are already thin. There is no oil. Then you are admitted to the intensive care unit because he has stomach bleeding and he is not allowed to eat. You know that the calories in the drip are actually very small. The drip is not used to provide calories. You really have to provide nutrients . Total intravenous nutrition, which contains oil, is an injection and is nutritious. It is impossible to give sugar water to support the patient. As a result, the patient was so hungry that his heart stopped three times in a row. So did you know that in fact, the cause of death of many hospitalized patients is due to malnutrition ? If you look at the whole kidney dialysis room, the patients who will die first are not the ones with high toxins. High toxins mean that the kidney dialysis has failed . Right - most of the ones that die are not the ones with high toxins. The ones who die are malnourished patients . Patients with low albumin eat less.
28:16 As long as they are malnourished, they will die better than the toxins. The higher you are, the faster you will go to dialysis. Many people say it is the "final point of chronic disease." That's right, because you talked about diabetes, hyperlipidemia, and high blood pressure. If I really have entered a large pool like kidney dialysis, what can I do to alleviate the pain? Or is there a chance to jump out of this large kidney dialysis pool? In fact, it is true that we have incentives in renal medicine , that is, if you can get a patient off dialysis, he will receive a certain reward. But frankly speaking, this is insignificant , so most doctors do not pay attention to this aspect. However, there are indeed a few patients whose kidneys fail. In fact, after dialysis, the cause is discovered and then solved. The cause is indeed not the same. I have a patient who needs kidney dialysis . She is a 39-year-old girl
29:05 . After 3 years of kidney dialysis, she was hospitalized for a fracture and was consulted by the nephrology department. It was discovered that she had multiple myeloma. Later, after the multiple myeloma was controlled, her kidney dialysis resolved it. So there are still such patients. Of course, some patients rely on the help of equipment. For example, I was just treating a patient who had already been dialyzed. He also had kidney dialysis for 5 years without even a drop of urine because his heart was very bad , so I thought he was undergoing kidney dialysis because the kidneys were dragged down by the heart. Later, we used external counterpulsation to treat his heart. As a result, his heart improved and only half of it was achieved after 35 hours of treatment. His urine output was 900cc a day, and his overall dialysis number dropped, so we We have reduced his dialysis from three times to two times to one time. We are still trying
29:50 to see if we can get him out of it completely. So in fact, a dialysis patient does not necessarily have to be dialyzed once, nor does he need to be dialyzed for the rest of his life. It depends on the condition of his disease . If I am a healthy person and try to avoid jumping into this big reservoir to avoid taking this road , what can I do? According to general health education, please ask a doctor to help us see if it is right. The first is good eating habits, such as the Mediterranean diet. The second is drinking more water. Dr. Jiang has just emphasized that the third is regular exercise, which is also necessary, right? The fourth is to avoid staying up for a long time . Ye found in a study that nephrology patients no matter what kind of kidney disease they have, whether they have diabetes, glomerulonephritis, polycystic kidney disease , or polycystic kidney disease , as long as they sleep less than 7 hours a day, the damage to the kidneys will be accelerated
30:35 , and nephrology patients will develop nocturia very early. Will they get up to urinate at night? This is called concentration failure. Concentration failure is a sign of kidney disease that appears from a very early stage . However, most people ignore it , so many patients have nocturia for 5 or 6 years. I can’t remember how many years it took before I knew I needed to see a doctor . I want to ask the doctor what nocturia is? Well, if waking up in the middle of the night does not count as more than one urination, it is called nocturia. OK , but you have to know that girls do not have a prostate , so as long as a girl gets up more than once at night to urinate, it is called nocturia. There are some sayings that women have nocturia because they have menopause. Girls after menopause should not have nocturia because menopausal girls should not damage the concentrator of the kidneys.
31:20 OK , then boys are more annoying because boys also have a so-called comorbidity problem, that is, they are older. Later, he often has enlarged prostate . The main reason for enlargement is because it strangles your urinary tube . After strangulation, it will be pressed back and affect the rotation of your concentrator , so it will also cause concentration failure. However, the reason is not the disease of the kidney itself , but from the strangulation at the back. Of course, you have to solve this section . So the fourth is to avoid staying up late and get enough sleep for at least 7 hours. If you have nocturia at night and get up to go to the toilet more than once, you must treat your kidneys carefully. Yes, you should check to see if there are any problems with your kidneys. Also, moderate stress relief. Of course, the source of many diseases is stress. Also, don’t smoke
32:06 . In fact, apart from alcohol, it has nothing to do with kidneys. In the research of Professor Gu Jinyu of Kaohsiung Medical University, he used to explain a problem. Taiwan is a very small island, right? But did you know that the ratio of dialysis population in the south is almost twice that of Taipei per 100,000 people ? Why? Because many of them eat betel nut. According to Professor Gu Jinyu’s research, betel nut and cigarettes can damage kidney function one by one . The damage to the kidneys can be quantified and estimated. The biggest natural enemies of the kidneys are cigarettes and betel nut! Can you put it this way? You can say OK like this. In addition, the doctor just told you to change everyone's idea that you should eat more fruits. If you have diabetes , you can eat whole fruits like grapes, dragon fruit, mango, apples
32:51 with skin , guava without skin, and apples with skin. You can eat more avocados, which can also lower blood sugar . Avocados can also lower blood sugar . In addition, it subverts everyone's ideas. You need to consume enough salt - yes - it is sodium . And it is much more than we imagined. In fact, it is almost twice as much. After that, we no longer need to eat so light. Especially, don’t use filial piety as an excuse to restrict your parents’ diet. If you make him thin, he may be more likely to die from septicemia and other problems of insufficient immunity. So the elderly should remember that being too thin is not good for him. Yes , don’t say that you dare not eat this , you dare not eat that, don’t eat that, you ca n’t do this! Yes, thank you very much Dr. Jiang for coming to our site today. Thank you everyone . Please continue to watch "Healthy Big Money Line". We will see you on time next Friday.
