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Chapter 163 Contrast Agent Nephropathy! (Add more rewards for "Xi Ru Shui")
Lu Chen met Wang Jun's gaze.

"I?"

"That's right, didn't you just say that you were considering acute renal failure?" Wang Jun smiled, "There must be a reason for renal failure, right?"

Lu Chen glanced at Sun Guoguo at 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 on him.

Even those students who were working were watching Lu Chen from the corner of their eyes.

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

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

Lu Chen was silent for a while.

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

At this moment, all possible factors of 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 a certain organ becomes diseased, it is likely to affect other organs and tissues.

For example, if there is a problem with the heart, there is heart failure, the ejected blood is not enough, and the blood flowing through other organs is not enough.

Heart failure can 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 kidney are not separated, and 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 found that there was something strange about this patient.

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

And this patient named Yang Song, before the stent operation, only had symptoms of chest pain, but no symptoms of chest tightness.

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

Could it be that his heart got worse after the stent operation?Heart failure?
This is somewhat unreasonable.

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

If it wasn't for heart failure, what could it be?

"By the way, he has no urine after the operation!"

Lu Chen's eyes suddenly brightened.

The difference between preoperative and postoperative is whether there is surgery or not.

In other words, the patient's renal failure must be related to a certain factor in the operation!
And the heart stent surgery is a contrast surgery, so it will definitely use a contrast agent!
At this moment, Lu Chen suddenly realized.

"Generally speaking, acute renal failure has three major categories of factors."

Lu Chen spoke, and everyone focused on him.

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

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

"The only thing left is renal factors. The patient denies any previous kidney disease, and the renal function was normal before the operation, so now there is only one possibility left."

Lu Chen paused, looked around, and said slowly, "Contrast medium nephropathy!"

As soon as the voice fell, there were whispers in the doctor's office.

"Why not consider renal failure caused by heart failure?"

"I think this patient is very young, the condition before the operation is good, and the probability of heart failure after the operation is not high."

"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 renal function caused by contrast media.

Commonly used contrast agents are generally hypertonic, with iodine content as high as 37%. In the body, they are filtered by the glomeruli in their original form and are not absorbed by the renal tubules. Acute renal failure develops.

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

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

However, renal failure caused by contrast agents is very rare.

Wang Jun looked Lu Chen up and down.

This student is not easy.

For these veteran clinical doctors, it is normal to think of the diagnosis of contrast nephropathy.

But for a fledgling student, it is not easy to think of contrast 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 exclusion, the diagnosis of contrast nephropathy was finally made.

In other words, no matter what the cause of kidney failure is, Lu Chen can use his own clinical thinking to finally analyze and draw a conclusion.

"Guoguo, did you teach this student?" Wang Jun looked at Sun Guoguo with a smile.

"Mr. Wang, Lu Chen is the graduate student of Mr. Li Yao this year, and he just entered the department." Sun Guoguo smiled.

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

He was actually still a freshman in Yanyi.

So young, but the clinical thinking model is very mature.

"Student Lu Chen, your analysis is very good. I am currently considering the possibility of contrast nephropathy." Wang Jun looked through the patient's doctor's order, "Wait for the patient's urgent blood test results to evaluate the renal function. If the patient If there is persistent anuria, it is likely to require emergency dialysis treatment."

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

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

Cheng Peng glanced at Lu Chen again.

He remembered that Lu Chen also said before that the patient is likely to need emergency dialysis.

"Others, there is no special treatment for the time being, wait for your superior doctor to come back, and then communicate with the patient's family about the condition."

"Moreover, after the results of the emergency renal function test come out, please continue to ask our department for consultation."

Wang Jun finished writing the consultation opinion on the computer.

"Guoguo, then I'll go first."

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

"Mr. Wang, goodbye."

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

Lu Chen and Cheng Peng looked at each other and smiled, both heaving a sigh of relief.

"Junior Brother, Mr. Wang was my teacher in Kidney back then, and I know he rarely praises others." Sun Guoguo said to Lu Chen, "Your analysis today won his favor. "

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

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

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

"Fatty, hurry up! Check your kidney function urgently! Then please consult with the nephrology department!"

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(End of this chapter)