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Steroids are the commonly used medicine for kidney disease, but they have many side effects, one of which is femoral head necrosis. In this article, 6 priciples to help you avoid it.

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6 Principles for Kidney Patients with Steroid Treatment to Avoid Femoral Head Necrosis

2018-11-14 03:53

6 Principles for Kidney Patients with Steroid Treatment to Avoid Femoral Head NecrosisProteinuria is one of the indicators to measure renal function. The amount of proteinuria does not only represent the severity of the disease, but also can indicate the degree of damage to renal function. Therefore, the treatment of proteinuria is always the focus of kidney disease treatment. The effect of steroids or hormone on lowering protein has been recognized by kidney patients. Although this medicine is still controversial, it is irreplaceable in clinical treatment at present.

Because steroids have to be used, but they have many side effects, doctors are wary of using them. Some of the side effects can be controlled or mitigated with drugs. Some gradually fade with the decrease of steroids, and there is no significant harm; and some have serious side effects, which must be taken seriously. Femoral head necrosis is a relatively serious one, and it is also easy to ignore.

Why can steroids cause femoral head necrosis?

Steroid application makes human body fat metabolism disorder, leading to hyperlipidemia. At the same time, it can make adipose cell inside femoral head swelling, leading to vascular thrombosis or be pressed so as to cause bone cells inside femoral head to necrotic due to ischemia.

When can femoral head necrosis occur after using steroids?

Studies have found that the highest incidence of femoral head necrosis occurred within 3 years after the use of hormones, and the incidence decreased significantly after 3 years. In cases of femoral head necrosis within 3 years, the proportion of femoral head necrosis within 3 months is very small, and most cases of femoral head necrosis occur within 5 months after the use of high-dose hormones. In other words, the incidence rate is high at 5-8 months, which requires more attention.

Which is the high risk population of femoral head necrosis?

Femoral head necrosis may occur at doses of more than 20mg per day. However, in the majority of patients with femoral head necrosis, the amount of steroids is generally more than 20mg, while patients with steroids above 40mg are more likely to have.

Adolescents and adults are more likely to have femoral head necrosis than children.

Men have higher rates than women.

The incidence of femoral head necrosis is higher in patients with systemic lupus erythematosus than in other kidney diseases.

At the same time, articular cavity injection patients > intravenous injection patients > oral taking patients, and those who drink a lot, as well as patients with diabetes and rheumatoid diseases, and some people who are sensitive to hormones, especially the menopausal women, will have a higher incidence of femoral head necrosis after massive use of hormones.

And the patients that use medium or long acting hormone such as prednisone and dexamethasone have a higher risk of femoral head necrosis than patients that use short acting hormone such as cortisone.

Prevention of femoral head necrosis

1. You had better avoid steroids unless it is necessary. Conservative treatment is always the first treatment;

2. If hormones must be used, they must be taken in a short course of treatment and in appropriate doses, and may be used with appropriate vasodilators, vitamin D, calcium or some traditional Chinese medicine to alleviate the side effects of hormones.

3. If the patient takes the hormone in the way of large dose and short course, he/she should go to the hospital for imaging examination after stopping using the drug for two months. If the problem is found, he/she can take prompt treatment.

4. For patients who use hormones for a long time, they must avoid heavy physical labor. After one or two years of not using hormones, they should do physical labor properly.

5. Regular examination. Early symptoms are not easy to find, so we should pay attention to regular physical examination to prevent the disease in the future.

6. If the symptoms are typical, further examination should be performed immediately to determine, for example, hip pain, or stiffness, and a little inconvenience in walking. You can have a hip X-ray or an MRI.

Although at present there is no particularly effective way to prevent femoral head necrosis, the above 6 points can reduce the risk of femoral head necrosis to a minimum. For more information on kidney disease treatment, please leave a message below or contact online doctor.

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