What do men eat to tonify the kidney and invigorate yang? [http://www.gzznjj.com]
I. Classification of Causes
1. Endocrine and Metabolic Diseases
(1) Diabetes Insipidus: Due to the reduction in hypothalamus-neurohypophysis function, there is a decrease in antidiuretic hormone secretion which leads to a decline in the renal tubule's reabsorption function, causing polyuria.
(2) Diabetes Mellitus: Because of excessively high blood glucose levels, large amounts of sugar are excreted in the urine, which can cause solute diuresis. The increase in blood glucose also prompts the body to drink more water to dilute the blood, which is another cause of polyuria.
(3) Potassium Deficiency: In primary aldosteronism, due to reduced hypothalamus-neurohypophysis function and insufficient secretion of antidiuretic hormone, patients exhibit intense thirst and excessive drinking (daily water intake exceeding 4 liters). Polyuria leads to dehydration, and as urine volume increases, potassium loss in the urine also increases, leading to persistent hypokalemia. Urine volume increases with relative density below 1.006. Long-term hypokalemia caused by various reasons can lead to vacuolar degeneration of the renal tubules or even necrosis of the renal tubules, known as potassium-losing nephritis. Impaired reabsorption of potassium in the renal tubules results in significant potassium loss through the urine. Patients experience intense thirst and polyuria. Laboratory tests reveal not only hypokalemia but also impaired renal tubule function as a characteristic feature.
(4) Hypercalcemia: In hyperparathyroidism or multiple myeloma, elevated blood calcium damages the renal tubules, reducing their reabsorption function and manifesting as polyuria. It also easily forms urinary system stones, further damaging the renal tubule function and worsening the condition.
2. Polyuria Caused by Kidney Diseases: Seen in the early stages of chronic renal failure, characterized by increased nocturnal urine output. Polyuria during the acute renal failure recovery phase or non-oliguric acute renal failure manifests as polyuria, indicating dysfunction in the renal tubule's concentration ability. Various types of renal tubular acidosis generally present with polyuria. Type I renal tubular acidosis, also known as distal renal tubular acidosis, is due to dysfunction in hydrogen and ammonia secretion in the distal renal tubules, manifesting as persistent metabolic acidosis, alkaline urine, with urine pH generally above 6, hyperchloremia, hypokalemia, hypocalcemia. Type II renal tubular acidosis is due to impaired bicarbonate reabsorption in the proximal renal tubules, resulting in metabolic acidosis. Since the proximal renal tubules cannot completely reabsorb sugar, urinary sugar excretion increases, presenting as renal glycosuria. Type III renal tubular acidosis involves simultaneous damage to both proximal and distal renal tubules, combining the clinical features of Types I and II. Type IV renal tubular acidosis is due to aldosterone deficiency or insensitivity of the distal renal tubules to aldosterone, leading to polyuria, metabolic acidosis, and hyperkalemia. Common characteristics of all types of renal tubular acidosis include intense thirst, polyuria, metabolic acidosis, alkaline urine, with urine pH above 6. Types II and III may present with renal glycosuria, while Type IV shows hyperkalemia.
3. Solute Diuresis: Due to treatment reasons, such as the use of mannitol, sorbitol, or high blood sugar, polyuria can occur. If diuretics are used simultaneously, polyuria becomes more pronounced.
4. Others: Excessive water intake, tea drinking, consuming overly salty or excessive sugary foods can also lead to polyuria.
II. Mechanism
Under normal circumstances, the glomerular filtrate reaches 170 L in 24 hours, with over 99% of the water being reabsorbed by the renal tubules. If glomerular function is normal or relatively normal but renal tubule function is impaired, reduced reabsorption can lead to polyuria. If glomerular function is hyperactive with increased filtration rate, even if renal tubule function is normal, exceeding the workload of the renal tubules is another cause of polyuria. The third reason is the lack of endocrine hormones, most commonly the deficiency of antidiuretic hormone or insensitivity of the renal tubules to antidiuretic hormone.
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