Why should furosemide be used after albumin infusion?

First of all, let's understand the physiological role of albumin and the role of furosemide.

Physiological effects of albumin: first, increase colloidal osmotic pressure and reduce edema; One is to supplement nutrition.

1.Increases colloidal osmotic pressure.

The maintenance of plasma colloidal osmolality mainly depends on the albumin in the plasma, and the colloidal osmotic pressure is the main driving force for the venous interstitial fluid to return to the blood vessels. When plasma albumin is reduced due to pathological conditions, the colloidal osmotic pressure of plasma also decreases, which can lead to excessive water in the blood entering the interstitial fluid and edema.

2.Albumin is an important nutrient in the human body, and it is constantly metabolized in the plasma, and the amino acids produced by the decomposition of albumin in plasma can be used to synthesize tissue proteins, oxidize and decompose them to energy or convert them into other nitrogen-containing substances.

Furosemide is a powerful diuretic, which mainly inhibits the active reabsorption of NaCl by the thick-walled segment of the renal tubular loop, which increases the concentration of Na+ and C1 in the luminal fluid, while the concentration of Na+ and Cl in the intermedullary fluid decreases, which reduces the osmotic gradient difference and decreases the concentration function of the renal tubules, thereby promoting the excretion of water, Na+ and Cl.

Our intravenous albumin increases the colloidal osmotic pressure, which absorbs interstitial fluid into the blood vessels and eliminates edema in the interstitial space. Furosemide quickly removes water from the body. Therefore, after the infusion of albumin, intravenous furosemia only excretes the excess water, and the protein is not "profitable".

Especially in patients with cardiac insufficiency, after albumin infusion, the blood volume will increase, the central venous pressure will increase, and the cardiac volume load will increase, affecting cardiac output, and the combination of the two can avoid increasing the burden on the heart.

We should pay attention when using:

1.The molecular weight of albumin is slightly larger than that of commonly used intravenous drugs, so it needs to be transfused with a blood transfusion set with a strainer.

2.Tissue dehydration is associated with large amounts of albumin, so it is necessary to dilute the buffer appropriately with 5% glucose or sodium chloride before use.

3.Inject albumin for 15 minutes, it is advisable to drip slowly, and 15 drops are suitable for young and middle-aged people and those in good health; Elderly and young patients should start intravenous infusion from 10 drops, and gradually increase the intravenous infusion rate in 15 minutes, but the fastest drip rate should not exceed 60 drops.

4.When transfusing protein, the patient's vital signs must be closely observed for adverse reactions, especially whether pulmonary edema or heart failure occurs in patients with poor cardiac function.

5.Intravenous furosemide is given in time after protein infusion to reduce the amount of water in the blood, thereby reducing the impact on the heart.

Hypoproteinemia can cause edema. Protein infusion supplements colloid, and furosemide is used after infusion.

It can achieve a good diuretic effect and reduce edema. We ordinary people may understand: just after protein infusion and furosemide, the protein will not be discharged.

Albumin is a hypertonic solution, which will not be decomposed immediately after entering the blood vessels, and its hypertonic state can be maintained for 24 to 36 hours, increasing the osmotic pressure of plasma colloids, so that the fluid between human tissues can be quickly transferred to the blood vessels, thereby expanding blood volume; Furosemide is a powerful diuretic, which can inhibit the reabsorption of water and sodium by the kidneys, inhibit the activity of prostaglandin-decomposing enzymes, thereby increasing the content of prostaglandin E2, dilating renal blood vessels, increasing renal blood flow, improving the filtration rate of glomeruli, increasing urine output, and promoting the excretion of sodium and water from the body, thereby reducing tissue edema. Albumin can transfer interstitial edema to blood vessels, and furosemide can transfer edema fluid from blood vessels to urine and excrete from the body, thereby reducing tissue edema.

1. Recheck the urine routine several times to rule out physiological proteinuria.

2. If physiological urine protein is ruled out, it must be kidney disease, and to determine whether it is chronic glomerulonephritis, occult nephritis, or IgA nephropathy, then the only way is to do kidney puncture.

3. In fact, the damage to the kidneys caused by renal puncture is not as serious as imagined, and it has no major impact on the human body.

4. Your situation may be occult nephritis, which generally has no obvious clinical manifestations, only good attention at ordinary times, and the prognosis is generally better.

Nephritis can be basically determined, doing kidney wear can only be further diagnosed with which type of nephritis, your girlfriend's condition is not serious, there is no need to do kidney wear, even if it is diagnosed after doing which nephritis is useless, **means are the same, nephritis is no way**, can only be long-term drinking Chinese medicine conditioning, personal suggestions are as follows:

Do a B ultrasound to rule out kidney stones, and then do an IgG Iga C3 C4 complement test antibody test, so that you can almost confirm what kind of nephritis is (it can only be said to be about the same, because you have to do a puncture to confirm the diagnosis) Most of the nephritis with asymptomatic urine protein or hematuria is IgA nephropathy, generally IgA nephropathy is very stable, and the prognosis is better, and then do an early kidney injury to see if there is a trace albumin, and then do a kidney function test, it is useless to find Western medicine, only ** surface symptoms, find a good Chinese medicine, taking Chinese medicine for a period of time is not a big problem.

In the future life, try to eat less high-protein foods, because the more protein intake, the more protein in the urine, you can not eat seafood, bananas, and soy products, you can eat more lotus root, crucian carp.

In the future, we should pay attention to three points: urine protein, high blood pressure, and kidney function, the first two must be well controlled.

Proteinuria is physiological and pathological, and sometimes temporary proteinuria may be formed due to overwork or excessive exercise, which will disappear soon.

But if the proteinuria is exceeded the standard for many times, it is necessary to consider kidney disease, although your kidney puncture people have a bad impression of him, thinking that there is ***, but it is an important sign to check whether the kidney function is normal, so it is recommended to carry out a kidney puncture examination, so as to confirm whether it is really a kidney problem, and then what kind of kidney disease, so as to carry out the **, kidney disease is not a simple disease, it is necessary to pay attention to it, it is easy to aggravate and become uremia.

Your friend's is not serious, why do you have a traumatic examination like kidney puncture! It is recommended to go to another regular hospital for re-examination.

It is estimated that it looks like a bit of chronic nephritis, and the current quantification is okay. Within, there is no need to do a puncture --

It was not clear whether it was an acute infection, general diarrhea, and protein may increase during --- cold

Your girlfriend has a bit of chronic nephritis. At present, it is not conclusive--- it is generally recommended to repeat the urine routine every 2 months. Pay attention to blood pressure, and repeat urinalysis when you have a fever, infection, etc. Nephritis is generally not uncomfortable and should be detected by physical examination.

I agree with 9725sun's answer, 219mg is still very mild, but it can also indicate that there is a lesion in the kidney, it may be occult glomerulonephritis, and you should protect yourself well before there are no symptoms to delay the development of the disease.

24-hour urine protein exceeded, indicating that there is slight damage to the kidneys, because normal people are < = 150mg, which can basically determine kidney disease. But your girlfriend's 219mg is not too important, as long as it is less than 300mg, it is mild, it is recommended to eat Huangkui capsules to reduce protein, and eat Jinshuibao to regulate the kidneys. If there is no urine protein, stop Huang Kui, keep eating Jin Shui Bao, eat for a year or two, don't catch a cold, don't have inflammation, if you don't **, basically the condition will be stable.

Don't worry, this disease has to be slow, don't think about it so terrible, as long as the above two drugs can be controlled, you don't need to do puncture.

Urine protein is the protein in the body's urine. Normal urine contains a small amount of small molecule protein, which cannot be detected by ordinary urine routine examination, and can be detected by urine routine examination when the protein in the urine increases.

Higher protein in the urine indicates worse renal filtration function, which is an important indicator of kidney function. Generally, normal urine does not contain protein or only a trace amount of protein, and the protein content in the urine exceeds 150mg for 24 hours, which is called proteinuria.

Physiologic proteinuria, which often occurs after a high fever or strenuous exercise.

There are often patients who take the urine routine test sheet and ask the author with a blank face, what is the matter with ++ urine protein? In fact, there is a medical term for this project, which is called proteinuria.

Proteinuria refers to the presence of protein in the urine after microscopic examination, which is not milky white urine, and cannot be found without microscopic examination. The presence of protein in the urine indicates pathological changes in the kidneys, but with the improvement of the condition, the protein in the urine can gradually decrease and disappear. Protein is the basic substance that maintains the life of the human body, and a large loss of protein is harmful to the human body, and the qualitative proteinuria can be obtained from +-

-"Negative, no protein.

-"Trace proteins.

"Represents a small amount of protein.

+"Medium amount.

++"Lots of protein.

++'Lots of protein.

Renal damage is mild, urine pH is in the normal range, and urine specific gravity is in the maximum range;

Morning urine is usually around the place. The urine specific gravity of this patient is slightly high, but it is still within the maximum range, the pH of urine is the average value is in the normal range, and proteinuria is closely related to diet, such as meat and eggs. pH is also associated with a more acidic or alkaline diet.

Even if there is a slight amount of protein, there is no need to worry about it, and after proper rest, or attention to the adjustment of the diet, it will gradually disappear.

It is also advisable to drink more water appropriately, and the specific gravity of urine will gradually decrease with the increase of urine output.

+ - is half a protein, indicating inflammation in the kidneys. You have to hurry**, it's not so simple to drag it into a chronic one**. Milky white urine, possibly chyluria, may be caused by a urinary tract infection.

You are weak yang proteinuria, there is no diagnostic value - drinking water, light diet, rest and re-examination is negative, proteinuria is the loss of protein in the body with urine ---

Milky urine is chyluria.