Osteoarthritis and management of acute renal failure: Guidelines for the diagnosis and treatment of obesity-related complications

Management of Acute Renal Failure:

For uric acid nephropathy, administer acetazolamide 500mg initially, followed by 250mg three times daily. While ensuring adequate hydration with intravenous 1.25% sodium bicarbonate, administer furosemide 40-100mg intravenously to increase urine flow. Immediately administer allopurinol, starting at 8mg/kg body weight daily, reducing to 100-300mg daily after 3-4 days. If blood urea nitrogen and creatinine levels are significantly elevated, hemodialysis may be performed. If the nephropathy is caused by uric acid in the renal pelvis or ureter, in addition to urine alkalization and allopurinol, percutaneous nephrostomy may be performed first to relieve extrarenal obstruction, followed by further treatment of kidney stones.

Prognosis: Gouty nephropathy and kidney stones are major complications of gout. Approximately one-third of patients experience varying degrees of renal insufficiency. Acute obstructive renal failure caused by a sharp increase in uric acid levels can lead to death if not treated promptly. Drinking plenty of water, alkalizing urine, and using allopurinol are the main measures to prevent and treat this serious complication.

Osteoarthritis, also known as degenerative joint disease or proliferative osteoarthritis, is the most common joint disease and a complication of obesity. Weight gain is directly proportional to the incidence of osteoarthritis, and its onset is often closely related to age.

The treatment principle for osteoarthritis is to relieve pain and preserve function.

Pain relief methods include drug therapy, exercise therapy, hydrotherapy, acupuncture, and relaxation techniques. Functional maintenance can be achieved through regular and moderate exercise, physical therapy and occupational therapy, and walking aids.