Kidney failure signs and symptoms. Treatment of acute and chronic renal failure. Chronic stage

Kidney failure provokes irreversible processes in organs and tissues of the whole body. Develops when there is a problem with the heart, sharp drop blood pressure, dehydration, liver cirrhosis, organ damage from toxic substances or harmful microorganisms. Kidney failure is characterized by general malaise, intoxication, and disturbances in the functioning of other organs, in particular the gastrointestinal tract, heart, and brain. As the pathology progresses, patients note skin manifestations, the functioning of the respiratory system is impaired.

In acute renal failure, tissue death of these organs occurs, which is accompanied by loss of their functions. The clinical picture depends on the stage pathological process.

Table. Stages of renal failure.

Stage	Symptoms
Initial	The clinical picture characteristic of renal failure is not detected. Typically, patients complain of symptoms of the underlying disease, which provoked pathologies in the kidneys. Disturbances occur in the structure of the kidney tissue, which can be completely eliminated with a course of treatment.
Oliguric	The kidneys do not work properly, the amount of fluid excreted decreases. Intoxication of the body occurs due to the accumulation of decay products. Patients complain of swelling, as pathologies of water-salt balance occur. The main signs of this stage of the disease: - the volume of urine excreted per day rapidly decreases; - constant weakness, inability to perform active actions; - loss or significant decrease in appetite; - nausea, various disorders of the gastrointestinal tract, which is why patients often vomit; - muscle twitching, as the number of ions in the blood quickly decreases; - pathologies in the functioning of the cardiovascular system, expressed by shortness of breath, arrhythmia, and many patients also note that the heart rhythm - - contractions increase; - pain in the lower abdomen; - in rare cases, a stomach ulcer develops, which can cause regular bleeding; - infectious processes affecting the urinary system. Also, harmful microorganisms can spread to organs located in abdominal cavity; - exacerbation of chronic diseases is possible, since due to infectious process in the kidneys the immune system is significantly weakened. This stage has pronounced clinical manifestations and usually lasts no more than 11 days.
Polyuric	There is a visible stabilization of the patient's general condition. The daily amount of fluid secreted increases, sometimes this figure exceeds the norm. There is a risk of severe dehydration of the body, as well as the transition of infectious processes to the chronic stage.
Full recovery	If it was carried out competent treatment, kidney function is gradually restored. In most cases, this period lasts at least 6 months, but can last up to a year. If during the flow acute form The disease has undergone irreversible processes in the kidney cells, and it is impossible to fully recover.

Chronic renal failure: signs

At chronic oppression the functioning of the kidneys, the death of nephrons and the replacement of dead cells with connective tissue are possible. At stage 4 of the pathological process, the kidneys stop functioning, urine is not excreted, which causes changes in the electrolyte composition of the blood.

Latent stage

Symptoms of the disease at this stage depend on the pathology that provoked the occurrence of impaired renal function.

Edema. They can appear not only in the morning, but also during the day. Usually their size depends on the amount of liquid taken per day.
Increased pressure, not caused by obvious factors.
Strong pain in the lumbar region.

Attention! There is a possibility of complete absence characteristic symptoms diseases, if renal failure occurred due to polycystic disease or glomerulonephritis.

Signs indicating the presence of an infectious process in the body:

fast fatiguability;
problems with sleep, most often patients report insomnia;
loss of appetite, patients often refuse most foods.

Important! These symptoms can indicate an extensive list of diseases. You cannot rely solely on a person’s well-being to make a diagnosis of kidney failure. If you notice the listed symptoms, it is advisable to consult a doctor and then conduct a full diagnostic examination.

The latent stage of the pathology can be suspected by the frequent urge to urinate at night. To find out whether this deviation is a symptom of kidney disease, you need to consume a minimum amount of fluid during the day. If a temporary decrease in the amount of fluid consumed does not affect the number of urinations, it is advisable to undergo an examination.

If early signs of kidney failure are ignored, additional symptoms will become noticeable as the disease progresses.

Intense thirst even if the patient regularly drinks the required amount of fluid. You should make sure that this symptom not caused by chronically high blood pressure.
A decrease in the amount of hemoglobin in the blood, electrolyte disturbances that can be detected by taking a blood test. Also often diagnosed is a decrease in the amount of vitamin D, a decrease in the level of parathyroid hormone without symptoms of osteoporosis.

Attention! If you notice the disease at a latent stage, you can completely eliminate the negative symptoms. To do this, it is important to undergo a diagnostic examination, then follow the recommendations of the doctor who prescribed the course of treatment.

Azotemic stage

If the prescribed treatment is ineffective, as well as the symptoms of the latent stage of renal failure are ignored, irreversible pathological processes appear in the structure of the renal tissue. The clinical picture of the disease is characterized by the following signs.

Intermittent stage

The intensity of the symptoms of renal failure that have already appeared increases, and additional abnormalities also arise.

Pathologies of lipid metabolism, an increase in the amount of cholesterol in the blood, which can be detected during testing. The listed disorders are provoked by pathologies in the structure of the walls of blood vessels, as well as brain cells.
Increased amount of phosphorus in the blood. As a result, the initial stage of osteoporosis occurs, salt deposits appear in the cells.
Patients complain of pain in the joints. Usually discomfort occur periodically, but the pain appears sharply and is of high intensity.
The kidneys do not excrete purine compounds, since their functioning processes are disrupted. As a result, secondary gout develops and the intensity also increases. pain syndrome in the joints.
Malfunctions of the heart, chronic arrhythmia, extrasystole. Gradually, the course of these diseases worsens. Pathologies in the functioning of the heart are provoked due to an increase in the amount of potassium. If the patient does a cardiogram, signs of microinfarctions will be detected.
Changes in appearance. The patient's face becomes puffy and increases in size salivary glands. Both strangers and the patient himself regularly note the presence of the smell of acetone from the mouth. An unpleasant taste appears in the mouth.

Attention! These signs indicate an increase in the amount of uremic toxins in the body.

Terminal stage

Replacement treatment is required. Hemodialysis is performed; it can be replaced by peritoneal dialysis. Sometimes these procedures are combined. Failure to artificially support kidney function can lead to death.

The main symptoms indicating the transition of the disease to the terminal stage are given below.

The kidneys cannot fully produce urine. Excretion products are excreted in minimal quantities. As a result, swelling occurs. They appear visually and damage also occurs internal organs. The most dangerous complication that can lead to death is pulmonary edema.
Itching skin. Usually this deviation manifests itself so strongly that patients cannot ignore it, and scratches appear on the skin. The patient's complexion takes on a gray-yellow hue.
Nosebleeds often occur. There may also be periodic bleeding from the gums. Traces of small intracellular bleeding can be seen on the skin. They usually occur even with minimal mechanical impact. The predisposition to bleeding is caused by a large amount of uremic toxins, which quickly accumulate in the body and are excreted extremely slowly. In some cases, bleeding occurs in the gastrointestinal tract, which worsens the symptoms of anemia.
Electrolyte disturbances that lead to serious mental and neurological pathologies. There is a risk of paralysis, prolonged depression, and the development of manic disorders is possible.
A persistent increase in blood pressure that cannot be reduced even with the help of potent medications. The course of heart failure also worsens.
The patient experiences difficulty breathing, congestion occurs in the lungs, which often provoke the onset of pneumonia.
Uremic gastroenterocolitis. Patients indicate frequent vomiting, diarrhea, and nausea also occurs periodically.

Attention! At stages 3 and 4 of chronic renal failure, there is a threat to the patient’s life. To prevent the occurrence dangerous symptoms, you should undergo a course of treatment when the first symptoms of abnormalities in kidney function are detected.

Specific symptoms that help identify chronic renal failure, focusing on clinical picture diseases occur due to irreversible processes in organs. In order to promptly diagnose the disease in the initial stages, it is necessary to regularly take blood and urine tests, and also consult a doctor if weakness or decreased ability to work appears.

Video - Kidney failure: symptoms, causes and treatment

Content

Renal failure - symptoms of malfunctions in the secretory, excretory and filtration functions of the kidneys; the late stage or severe degree of the disease has a chronic symptom and leads to the destruction of kidney tissue. Kidney function is impaired due to traumatic condition or due to inflammatory processes occurring in the body.

What is kidney failure

Kidney failure is a disease caused by failure of the kidneys to function. They stop forming and excreting urine, which leads to a failure in the regulation of the water-salt, osmotic state of the body, and then causes acidosis (violation of the PH level). Deficiency can be acute or chronic. Acute occurs abruptly, as a consequence of shock from injury or intoxication. Chronic occurs in several stages.

Causes

Acute renal failure occurs due to external influences on the body. At timely treatment proceeds practically without serious consequences. Factors provoking the disease:

injury;
burn;
toxic effects of poisons or drugs;
infection;
acute kidney diseases;
obstruction of the patency of the upper urethra.

The acute stage can develop into a chronic stage. Serious diseases of internal organs and serious illnesses that require constant medication are also a risk for the occurrence of chronic renal failure:

stones in the kidneys;
cardiovascular disorders;
diabetes;
hypertension;
hepatitis B, C;
chronic glomerulonephritis;
chronic pyelonephritis;
cysts;
anomaly of the urinary system;
intoxication.

Classification

ARF varies in form, course and severity. The course of the disease is divided into 4 phases, from initial period to the recovery stage. In severity there are 1, 2 and 3 degrees, depending on the amount of creatinine in the blood. According to the nature of the location of kidney damage, acute renal failure occurs:

Prerenal acute. Caused by a violation of blood hemodynamics.
Parenchymatous (renal). Occurs due to toxic or ischemic kidney damage, infection or inflammatory process.
Obstructive (postrenal) – a consequence of obstruction of the urethra.

CRF occurs in several stages. Depending on the degree of damage to kidney tissue cells, the stages of the disease are classified:

Latent stage. Main signs: dry mouth, fatigue, protein in urine.
Compensatory stage. Increased daily urine output (up to 2.5 l), with characteristic changes in composition, pain in the abdomen and when urinating. There are symptoms of intoxication.
Intermittent stage. Progression of kidney dysfunction, nausea, vomiting, lack of appetite, changes in the color and condition of the skin, increased urea, creatinine in the blood.
Terminal stage. Complete kidney failure, death of kidney tissue. The electrolyte composition of the blood is disrupted, anuria occurs. Complications: pulmonary edema, heart disease, hormonal imbalance, worse blood clotting, weak immunity, disruptions in the central nervous system.

Diagnostics

In the early stages of development, the symptoms of the disease are similar to ordinary illness. Laboratory tests are used to make a more accurate diagnosis. How to determine kidney failure:

Laboratory research method
General urine analysis	Presence of sediment. Protein and red blood cell levels indicate stones, infections, trauma, tumors. White blood cell levels change with infection and low immunity.
Bacteriological research urine	The causative agent of kidney infection is determined, incl. secondary. Appointed antibacterial drugs according to the reaction of the pathogen.
General blood analysis	An increase in leukocytes and ESR levels indicate infection. A decrease in red blood cells and white blood cells indicates anemia.
Blood chemistry	Assess the degree of pathology. Measure: calcium; phosphorus; potassium; creatine; PH level.	The presence of chronic renal failure is determined by the level of: urea; squirrel residual nitrogen; creatinine; cholesterol; hyperkalemia.
Ultrasound, CT, MRI	The internal structure of the kidneys helps determine the extent of tissue damage, Bladder– identify obstructions in the patency of the urethra.
Dopplerography	Blood flow in the vessels of the kidneys.
X-rays of light	Condition of the upper respiratory tract.
Chromocystoscopy – staining and examination of urine	For emergency situations
Kidney biopsy	Clarifying the diagnosis
	Detection of cardiac dysfunction.
Zimnitsky test: measuring the composition and volume of urine up to 8 times during the day		Kidney functions.

How does kidney failure manifest in humans?

Kidney failure is manifested by difficulty urinating. The daily amount of fluid excreted sharply decreases to the point of anuria, nausea and swelling appear, the skin becomes dry and flabby with a yellow tint. Later, sweating increases as a result of the removal of toxins from the body alternative way, and the sweat has a strong smell of urine.

First signs

In the early stages, the disease may manifest itself as abdominal pain. The symptoms are similar to body poisoning or a simple viral infection. Common syndromes:

headache;
nausea;
vomit;
dryness and bitterness in the mouth;
diarrhea;
convulsions;
itchy skin;
abdominal pain;
nosebleeds;
swelling, bruising.

Acute

In case of acute renal failure in the early stages, no clinical symptoms are observed, because the disease that provoked it clearly manifests itself. Signs appear later: acute uremia, anuria and polyuria (a sharp increase in urine volume) occurs. AKI is triggered by external kidney damage, infections, toxins, side effects medications.

Chronic

CRF is accompanied by the death of nephrons and kidney tissue cells. When homeostasis is disrupted and a significant number of nephrons die, performance decreases, the skin dries out, and thirst suffers. The terminal stage leads to dystrophy due to decreased appetite, changes in skin color and structure, muscle damage, the appearance of cramps, itching, vomiting, diarrhea, and bloating. There is an odor of ammonia from the mouth and urine from the body. Without treatment, serious complications occur, incl. pulmonary edema, uremic coma.

Cardiorenal

Chronic renal failure causes cardiovascular failure, leads to a decrease in blood flow in the heart, disorders heart rate, decrease in oxygen concentration in the blood. Complications:

arterial hypertension;
decreased blood pressure;
hypertrophy, diastolic and systolic dysfunction of the left ventricle;
atherosclerosis;
ischemia;
chronic heart failure;
arrhythmia;
valvular heart disorders.

Hepatorenal

CRF occurs when there is a change in blood circulation in the kidneys. Renal blood flow is disrupted, and anemia of the renal arteries develops. The condition is aggravated by drinking alcohol, taking medications, and local anesthesia. The disease progresses rapidly, urine output decreases sharply, the liver and kidneys fail, and toxic poisoning of the body begins. Complications:

damage to the gastrointestinal tract;
pulmonary edema;
osteodystrophy (structural disorder bone tissue);
malfunction of other internal organs;
encephalopathy.

Heavy

The disease occurs with significant loss of nephrons renal parenchyma– building tissue of the kidneys. Nephron damage is an irreversible process, so the late stage is treated surgically, through the introduction of a catheter into the abdominal cavity to remove urine from the body. At the most severe forms artificial kidney implantation is required.

Symptoms in women

Women have a special structure genitourinary system. Urethra in female body shorter and wider than in men's, which facilitates the unhindered penetration of infections into the bladder. The inflammatory process travels through the ureters to the kidneys. Ingestion of toxins, poisons and drug waste is especially dangerous, as are hormonal disorders. Renal failure may manifest itself as a pathology after pregnancy or gynecological treatment, and can develop into chronic uremia.

Signs in men

The urethra in men has a narrow and elongated shape. Renal failure may occur with uremic pericarditis, urinary tract obstruction, urolithiasis, inflammation of the genitourinary system. There is an inverse relationship - stones form in the bladder, the urethra becomes inflamed, prostate. All of the above are a consequence of kidney disease.

During pregnancy

Acute and chronic renal failure for a pregnant woman becomes a risk during pregnancy, which provokes miscarriages, miscarriage, early birth and stillbirth. A complication during pregnancy is hypertension. Offensive terminal stage during pregnancy, early delivery is required to preserve the life and health of the baby.

Video

Renal failure means a syndrome in which all functions relevant to the kidneys are disrupted, resulting in a disorder various types exchanges in them (nitrogen, electrolyte, water, etc.). Kidney failure, the symptoms of which depend on the course of this disorder, can be acute or chronic, each of the pathologies develops due to exposure great friend from other circumstances.

general description

The main functions of the kidneys, which in particular include the functions of removing metabolic products from the body, as well as maintaining the balance in the acid-base state and water-electrolyte composition, directly involve renal blood flow, as well as glomerular filtration in combination with the tubules. In the latter version, the processes consist of concentration ability, secretion and re-absorption.

What is noteworthy is that not all changes that may affect the listed variants of the processes are the obligatory cause of subsequent pronounced disturbances in kidney function; accordingly, any disturbance in the processes cannot be defined as renal failure, which interests us. Thus, it is important to determine what renal failure actually is and on the basis of what specific processes it is advisable to distinguish it as this type of pathology.

So, by renal failure we mean a syndrome that develops against the background of severe disturbances in renal processes, in which we are talking about a disorder of homeostasis. Homeostasis generally refers to the maintenance at a level of relative constancy of the internal environment characteristic of the body, which in the variant we are considering is attached to its specific area - that is, to the kidneys. At the same time, azotemia (in which there is an excess of protein metabolic products in the blood, which includes nitrogen), disturbances in the body’s general acid-base balance, as well as disturbances in the water-electrolyte balance, become relevant in these processes.

As we have already noted, the condition we are interested in today can arise against the background of the influence of various causes; these causes, in particular, are determined by what type of renal failure (acute or chronic) we are talking about.

Renal failure, the symptoms of which in children manifest themselves similarly to those in adults, will be discussed below in terms of the course of interest (acute, chronic) in combination with the reasons that provoke their development. The only point that I would like to note against the background of the commonality of symptoms is that in children with a chronic form of renal failure, growth retardation, and this connection has been known for quite a long time, noted by a number of authors as “renal infantilism.”

The actual reasons that provoke such a delay have not been fully elucidated, however, the loss of potassium and calcium against the background of effects provoked by acidosis can be considered as the most likely factor leading to it. It is possible that this also occurs due to renal rickets, which develops as a result of the relevance of osteoporosis and hypocalcemia in the condition under consideration in combination with the lack of conversion to the required form of vitamin D, which becomes impossible due to the death of renal tissue.

Acute renal failure :
- Shock bud. This state is achieved due to traumatic shock, which manifests itself in combination with massive tissue damage, which occurs as a result of a decrease in the total volume of circulating blood. This condition is provoked by: massive blood loss; abortions; burns; a syndrome that occurs against the background of crushing muscles with their crushing; blood transfusion (in case of incompatibility); debilitating vomiting or toxicosis during pregnancy; myocardial infarction.
- Toxic kidney. In this case, we are talking about poisoning that occurred due to exposure to neurotropic poisons (mushrooms, insects, snake bites, arsenic, mercury, etc.). Among other things, intoxication with radiocontrast substances, medications (analgesics, antibiotics), alcohol, narcotic substances. The possibility of acute renal failure in this variant of the provoking factor cannot be excluded if relevant professional activity, directly related to ionizing radiation, as well as salts of heavy metals (organic poisons, mercury salts).
- Acute infectious kidney. This condition is accompanied by the impact of infectious diseases on the body. So, for example, an acute infectious kidney is an actual condition in sepsis, which, in turn, can have a different type of origin (primarily anaerobic origin is relevant here, as well as an origin against the background of septic abortions). In addition, the condition in question develops against the background of hemorrhagic fever and leptospirosis; with dehydration due to bacterial shock and infectious diseases such as cholera or dysentery, etc.
- Embolism and thrombosis, relevant for the renal arteries.
- Acute pyelonephritis or glomerulonephritis.
- Ureteral obstruction, caused by compression, the presence of tumor formation or stones in them.

It should be noted that acute renal failure occurs in about 60% of cases as a result of injury or surgery, about 40% occurs during treatment in medical institutions, and up to 2% during pregnancy.

Chronic renal failure:
- Chronic form of glomerulonephritis.
- Secondary kidney damage caused by the following factors:
  - arterial hypertension;
  - diabetes;
  - viral hepatitis;
  - malaria;
  - systemic vasculitis;
  - systemic diseases affecting connective tissues;
  - gout.
- Urolithiasis, ureteral obstruction.
- Renal polycystic disease.
- Chronic form of pyelonephritis.
- Current anomalies associated with the activity of the urinary system.
- Exposure due to a number of medications and toxic substances.

Leadership in the positions of the causes provoking the development of chronic renal failure syndrome is assigned to chronic glomerulonephritis And chronic form pyelonephritis.

Acute renal failure: symptoms

Acute renal failure, which we will further abbreviate to the abbreviation ARF, is a syndrome in which there is a rapid decrease or complete cessation of kidney functions, and these functions can decrease/stop in one kidney or in both at the same time. As a result of this syndrome, the metabolic processes, there is an increase in products formed during nitrogen metabolism. Relevant disorders of the nephron, which is defined as a structural renal unit, in this situation arise due to a decrease in blood flow in the kidneys and, at the same time, due to a decrease in the volume of oxygen delivered to them.

The development of acute renal failure can occur either within literally a few hours or within a period of 1 to 7 days. The duration of the condition that patients experience with this syndrome can be 24 hours or more. Timely seeking medical help with subsequent adequate treatment can ensure complete restoration of all functions in which the kidneys are directly involved.

Turning, in fact, to the symptoms of acute renal failure, it should initially be noted that in the overall picture in the foreground there is precisely the symptomatology that served as a kind of basis for the occurrence of this syndrome, that is, from the disease that directly provoked it.

Thus, we can distinguish 4 main periods that characterize the course of acute renal failure: the shock period, the period of oligoanuria, recovery period diuresis in combination with the initial phase of diuresis (plus the polyuria phase), as well as the recovery period.

Symptoms first period (mostly its duration is 1-2 days) is characterized by the already noted above symptoms of the disease that provoked the OPS syndrome - it is at this moment in its course that it manifests itself most clearly. Along with it, tachycardia and a decrease in blood pressure are also noted (which in most cases is transient, that is, soon stabilizing to normal levels). Chills occur, pale and yellow skin is noted, and body temperature rises.

Next, second period (oligoanuria, the duration is usually about 1-2 weeks), is characterized by a decrease or absolute cessation of the process of urine formation, which is accompanied by a parallel increase in residual nitrogen in the blood, as well as phenol in combination with other types of metabolic products. What is noteworthy is that in many cases it is during this period that the condition of most patients improves significantly, although, as already noted, there is no urine. Later, complaints of severe weakness and headache appear; patients’ appetite and sleep worsen. Nausea with accompanying vomiting also appears. The progression of the condition is indicated by the smell of ammonia that appears during breathing.

Also, in acute renal failure, patients experience disorders associated with the activity of the central nervous system, and these disorders are quite diverse. The most common manifestations of this type are apathy, although the opposite option is not excluded, in which, accordingly, patients are in an excited state, having difficulty navigating the environment that surrounds them; a general confusion of consciousness can also be a companion to this state. In frequent cases, convulsive seizures and hyperreflexia are also observed (that is, revival or strengthening of reflexes, in which, again, patients are in an overly excitable state due to an actual “shock” to the central nervous system).

In situations with the appearance of acute renal failure against the background of sepsis, patients may develop a herpetic type rash concentrated in the area around the nose and oral cavity. Skin changes in general can be very diverse, manifesting both in the form of urticarial rash or fixed erythema, and in the form of toxicoderma or other manifestations.

Almost every patient experiences nausea and vomiting, and somewhat less frequently, diarrhea. Especially often, certain digestive phenomena occur in combination with hemorrhagic fever along with renal syndrome. Lesions of the gastrointestinal tract are caused, first of all, by the development of excretory gastritis with enterocolitis, whose nature is defined as erosive. Meanwhile, some of the current symptoms are caused by disturbances arising from the electrolyte balance.

In addition to the listed processes, there is the development of edema in the lungs, resulting from increased permeability, which the alveolar capillaries have during this period. It is difficult to recognize it clinically, so diagnosis is made using an x-ray of the area chest.

During the period of oligoanuria, the total volume of urine excreted decreases. So, initially its volume is about 400 ml, and this, in turn, characterizes oliguria; then, with anuria, the volume of urine excreted is about 50 ml. The duration of oliguria or anuria can be up to 10 days, but some cases indicate the possibility of increasing this period to 30 days or more. Naturally, with a protracted form of manifestation of these processes, it is necessary active therapy to maintain human life.

During the same period, acute renal failure becomes a constant manifestation, in which, as the reader probably knows, hemoglobin drops. Anemia, in turn, is characterized by pale skin, general weakness, dizziness and shortness of breath, and possible fainting.

Acute renal failure is also accompanied by liver damage, and this occurs in almost all cases. Concerning clinical manifestations of this lesion, they consist of yellowness of the skin and mucous membranes.

The period during which there is an increase in diuresis (that is, the volume of urine formed within a certain time period; as a rule, this indicator is considered within 24 hours, that is, within the framework of daily diuresis) often occurs several days after the end of oliguria/anuria. It is characterized by a gradual onset, in which urine is initially excreted in a volume of about 500 ml with a gradual increase, and only after, again, gradually, this figure increases to about 2000 ml or more per day, and from this moment we can talk about the beginning of the third period of OPN.

WITH third period improvements in the patient’s condition are not immediately observed; moreover, in some cases the condition may even worsen. Polyuria phase in in this case is accompanied by weight loss of the patient, the duration of the phase is on average about 4-6 days. There is an improvement in the appetite of patients; in addition, previously relevant changes in the circulatory system and the functioning of the central nervous system disappear.

Conventionally, the beginning of the recovery period, that is, the next fourth period disease, the day of normalization of urea or residual nitrogen levels is noted (as determined based on appropriate tests), the duration of this period ranges from 3-6 months to 22 months. During this period of time, homeostasis is restored, renal concentration function and filtration improve, along with an improvement in tubular secretion.

It should be taken into account that over the next year or two it is possible that signs indicating functional failure in certain systems and organs (liver, heart, etc.) will persist.

Acute renal failure: prognosis

OPN, if it does not cause fatal outcome for the patient, ends with a slow, but, one might say, confident recovery, and this does not indicate the relevance for him of the tendency to transition to development against the background of this state to chronic disease kidney

After about 6 months, more than half of the patients reach the state full recovery ability to work, however, the possibility of its limitation for a certain part of patients is not excluded, on the basis of which they are assigned disability (group III). In general, ability to work in this situation is determined based on the characteristics of the course of the disease that provoked acute renal failure.

Chronic renal failure: symptoms

CRF, as we will further periodically define the considered variant of the course of chronic renal failure syndrome, is a process indicating an irreversible impairment to which kidney function has been subjected for a duration of 3 months or longer. This condition develops as a result of the gradual progression of the death of nephrons (structural and functional units of the kidneys). Chronic renal failure is characterized by a number of disorders, and in particular these include disturbances in excretory function (directly related to the kidneys) and the appearance of uremia, which occurs as a result of the accumulation of nitrogenous metabolic products in the body and the toxic effects they have.

On initial stage CRF has insignificant, one might say, symptoms, therefore it can only be determined on the basis of the corresponding laboratory research. Already obvious symptoms of chronic renal failure appear by the time of death in about 90% of total number nephrons. The peculiarity of this course of renal failure, as we have already noted, is the irreversibility of the process with the exception of subsequent regeneration of the renal parenchyma (that is, the outer layer from the cortex of the organ in question and the inner layer, presented in the form of the medulla). In addition to structural kidney damage against the background of chronic renal failure, other types of immunological changes cannot be excluded. The development of an irreversible process, as we have already noted, can be quite short (up to six months).

With chronic renal failure, the kidneys lose the ability to concentrate urine and dilute it, which is determined by a number of actual lesions of this period. In addition, the secretory function characteristic of the tubules is significantly reduced, and when the terminal stage of the syndrome we are considering is reached, it is completely reduced to zero. Chronic renal failure consists of two main stages, this is the conservative stage (in which, accordingly, it remains possible conservative treatment) and the stage, in fact, terminal (in this case the question arises regarding the choice replacement therapy, which consists of either extrarenal cleansing or a kidney transplant procedure).

In addition to disorders associated with the excretory function of the kidneys, disruption of their homeostatic, blood purification and hematopoietic functions also becomes relevant. Forced polyuria (increased urine production) is noted, on the basis of which one can judge a small number of still surviving nephrons performing their functions, which occurs in combination with isosthenuria (in which the kidneys are unable to produce urine with a higher or lower specific gravity). Isosthenuria in this case is a direct indicator that renal failure is at the final stage of its development. Along with other processes relevant to this condition, chronic renal failure, as can be understood, also affects other organs in which, as a result of processes characteristic of the syndrome in question, changes similar to dystrophy develop with simultaneous disruption of enzymatic reactions and a decrease in reactions of an immunological nature.

Meanwhile, it should be noted that the kidneys in most cases still do not lose their ability to full release water entering the body (in combination with calcium, iron, magnesium, etc.), due to the corresponding effects of which, the adequate functioning of other organs is subsequently ensured.

So, now let's move directly to the symptoms that accompany chronic renal failure.

First of all, patients experience a pronounced state of weakness, drowsiness and general apathy predominate. Polyuria also appears, in which about 2 to 4 liters of urine are released per day, and nocturia, characterized by frequent urination at night. As a result of this course of the disease, patients are faced with dehydration, and as it progresses, with the involvement of other systems and organs of the body in the process. Subsequently, weakness becomes even more pronounced, accompanied by nausea and vomiting.

Other manifestations of symptoms include puffiness of the patient’s face and severe muscle weakness, which in this condition occurs as a result of hypokalemia (that is, a lack of potassium in the body, which, in fact, is lost due to processes relevant to the kidneys). The skin of patients is dry, itchy, excessive agitation is accompanied by increased sweating. Muscle twitching also appears (in some cases reaching cramps) - this is already caused by loss of calcium in the blood.

Bones are also affected, which is accompanied by pain, disturbances in movement and gait. The development of this type of symptomatology is caused by a gradual increase in renal failure, balance in calcium levels and reduced glomerular filtration function in the kidneys. Moreover, such changes are often accompanied by changes in the skeleton, even at the level of a disease such as osteoporosis, and this occurs due to demineralization (that is, a decrease in the content of mineral components in bone tissue). The previously noted pain in movements occurs against the background of the accumulation of urates in the synovial fluid, which, in turn, leads to the deposition of salts, as a result of which this pain, in combination with the inflammatory reaction, occurs (this is defined as secondary gout).

Many patients experience chest pain, which can also appear as a result of fibrous uremic pleurisy. In this case, when listening to the lungs, wheezing may be noted, although more often this indicates the pathology of pulmonary heart failure. Against the background of such processes in the lungs, the possibility of secondary pneumonia cannot be ruled out.

Anorexia developing with chronic renal failure can cause patients to develop an aversion to any food, also combined with nausea and vomiting, the appearance of an unpleasant taste in the mouth and dryness. After eating, you may feel fullness and heaviness in the pit of the stomach - along with thirst, these symptoms are also characteristic of chronic renal failure. In addition, patients experience shortness of breath, often high blood pressure, and frequent pain in the heart area. Blood clotting decreases, which causes not only nosebleeds, but also gastrointestinal bleeding, with possible skin hemorrhages. Anemia also develops against the background general processes, affecting the composition of the blood, and in particular, leading to a decrease in the level of red blood cells in it, which is relevant for this symptom.

Late stages of chronic renal failure are accompanied by attacks of cardiac asthma. Edema forms in the lungs, consciousness is impaired. As a result of a number of these processes, the possibility of coma cannot be excluded. An important point is also the susceptibility of patients to infectious effects, because they easily fall ill with both common colds and more serious diseases, the impact of which only worsens the general condition and kidney failure, in particular.

In the preterminal period of the disease, patients experience polyuria, while in the terminal period there is predominantly oliguria (some patients experience anuria). Kidney functions, as you can understand, decrease with the progression of the disease, and this happens until they disappear completely.

Chronic renal failure: prognosis

The prognosis for a given variant of the course of the pathological process is determined largely on the basis of the course of the disease, which gave the main impetus for its development, as well as on the basis of complications that arose during the process in a complex form. Meanwhile, important role For prognosis, the current phase (period) of chronic renal failure for the patient with its rate of development is also assigned.

Let us highlight separately that the course of chronic renal failure is not only an irreversible process, but also a steadily progressive one, and therefore a significant prolongation of the patient’s life can only be said if he is provided with chronic hemodialysis or a kidney transplant is performed (we will dwell on these treatment options below).

Of course, cases in which chronic renal failure develops slowly with a corresponding clinical picture of uremia cannot be excluded, but these are rather exceptions - in the vast majority of cases (especially with high arterial hypertension, that is, high blood pressure), the clinic of this disease is characterized by its previously noted rapid progression.

Diagnosis

As the main marker taken into account in diagnosis acute renal failure , emit an increase in the level of nitrogenous compounds and potassium in the blood, which occurs with a simultaneous significant decrease in urine output (up to the complete cessation of this process). An assessment of the concentrating ability of the kidneys and the volume of urine excreted during the day is based on the results obtained from the Zimnitsky test.

An important role is also played by a biochemical blood test for electrolytes, creatinine and urea, because it is on the basis of indicators for these components that one can draw specific conclusions regarding the severity of acute renal failure, as well as how effective the methods used in treatment are.

The main task of diagnosing acute renal failure comes down to determining this form itself (that is, its specification), for which an ultrasound scan of the bladder and kidney area is performed. Based on the results of this research measure, the relevance/absence of ureteral obstruction is determined.

If necessary, to assess the state of renal blood flow, an ultrasound ultrasound procedure is performed, aimed at an appropriate study of the renal vessels. A kidney biopsy may be performed if acute glomerulonephritis, tubular necrosis, or systemic disease is suspected.

Regarding diagnostics chronic renal failure, then it uses, again, urine and blood analysis, as well as the Rehberg test. As a basis for confirming chronic renal failure, data indicating a reduced level of filtration, as well as an increase in the level of urea and creatinine are used. In this case, performing the Zimnitsky test determines isohyposthenuria. Ultrasound of the kidney area in this situation reveals thinning of the kidney parenchyma while simultaneously decreasing in size.

Treatment

Treatment of acute renal failure

Initial phase

First of all, the goals of therapy come down to eliminating the causes that led to disturbances in the functioning of the kidneys, that is, to treating the underlying disease that provoked acute renal failure. If shock occurs, it is urgent to ensure replenishment of blood volumes while simultaneously normalizing blood pressure. Poisoning with nephrotoxins implies the need to lavage the patient’s stomach and intestines.

Modern methods of cleansing the body of toxins have various options, and in particular - by the method of extracorporeal hemocorrection. Plasmapheresis and hemosorption are also used for this purpose. If the obstruction is relevant, the normal state of urine passage is restored, which is ensured by removing stones from the ureters and kidneys, eliminating operative method tumors and strictures in the ureters.

Oliguric phase

Osmotic diuretics, furosemide, are prescribed as a method to stimulate diuresis. Vasoconstriction (that is, narrowing of the arteries and blood vessels) against the background of the condition under consideration is carried out through the administration of dopamine, in determining the appropriate volume of which not only losses from urination, bowel movements and vomiting are taken into account, but also losses during breathing and sweating. Additionally, the patient is provided with a protein-free diet with limited intake of potassium from food. Wounds are drained and areas with necrosis are eliminated. The selection of antibiotics involves taking into account the overall severity of renal damage.

Hemodialysis: indications

The use of hemodialysis is relevant if urea levels increase to 24 mol/l, as well as potassium to 7 or more mol/l. Symptoms of uremia, as well as overhydration and acidosis are used as indications for hemodialysis. Today, in order to avoid complications that arise against the background of actual disturbances in metabolic processes, hemodialysis is increasingly prescribed by specialists in the early stages, as well as for the purpose of prevention.

This method itself consists of extrarenal blood purification, which ensures the removal of toxic substances from the body while normalizing disturbances in electrolyte and water balance. To do this, the plasma is filtered using a semi-permeable membrane for this purpose, which is equipped with an “artificial kidney” apparatus.

Treatment of chronic renal failure

With timely treatment of chronic renal failure, focused on the result in the form of stable remission, there is often the possibility of a significant slowdown in the development of processes relevant to this condition with a delay in the appearance of symptoms in its characteristic pronounced form.

Early-stage therapy is focused more on those measures that can prevent/slow down the progression of the underlying disease. Of course, the underlying disease requires treatment for disorders in the renal processes, but it is the early stage that determines the greater role for therapy aimed at it.

As active measures in the treatment of chronic renal failure, hemodialysis (chronic) and peritoneal dialysis (chronic) are used.

Chronic hemodialysis is aimed specifically at patients with this form of renal failure; we noted its general specifics somewhat above. Hospitalization is not required, but a visit to a dialysis unit in a hospital or outpatient center cannot be avoided in this case. The so-called dialysis time is defined within the standard framework (about 12-15 hours/week, that is, for 2-3 visits per week). After completing the procedure, you can go home; this procedure has virtually no effect on the quality of life.

As for peritoneal chronic dialysis, it consists of introducing a dialysate solution into the abdominal cavity through the use of a chronic peritoneal catheter. This procedure does not require any special installations; moreover, the patient can carry it out independently in any conditions. The general condition is monitored every month with a direct visit to the dialysis center. The use of dialysis is relevant as a treatment for the period during which a kidney transplant procedure is expected.

Kidney transplantation is the procedure of replacing a diseased kidney with a healthy kidney from a donor. What is noteworthy is that one healthy kidney can cope with all those functions that could not be provided by two diseased kidneys. The issue of acceptance/rejection is resolved by conducting a series of laboratory tests.

Any member of the family or environment, as well as a recently deceased person, can become a donor. In any case, the chance of the body rejecting the kidney remains even if the necessary indicators in the previously noted study are met. The likelihood of an organ being accepted for transplantation is determined by various factors (race, age, health status of the donor).

In about 80% of cases, a kidney from a deceased donor survives within a year from the date of surgery, although if we are talking about relatives, the chances of a successful outcome of the operation increase significantly.

Additionally, after kidney transplantation, immunosuppressants are prescribed, which the patient must take constantly throughout his subsequent life, although in some cases they cannot affect organ rejection. In addition, there are a number side effects from taking them, one of which is weakening immune system, on the basis of which the patient becomes particularly susceptible to infectious effects.

If symptoms appear that indicate the possible relevance of renal failure in one form or another of its course, consultation with a urologist, nephrologist and attending physician is necessary.

Kidney failure - pathological condition, which occurs in various diseases and is characterized by disruption of all kidney functions.

The kidney is an organ of the urinary system. Her main function- formation of urine.

It goes like this:

Blood entering the kidney vessels from the aorta reaches the glomerulus of capillaries, surrounded by special capsule(Shumlyansky-Bowman capsule). Under high pressure, the liquid part of the blood (plasma) with substances dissolved in it seeps into the capsule. This is how primary urine is formed.
Primary urine then moves through the convoluted tubule system. Here, water and substances necessary for the body are absorbed back into the blood. Secondary urine is formed. Compared to the primary one, it loses in volume and becomes more concentrated, only harmful products metabolism: creatine, urea, uric acid.
From the tubular system, secondary urine enters the renal calyces, then into the pelvis and into the ureter.

Kidney functions, which are realized through the formation of urine:

Excretion of harmful metabolic products from the body.
Regulation of blood osmotic pressure.
Hormone production. For example, renin, which is involved in the regulation blood pressure.
Regulation of the content of various ions in the blood.
Participation in hematopoiesis. The kidneys secrete biologically active substance erythropoietin, which activates the formation of erythrocytes (red blood cells).

In renal failure, all these renal functions are impaired.

Causes of kidney failure

Causes of acute renal failure

Classification of acute renal failure, depending on the causes:

Prerenal. Caused by impaired renal blood flow. The kidney does not receive enough blood. As a result, the process of urine formation is disrupted, and pathological changes occur in the kidney tissue. Occurs in approximately half (55%) of patients.
Renal. Associated with pathology of renal tissue. The kidney receives enough blood, but cannot produce urine. Occurs in 40% of patients.
Postrenal. Urine is formed in the kidneys, but cannot flow out due to an obstruction in the kidneys. urethra. If an obstruction occurs in one ureter, the function of the affected kidney will be taken over by the healthy one - renal failure will not occur. This condition occurs in 5% of patients.

In the picture: A - prerenal renal failure; B - postrenal renal failure; C - renal renal failure.

Causes of acute renal failure:

Prerenal	Conditions in which the heart stops coping with its functions and pumps less blood: arrhythmias, heart failure, severe bleeding, thromboembolism pulmonary artery. A sharp drop in blood pressure: shock during generalized infections (sepsis), severe allergic reactions, overdose of certain medications. Dehydration: severe vomiting, diarrhea, burns, use of excessive doses of diuretics. Cirrhosis and other liver diseases: this disrupts the outflow venous blood, swelling occurs, the functioning of the cardiovascular system and blood supply to the kidneys are disrupted.
Renal	Poisoning: toxic substances in everyday life and in industry, snake bites, insect bites, heavy metals, excessive doses of certain medications. Once in the bloodstream, the toxic substance reaches the kidneys and disrupts their function. Massive destruction of red blood cells and hemoglobin with transfusion of incompatible blood, malaria. This causes damage to the kidney tissue. Antibody damage to the kidneys autoimmune diseases, for example, in myeloma. Damage to the kidneys by metabolic products in some diseases, for example, salts uric acid for gout. Inflammatory process in the kidneys: glomerulonephritis, hemorrhagic fever with renal syndrome, etc. Kidney damage in diseases accompanied by damage to the renal vessels: scleroderma, thrombocytopenic purpura, etc. Trauma to a single kidney(if the second one does not function for some reason).
Postrenal	Tumors prostate, bladder, and other pelvic organs. Damage or accidental ligation of the ureter during surgery. Ureteral obstruction. Possible reasons: blood clot, pus, stone, congenital malformations. Urinary dysfunction caused by the use of certain medications.

Causes of chronic renal failure

Symptoms of kidney failure

Symptoms of acute renal failure

Symptoms of acute renal failure depend on the stage:

initial stage;
stage of decrease in daily urine volume to less than 400 ml (oliguric stage);
stage of restoration of urine volume (polyuric stage);
full recovery stage.

Stage	Symptoms
Initial	At this stage, there is no renal failure as such yet. The person is concerned about the symptoms of the underlying disease. But disturbances in the kidney tissue are already occurring.
Oliguric	Renal dysfunction increases and the amount of urine decreases. Due to this, harmful metabolic products are retained in the body, and disturbances in the water-salt balance occur. Symptoms: decrease in daily urine volume less than 400 ml; weakness, lethargy, lethargy; decreased appetite; nausea and vomiting; muscle twitching (due to a violation of the ion content in the blood); cardiopalmus; arrhythmias; some patients experience ulcers and gastrointestinal bleeding; infections of the urinary, respiratory system, abdominal cavity against the background of weakening of the body. This stage of acute renal failure is the most severe and can last from 5 to 11 days.
Polyuric	The patient's condition returns to normal, the amount of urine increases, usually even more than normal. At this stage, dehydration and infections may develop.
Full recovery	Final restoration of kidney function. Usually lasts from 6 to 12 months. If during acute renal failure the work was switched off most of renal tissue, then complete recovery is impossible.

Symptoms of chronic renal failure

At the initial stage, chronic renal failure has no manifestations. The patient feels relatively normal. Typically, the first symptoms appear when 80%-90% of the kidney tissue ceases to perform its functions. But before this time, a diagnosis can be made if an examination is carried out.

Usually the first to appear are general symptoms: lethargy, weakness, increased fatigue, frequent malaise.

Urine excretion is impaired. More of it is produced per day than it should be (2-4 liters). Because of this, dehydration may develop. There is frequent urination at night. In the later stages of chronic renal failure, the amount of urine decreases sharply - this bad sign.

Nausea and vomiting.

Muscle twitching.

Skin itching.

Dryness and bitter feeling in the mouth.

Stomach ache.

Diarrhea.

Nose and stomach bleeding due to decreased blood clotting.

Hemorrhages on the skin.

Increased susceptibility to infections. Such patients often suffer respiratory infections, pneumonia.

At a late stage: the condition worsens. Attacks of shortness of breath and bronchial asthma occur. The patient may lose consciousness or fall into a coma.

Symptoms of chronic renal failure resemble those of acute renal failure. But they grow more slowly.

Diagnosis of kidney failure

Diagnostic method	Acute renal failure	Chronic renal failure
General urine analysis	A general urine test for acute and chronic renal failure can reveal: change in urine density, depending on the cause of renal dysfunction; small amount of protein; red blood cells for urolithiasis, infection, tumor, injury; leukocytes - for infections, autoimmune diseases.
Bacteriological examination of urine	If the renal dysfunction was caused by an infection, the pathogen will be detected during the study. This analysis also makes it possible to identify an infection that has occurred against the background of renal failure and determine the sensitivity of the pathogen to antibacterial drugs.
General blood analysis	In acute and chronic renal failure, changes in the general blood test are revealed: an increase in the number of leukocytes, an increase in the erythrocyte sedimentation rate (ESR) - a sign of infection, inflammatory process; decreased number of red blood cells and hemoglobin (anemia); decreased platelet count (usually small).
Blood chemistry	Helps evaluate pathological changes in the body caused by impaired renal function. In a biochemical blood test in acute renal failure, changes can be detected: decreased or increased calcium levels; decrease or increase in phosphorus levels; decrease or increase in potassium content; increased magnesium levels; increasing the concentration of creatine (an amino acid that is involved in energy metabolism); decrease in pH (blood acidification).	In chronic renal failure, biochemical blood tests usually reveal changes: increased levels of urea, residual blood nitrogen, creatinine; increased levels of potassium and phosphorus; decreased calcium levels; decreased protein levels; increased cholesterol levels are a sign of vascular atherosclerosis, which has led to impaired renal blood flow.
computed tomography (CT); magnetic resonance imaging (MRI).	These methods allow you to examine the kidneys, their internal structure, renal calyces, pelvis, ureters, and bladder. In acute renal failure, CT, MRI and ultrasound are most often used to find the cause of the narrowing urinary tract.
Doppler ultrasound	Ultrasound examination, during which you can evaluate the blood flow in the vessels of the kidneys.
Chest X-ray	It is used to identify disorders of the respiratory system and some diseases that may cause renal failure.
Chromocystoscopy	The patient is injected intravenously with a substance that is excreted through the kidneys and colors the urine. Then a cystoscopy is performed - an examination of the bladder using a special endoscopic instrument inserted through the urethra. Chromocystoscopy is a simple, fast and safe diagnostic method that is often used during emergency situations.
Kidney biopsy	The doctor obtains a piece of kidney tissue and sends it to the laboratory for examination under a microscope. Most often this is done using a special thick needle, which the doctor inserts into the kidney through the skin. Biopsy is resorted to in doubtful cases when it is not possible to establish a diagnosis.
Electrocardiography (ECG)	This study is mandatory for all patients with acute renal failure. It helps to identify heart problems and arrhythmias.
Zimnitsky test		The patient collects all urine during the day into 8 containers (each for 3 hours). Determine its density and volume. The doctor can evaluate the state of kidney function and the ratio of daytime and nighttime urine volumes.

Treatment of kidney failure

Acute renal failure requires immediate hospitalization of the patient in a nephrology hospital. If the patient is in serious condition, he is placed in the intensive care unit. Therapy depends on the causes of renal dysfunction.

For chronic renal failure, therapy depends on the stage. At the initial stage, treatment of the underlying disease is carried out - this will help prevent severe renal dysfunction and make it easier to cope with them later. If the amount of urine decreases and signs of renal failure appear, it is necessary to deal with pathological changes in organism. And during the recovery period, you need to eliminate the consequences.

Directions for treatment for renal failure:

Direction of treatment	Events
Eliminating the causes of prerenal acute renal failure.	In case of large blood loss - blood transfusion and blood substitutes. If lost large quantity plasma - administration through a dropper saline solution, glucose solution and other drugs. Fighting arrhythmia - antiarrhythmic drugs. If the functioning of the cardiovascular system is disrupted, use heart medications and drugs that improve microcirculation.
Eliminating the causes of renal acute renal failure	For glomerulonephritis and autoimmune diseases - administration of glucocorticosteroids (drugs of adrenal hormones), cytostatics (drugs that suppress the immune system). For arterial hypertension - drugs that lower blood pressure. In case of poisoning, use blood purification methods: plasmapheresis, hemosorption. For pyelonephritis, sepsis and other infectious diseases - the use of antibiotics and antiviral drugs.
Eliminating the causes of postrenal acute renal failure	It is necessary to remove the obstacle that interferes with the outflow of urine (tumor, stone, etc.). Most often, this requires surgical intervention.
Eliminating the causes of chronic renal failure	Depends on the underlying disease.
Measures to combat disorders that occur in the body during acute renal failure
Elimination of water-salt imbalances	In a hospital, the doctor must carefully monitor how much fluid the patient’s body receives and loses. To restore the water-salt balance, various solutions (sodium chloride, calcium gluconate, etc.) are administered intravenously through a dropper, and their total volume should exceed fluid loss by 400-500 ml. If there is fluid retention in the body, diuretics are prescribed, usually furosemide (Lasix). The doctor selects the dosage individually. Dopamine is used to improve blood flow to the kidneys.
Fighting blood acidification	The doctor prescribes treatment when the acidity (pH) of the blood drops below the critical value of 7.2. A sodium bicarbonate solution is injected intravenously until its concentration in the blood rises to certain values and the pH rises to 7.35.
Fighting Anemia	If the level of red blood cells and hemoglobin in the blood decreases, the doctor prescribes blood transfusions and epoetin (a drug that is an analogue of the kidney hormone erythropoietin and activates hematopoiesis).
Hemodialysis, peritoneal dialysis	Hemodialysis and peritoneal dialysis are methods of purifying the blood of various toxins and unwanted substances. Indications for acute renal failure: Dehydration and acidification of the blood that cannot be eliminated with medications. Damage to the heart, nerves and brain as a result of severe renal dysfunction. Severe poisoning with aminophylline, lithium salts, acetylsalicylic acid and other substances. During hemodialysis, the patient's blood is passed through a special device - an “artificial kidney”. It has a membrane that filters the blood and cleanses it of harmful substances. In peritoneal dialysis, a blood purification solution is injected into the abdominal cavity. As a result of the difference in osmotic pressure it absorbs harmful substances. It is then removed from the abdomen or replaced with a new one.
Kidney transplant	Kidney transplantation is carried out in case of chronic renal failure, when severe disorders occur in the patient’s body, and it becomes clear that it will not be possible to help the patient in other ways. The kidney is taken from a living donor or a cadaver. After the transplant, a course of therapy with drugs that suppress the immune system is administered to prevent rejection of the donor tissue.

Diet for acute renal failure

Prognosis for renal failure

Prognosis for acute renal failure

Depending on the severity of acute renal failure and the presence of complications, from 25% to 50% of patients die.

Most common reasons death:

Damage to the nervous system - uremic coma.
Severe circulatory disorders.
Sepsis is a generalized infection, “blood poisoning”, in which all organs and systems are affected.

If acute renal failure proceeds without complications, then complete restoration of kidney function occurs in approximately 90% of patients.

Prognosis for chronic renal failure

Depends on the disease against which the kidney function was impaired, the age, and the condition of the patient’s body. Since hemodialysis and kidney transplantation began to be used, patient deaths have become less frequent.

Factors that worsen the course of chronic renal failure:

arterial hypertension;
incorrect diet when food contains a lot of phosphorus and protein;
high content protein in the blood;
increased function of the parathyroid glands.

Factors that can provoke a deterioration in the condition of a patient with chronic renal failure:

kidney injury;
urinary tract infection;
dehydration.

Prevention of chronic renal failure

If proper treatment of a disease that can lead to chronic renal failure is started in a timely manner, then kidney function may not be affected or, at least, its impairment will not be as severe.

Some medications are toxic to renal tissue and can lead to chronic renal failure. You should not take any medications without a doctor's prescription.

Most often, renal failure develops in people suffering from diabetes mellitus, glomerulonephritis, arterial hypertension. Such patients need to be constantly monitored by a doctor and undergo timely examinations.

Homeostasis disorders are a direct consequence of a disease such as renal failure. This syndrome is associated with severe renal dysfunction. The occurrence of symptoms of renal failure in women is very closely related to a violation of water-electrolyte or acid-base balance in the human body.

Kinds

Interestingly, the disease depends on the symptoms and form of the disease; it can be acute or chronic renal failure. The first option is associated with a sudden deterioration in kidney function. Disorders of water, electrolyte, osmotic or acid-base balance are closely related to such a negative process as a sharp slowdown or cessation of the excretion of nitrogen metabolism products from the human body of a woman. As a result of renal failure, the symptoms of which are obvious, it is quite possible that such an unpleasant phenomenon as a violation of the normal composition of the blood.

If a woman has chronic renal failure, then this is due to a decrease in the number of functioning nephrons. Moreover, this form of the disease is characterized by a gradual progressive condition with a slow increase in symptoms of renal failure.

Due to the symptoms of gradual death of renal tissues, deficiency of renal functions becomes the cause of intoxication of the body in a woman, because her own waste products cannot be in to the fullest removed from the body.

By international classification Chronic renal failure in women, ICD 10 code number N18.

Chronic renal failure symptoms present in women, the stages of creatinine number 4. They are based on the level of its content in the blood. At the first stage, its level rises to 442.0 µmol per liter. On the second - up to 884.0 µmol per liter. On the third - up to 1326.0 µmol per liter, and on the fourth everything that is above this figure.

Causes

The occurrence of symptoms of renal failure in women is closely related to diseases that lead to a sharp deterioration in renal blood flow. Similar conditions can arise due to shock of various origins, severe infectious diseases, massive bleeding, acute heart failure, intoxication with nephrotoxic poisons, damage to the kidney vessels, acute diseases kidneys, urinary tract obstruction.

The chronic form may be associated with other chronic diseases and their symptoms. We are talking about diabetes mellitus hypertension, scleroderma, systemic lupus erythematosus, chronic intoxication, pyelonephritis, glomerulonephritis, urolithiasis in women. Such conditions may occur if some medicines were used as adequate treatment methods.

Kidney failure in women of this type is a real opportunity to recover quickly and never have to think about this problem and symptoms again. It is much worse if the presence of a chronic form is confirmed. The disease can last for several years, which has a catastrophic effect on the condition of the human body. In addition, a steady increase in symptoms is unlikely to be avoided. Chronic renal failure is complicated by the fact that the possibility of completely restoring the functions of damaged organs is practically absent.

The acute form and symptoms are observed at the first stage in women, so it is much easier to cure. Moreover, the symptoms of kidney failure are quite obvious. Acute violation kidney function can manifest itself in the form of fever, chills, headache, muscle pain. Confusion or loss of consciousness often occurs. Paleness, sweating, thready pulse and low blood pressure are also unpleasant signs of this disease. The disease can also be recognized by the presence of blood in the urine and pain in the lower back.

Due to late consultation with a doctor, the second stage of the disease often occurs. The disease is characterized by symptoms such as a sharp decrease or complete cessation of urine output, azothermia, impaired consciousness, weight gain, swelling of the subcutaneous tissue, swelling of vital organs, and accumulation of fluid in the abdominal cavity. The onset of a general serious condition is no exception.

A favorable outcome in the treatment of renal failure is associated with the period of restoration of diuresis. At first, urine output gradually increases, reaching normal levels, and then becomes even greater. This indicates the beginning of the process of removing fluid from the body that has accumulated during the development of the disease.

In case of improper control of renal failure, there is a possibility of the onset of the terminal stage. It is characterized by shortness of breath, cough, foamy pink sputum, subcutaneous hemorrhages, hematomas, and internal bleeding. At the nervous system level, we are talking about confusion, drowsiness, coma, spasms or muscle cramps. Disturbances in the functioning of the cardiovascular system are quite likely. People who have such health problems should be regularly checked by a doctor in order to prevent the occurrence of the disease.

Symptoms of kidney failure

The main difference between acute and chronic forms of the disease in women is the timing of the onset of symptoms of renal failure. In the first case, we are talking about rapid development, but the advantage of this point is that complete restoration of kidney function in women is possible if adequate methods of treating renal failure are used. Kidney failure in women of this type is a real opportunity to recover quickly and never have to think about this problem again. It is much worse if the fact of the presence of a permanent form is confirmed.

The disease can last for several years, which has a catastrophic effect on the condition of the woman’s body. In addition, a steady increase in symptoms is unlikely to be avoided. Chronic renal failure is complicated by the fact that the possibility of completely restoring the functions of damaged organs is practically absent.

In the early stages of the disease, its presence can be determined by signs and symptoms. Further we are talking about more significant changes in the structure of the kidney tissue. An immediate sign of the onset of this process in women is an increase in the amount of urine that is released at night. Moreover, swelling may appear on the face, especially in the morning. This is accompanied by weakness and malaise.

The disease in its final stage is closely associated with symptoms in women that are characteristic of uremia. Moreover, it is likely that water-electrolyte metabolism is impaired. Death can only be avoided if hemodialysis is applied in a timely manner.

If a woman develops symptoms of kidney failure, she should immediately seek help from a doctor, because at the initial stage it is much easier to cope with the disease.

Kidney failure symptoms and signs in women

Kidneys - most important organ excretory system. His spontaneous refusal leads to dire consequences. If you react in time and take action, you can manage to prevent the inevitable. It is very important to know the main symptoms of kidney failure in women in order to urgently go to the clinic.

Kidney failure symptoms and signs in men

The symptoms of the disease in men are completely identical to those in women. As the condition worsens, people experience shortness of breath due to fluid accumulating in the lungs and bruising may form on the body. General state can be described as drowsy. Spasms and cramps affect the muscles. Losing consciousness is critical.

Treatment of kidney failure

The first stage of treatment for the acute form is to eliminate the cause. Moreover, it is necessary to restore homeostasis and impaired renal function as quickly as possible. More specific agents used to treat renal failure depend on the course of the disease and the patient's condition. We can talk about antibacterial agents, detoxification therapy, fluid replenishment, hormonal drugs. Detoxification of the body and removal of nitrogenous wastes is carried out using hemodialysis, plasmapheresis, and hemosorption. To restore diuresis the best option is the correct selection of diuretics. The introduction of sodium, potassium and calcium salts is also practiced, which helps restore water-electrolytic balance.

When treating an advanced stage, the main principle is to address the cause of the disease. Moreover, it is necessary to pay attention to detoxification therapy and maintenance normal functioning kidney An important aspect is a special diet.

initial stage treatment of renal failure is associated with the need to achieve a slowdown or stable remission of the underlying disease. In the future it is possible to assign symptomatic therapy together with permanent measures. For example, swelling can be reduced by prescribing diuretics. If there is a threat of developing anemia, then you cannot do without vitamins and iron supplements.

The last stages are associated with the need for hemodialysis, which is also called artificial blood filtration. This procedure is prescribed 2-3 times a week. A good, but not always accessible, alternative to this procedure is organ transplantation.

More details about dialysis in the video:

Nutrition and diet

Proper nutrition is one of the factors that can influence a speedy recovery. the main task- reducing the load on the kidneys and slowing down the process of increasing the volume of affected kidney tissue.

Diet must be very nutritious. The basic principles include limiting the consumption of foods that contain protein. Moreover, it is necessary to ensure high caloric intake and consumption of more vegetables and fruits. Launched form is inextricably linked with fruit and vegetable fasting days, which are recommended to be used several times a week.

High calorie content of food can be achieved through vegetable fats and carbohydrates. In order to determine the amount of liquid that needs to be consumed per day, a special formula is used. First you need to measure the amount of urine that is released per day, and then add 500-800 ml to this number. For severe edema and hypertension, it is necessary to include 3-4 g of table salt in the diet. If sodium is used in the treatment of renal failure, the dosage of salt must be significantly reduced. However, restricting the amount of salt consumed for too long can lead to negative consequences. If during the treatment process a positive result is achieved in women, then it is necessary to return to the previous norm. As for protein, its intake should not exceed 20-30 g. Important point- introduction of essential amino acids. In order to consume enough of them, you need to drink two daily chicken eggs.

Treatment of kidney failure with folk remedies

In the early stages, treatment of kidney failure is very effective. folk remedies. Experts recommend using infusions and decoctions of plants that have a diuretic effect. We are talking about birch buds, lingonberry leaves, horsetail, string, black currant leaves, chamomile, and kidney tea. It is acceptable to use mint, corn silk, St. John's wort and other plants or collections from them. However, in this case, do not forget about the need for preliminary consultation with a doctor. Please note, however, that the use of some traditional medicine can be extremely dangerous for the human body. Especially if we are talking about such a serious illness. ethnoscience together with its methods is rather auxiliary treatment than the main one.The responsibility for how to treat the disease lies only with you, because you are the one who needs working kidneys for life.