Kidney failure is a progressive disease that gradually leads to tissue death. When the process becomes chronic, the functionality of all organs and systems is disrupted.
What are the symptoms of kidney failure?
Clinical picture
Kidney failure affects both men and women, occurring in their bodies in approximately the same way.
Starting from the acute phase, the process quickly becomes chronic, which is characterized by high concentrations of urea and creatinine in the blood. They are nitrogenous products of protein breakdown. Gradually, the kidneys fail, and the body tries to remove these substances through the delicate mucous membranes of the gastrointestinal tract and lungs, which are simply not adapted to such stress. The result is uremia, which poisons all cells.
With kidney failure, an aversion to meat develops, the patient constantly suffers from thirst, nausea and vomiting. Muscle cramps, aches and bone pain occur. The skin on the face becomes jaundiced, and the breath is accompanied by an ammonia odor.
The amount of urine produced is significantly reduced or urination stops completely. The patient takes diuretics, but they do not help much, and his swelling does not go away. A decrease in renal function is accompanied by a disruption in the production of biologically active substances in the filtering organ. At the same time, the metabolism of glucose, calcium and phosphorus becomes difficult, and the performance of the gonads deteriorates.
Acute form
Acute renal failure(AKI) in men and women usually develops asymptomatically and manifests itself suddenly. When a person learns about the disease, kidney damage is often irreversible. This results in urinary retention. In men, this condition in most cases becomes one of the manifestations of prostate adenoma. However, this symptom may also indicate the presence of kidney stones or a bladder tumor. In this case, men experience bursting pain in the lower abdomen, and the urge to go to the toilet becomes strong and frequent. If back pain and fever are added, pyelonephritis has most likely developed.
Acute renal failure is an indication for urgent hospitalization. The patient needs serious treatment. In this case, treatment methods are determined by the causes of renal dysfunction. Modern approach assumes conservative treatment, in which medications are used to relieve symptoms.
Causes
The following causes of acute renal failure are identified:
- Impaired renal hemodynamics.
- Infectious diseases.
- Pathologies of the urinary system.
- Kidney injuries and surgeries.
The prerenal form of acute renal failure causes difficulty in blood circulation as a result of blood loss and congestion. Treatment involves drugs to normalize heart rate, droppers with saline solutions to restore plasma levels, medications to improve blood microcirculation.
The renal form of acute renal failure occurs due to pathologies of small blood vessels or medications. Acute renal failure syndrome develops as a result of poisoning with household toxins and bites of poisonous snakes. Treatment is also conservative. For glomerulonephritis and immune disorders, cytotoxic drugs and glucocorticosteroids are prescribed, and for infections - antibiotics. Signs of intoxication are relieved by plasmapheresis.
The postrenal form of the disease occurs due to difficulty in the outflow of urine. This is common in older men with an enlarged prostate gland. Surgery is often required to remove the obstruction that is preventing the normal flow of urine. Otherwise, even diuretics will not be effective.
Characteristic signs
When acute renal failure develops, symptoms may not appear for a long time. The main symptom of acute renal failure syndrome is a decrease in urine output (oliguria), up to complete cessation of urination (anuria). The patient’s health is rapidly deteriorating, and the following signs are observed:
- nausea with vomiting;
- diarrhea;
- loss of appetite;
- swelling of the hands and feet;
- lethargy;
- excited state;
- enlarged liver.
Signs may vary depending on the stage of the disease. There are 4 stages of the disease in total.
In case of acute renal failure of the first degree, poisoning occurs with nausea, which is accompanied by intestinal pain. The patient becomes pale, feels weak and unwell.
Acute renal failure stage II is characterized by oliguria or anuria. The patient's condition worsens significantly; urea and other products of protein metabolism begin to quickly accumulate in his blood. Self-intoxication starts in the body, the person suffers from edema, diarrhea, hypertension, tachycardia. He quickly loses strength, constantly wants to sleep, and becomes lethargic.
Acute kidney failure of the third degree is marked by the beginning of recovery. Urine formation increases and the concentration function of the kidneys is restored. The functionality of the paired organ is restored.
Stage IV of acute renal failure syndrome is the recovery phase. All indicators of renal activity are normalized. However, full recovery may take a year.
Chronic form
Chronic renal failure (CRF) is a steady deterioration in kidney function due to the death of tissue, which is replaced by connective tissue. The organ shrinks and completely loses its functionality. Chronic renal failure syndrome affects up to 500 people out of every million men and women, and the number of cases is growing every year.
Reasons for appearance
Chronic renal failure develops as a result of various pathologies with concomitant damage to the glomeruli, among them:
- chronic kidney diseases;
- metabolic disorders;
- congenital kidney anomalies;
- rheumatic diseases;
- vascular diseases;
- pathologies leading to difficulty in the outflow of urine.
Often, chronic renal failure syndrome appears against the background of chronic pyelonephritis and glomerulonephritis, diabetes mellitus and gout. The hereditary factor has a significant influence on the development of the disease.
Among rheumatic diseases that provoke chronic renal failure syndrome, lupus erythematosus and scleroderma are distinguished; among vascular diseases - arterial hypertension. Chronic renal failure often develops as a consequence kidney stone disease, hydronephrosis and tumors that compress the urinary tract.
Symptoms
Signs of renal failure when it becomes chronic become pronounced, so it is not difficult to identify the disease.
Chronic renal failure occurs in 4 stages:
- Latent.
- Compensated.
- Intermittent.
- Terminal.
Depending on the degree of the disease, symptoms are expressed stronger or weaker, which affects treatment. Initially, a person experiences weakness and dry mouth.
At stage II, these signs intensify. Chronic renal failure syndrome, when compensated, is accompanied by an increase in urine output to 2.5 liters per day, while tests show deviations in chemical composition biological fluids.
In the intermittent stage, chronic renal failure is characterized by even greater inhibition of organ function. Detected consistently in blood increased level nitrogenous metabolic products of protein, urea and creatinine. Chronic renal failure syndrome leads to severe fatigue and nausea with vomiting. The patient experiences constant thirst and dry mouth, he loses his appetite. The skin becomes flabby and dry, acquiring a jaundiced color. At the same time, muscle tone is lost, tremors (involuntary vibrations of any part of the body) develop, and joints and bones begin to hurt less often.
When chronic renal failure syndrome reaches this stage of development, there is a sharp decrease in the body's defenses. A person's condition may periodically improve, but then it gets worse again. The patient is treated with conservative methods, at this time he is still able to work. But if you do not follow the diet, physical and emotional stress, the symptoms worsen. Surgery may be required.
With the onset of the final stage, people's general condition worsens. Apathy is replaced by excitement, problems with night sleep arise, retardation of movements and inappropriate behavior appear. A person’s appearance changes: the face becomes puffy and gray-yellow in color, the hair becomes thinner, loses its shine, scratches remain on the skin because it is constantly itching, and dystrophy develops. The voice becomes hoarse, and the breath begins to smell of ammonia.
From the gastrointestinal tract, bloating, diarrhea, and vomiting are observed. The tongue is constantly coated, it is observed aphthous stomatitis.
Tests reveal persistently elevated concentrations of urea and creatinine in the patient’s blood, which provokes uremia. Moreover, the presence of hematuria in men may be a sign of hemophilia.
End stage chronic renal failure syndrome is also accompanied by encephalopathy with depression, memory impairment, and mood swings. Normal hormone synthesis is disrupted, resulting in impaired blood clotting and decreased immunity. The patient requires long-term treatment, and the sooner it is started, the more likely it is that surgery can be avoided.
Method of examination
Diagnosis of acute and chronic renal failure is necessary for the doctor to clarify the diagnosis and prescribe competent treatment. The following tests are expected:
- General and bacteriological urine analysis.
- Biochemical and general analysis blood.
Urine tests can confirm the reason for the decrease in renal function. Red blood cells indicate urolithiasis, tumors, injuries, and leukocytes - about the presence of infection and immunity disorders.
If a decrease in renal function occurs due to infection, then a bacteriological analysis of urine will reveal the pathogen.
Both chronic and acute renal failure are characterized by a high level of leukocytes in the blood and a slight decrease in the content of platelets in it. A decrease in hemoglobin indicates anemia, and an acceleration of their sedimentation indicates the presence of inflammation.
A biochemical blood test allows you to trace changes in the body that caused a decrease in kidney function. In acute renal failure, high levels magnesium and creatine, lowered pH. When the process becomes chronic, increased levels of cholesterol, urea, potassium and phosphorus are found in the blood. At the same time, a decrease in calcium and protein concentrations is recorded.
Analyzes are carried out first, then hardware research methods are used:
- Computed and magnetic resonance imaging.
- X-ray.
- Kidney biopsy.
Ultrasound, CT and MRI are used in acute renal failure to determine the cause of the narrowing urinary tract which led to the deterioration renal functions.
X-rays are used to detect pathologies respiratory system. A biopsy is used when other methods fail to identify the cause of deterioration in kidney function. Arrhythmias are detected using an ECG.
Symptoms of kidney failure do not appear immediately, so the disease cannot always be diagnosed at an early stage . However, conservative treatment is usually used, and surgery is required only in advanced cases.
Content
Given pathological condition can be characterized as serious illness organ genitourinary system, which leads to disturbances in acid-base, osmotic and water-salt homeostasis. The disease affects all processes that occur in the body, which ultimately leads to secondary damage.
What is kidney failure
There are two main paths of the disease, the result of which will be either complete loss of kidney function or ESRD. Kidney failure is a syndrome that causes problems with the functioning of the kidneys. The disease is main reason disorders of most types of metabolism in the human body, including nitrogen, water or electrolyte. The disease has two forms of development - chronic and acute, as well as three stages of severity:
- risk;
- damage;
- failure.
Causes of kidney failure
Based on reviews from doctors, the main causes of kidney failure in people affect only two areas - high blood pressure and diabetes. In some cases, the disease may occur due to heredity or be suddenly triggered by unknown factors. Such patients seek help from the clinic in very advanced cases, when it is extremely difficult to establish the source and cure the disease.
Stages of kidney failure
Chronic kidney disease occurs in five hundred out of a million patients undergoing treatment, however, this figure is steadily increasing every year. As a result of the disease, there is a gradual death of tissue and the loss of all its functions by the organ. Medicine knows four stages of chronic renal failure that accompany the course of the disease:
- The first stage proceeds almost unnoticed; the patient may not even be aware of the development of the disease. The latent period is characterized by increased physical fatigue. The disease can only be detected through biochemical testing.
- At the compensated stage, there is an increase in the number of urinations against the background of general weakness. The pathological process can be detected by the results of blood tests.
- The intermittent stage is characterized by a sharp deterioration in kidney function, which is accompanied by an increase in the concentration of creatinine and other products of nitrogen metabolism in the blood.
- According to etiology, end-stage renal failure causes irreversible changes in the functioning of all body systems. The patient feels constant emotional instability, lethargy or drowsiness, appearance deteriorates, and appetite disappears. Consequence last stage CRF is uremia, aphthous stomatitis or dystrophy of the heart muscle.
Acute renal failure
The reversible process of kidney tissue damage is known as acute renal failure. AKI can be determined by referring to symptoms of kidney failure in a person, which are expressed by complete or partial cessation of urination. The constant deterioration of the patient's condition at the terminal stage is accompanied by poor appetite, nausea, vomiting and other painful manifestations. The causes of the syndrome are the following factors:
- infectious diseases;
- renal condition;
- decompensated renal hemodynamic disorder;
- obstruction urinary tract;
- exogenous intoxications;
- acute kidney diseases.
Chronic renal failure
Chronic renal failure gradually leads to a complete loss of the ability to function for this organ, causing shrinkage of the kidney, death of nephrons and complete replacement of its tissues. Being at the terminal stage of the disease, the patient’s body begins to refuse to excrete urine, which affects the electrolyte composition of the blood. Damage to the glomeruli can occur due to a number of reasons, the most common of which are:
- systemic lupus erythematosus;
- tumors;
- chronic glomerulonephritis;
- hydronephrosis;
- gout;
- urolithiasis disease;
- amyloidochronic pyelonephritis;
- diabetes;
- arterial hypertension;
- polycystic disease;
- hemorrhagic vasculitis;
- underdevelopment of the kidneys;
- scleroderma;
Kidney failure - symptoms
In order to find out how to treat kidney failure, it is first worth studying the main symptoms of chronic renal failure. At first, it is problematic to independently identify the disease, although timely medical intervention can reverse the development of dangerous pathological processes, eliminating the need for surgery. Mostly, patients complain of symptoms of kidney failure such as severe swelling, high blood pressure or pain.
The first signs of kidney failure
The syndrome of kidney dysfunction has a gradual stage of development, so each stage is characterized by more pronounced manifestations of the disease. The first signs of renal failure are considered to be weakness or fatigue without good reason, refusal to eat, problems sleeping. In addition, you can check for the presence of the disease based on the frequency of urination at night.
Kidney failure - symptoms in women
Disturbances in the functioning of the kidneys can cause a variety of manifestations depending on what stage of the pathological process the patient is at. Symptoms of kidney failure in women manifest themselves in a special, specific way. The first warning sign is emotional instability caused by a deficiency of progesterone in the body. Against this background, a number of complications associated with the functioning of the genitourinary system are actively developing.
Kidney failure - symptoms in men
The syndrome affects the body for as long as early stages appearance, therefore, how to determine kidney failure and what to do can be found out by comparing some key facts. The symptoms of kidney failure in men are practically no different from the reactions of other groups of patients. On initial stages characteristic: decreased urination, diarrhea, loss of appetite, itchy skin, clearly visible signs of the disorder nervous system.
Kidney failure in children - symptoms
Kidney problems rarely affect young children, but if action is not taken in time, inaction can cause death. Symptoms of renal failure in children are no different from the course of the disease in adult patients. In addition to general malaise, the child feels nausea, his temperature rises, and in some cases swelling is detected. Such children often go to the toilet, but the amount of urine excreted is not normal. Analyzes allow us to diagnose the following picture:
- stones in the kidneys;
- cough;
- increased amount of protein in the urine;
- decreased muscle tone;
- tremor;
- the skin acquires a yellow tint.
Kidney failure - diagnosis
The main sign of the presence of severe pathology in a patient is not only a decrease in the frequency of urination, but also the presence of an increased amount of potassium or nitrogenous compounds in the blood. Diagnosis of renal failure is carried out in several stages, the condition of the kidneys is assessed according to the diagnosis based on the results of the Zimnitsky test. The main indicators of treatment effectiveness are:
- biochemical blood monitoring;
- Biopsy;
- Doppler ultrasound of blood vessels.
Kidney failure - treatment
During therapy, the main cause of pathogenesis is eliminated using modern medications. The recovery process includes replenishing the missing blood volume and normalizing blood pressure in case of a shock reaction in the patient. Treatment of renal failure during the period of nephrotoxin poisoning consists of washing the intestines and stomach from toxins; for these purposes the following is often used:
- plasmapheresis;
- nephroprotective treatment;
- hemodialysis;
- hemoperfusion;
- peritoneal dialysis;
- hemosorption.
Treatment of kidney failure - drugs
Treatment of such a serious disease must be supported by appropriate medical intervention, for example, insulin drugs. Most of the existing diuretics, when taken uncontrolled, can be harmful to human health, so the use of therapeutic substances is possible only under the strict supervision of a specialist. The most effective drugs for the treatment of kidney failure can be divided into a separate category of drugs:
- Trimetazidine;
- Lisinopril;
- Desferal;
- Sulodexide;
- Eufillin;
- Hypothiazide;
- Digoxide;
- Ramipril;
- Chime;
- Glurenorm;
- Enalapril;
- Metoprolol;
- Deferoxamine;
- Propranolol;
- Dopamine.
Kidney failure - treatment with folk remedies
Some people adhere natural methods therapy, therefore treatment of renal failure folk remedies allows the use of only the gifts of nature. With the help of medicinal plants, fruits or vegetables, special decoctions are prepared, designed to relieve a person from of this disease. The most effective folk therapy methods are the use of burdock, pomegranate juice and corn silk. There are others healthy ingredients to be treated:
- seaweed;
- echinacea tincture;
- Dill seeds;
- horsetail.
Kidney failure during pregnancy
While carrying a child, the pregnant mother's body is subjected to an additional degree of stress, which is why all its systems are forced to work in increased mode. Sometimes the main cause of kidney failure during pregnancy is a malfunction of certain organs. These diseases threaten the health of the woman and her unborn child, so childbirth in such circumstances is impossible. The only exceptions are those cases when the disease was promptly eliminated in the early stages of diagnosis.
Prevention of kidney failure
Timely treatment of diseases such as chronic pyelonephritis and glomerulonephritis will help prevent further complications, and regular adherence to the doctor’s recommendations will ensure the preservation of the functionality of the genitourinary system. Prevention of kidney failure is used for any category of patients, no matter what stage of the disease they are at. Simple rules, including following a diet, adjusting the water-salt balance and using medications will help prevent the development of the disease.
Video: kidney failure symptoms and treatment
Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.
Found an error in the text? Select it, press Ctrl + Enter and we will fix everything!Kidney failure is the inability of the kidneys to produce and remove urine from the body. This has a severe effect on metabolic disorders of acid and alkali, water and electrolytes. In women, symptoms of kidney failure are diagnosed in acute and chronic forms. At acute illness Kidney function is suddenly impaired. As a result, the human renal system significantly worsens the removal of waste products. This is due to the deterioration of blood supply to the kidneys, the gradual destruction of important kidney cells - nephrons.
In the early stages, the disease passes without obvious manifestations, and if at this time you accidentally do not take tests for a preventive examination, or for other reasons, then the onset of dysfunction can simply be missed. At the same time, nephrons die, and the kidneys' ability to function normally decreases. Toxins accumulate in the body, the inability of the kidneys to remove the products of water metabolism leads to poisoning of the body with its own waste. Symptoms of renal failure in women and symptoms of general intoxication of the body alarm doctors, and they suggest that the woman undergo a full course of examination to clarify the causes of intoxication, establish the correct diagnosis and prescribe effective therapy.
Need to know! The kidneys in a woman’s body are one of the paired organs of the genitourinary system. Their purpose is to process liquid and remove waste residues in the form of urine. Kidney failure occurs when there is a serious malfunction of both or one of the kidneys, and in the absence of medical care.
Reasons for the formation of chronic renal failure
Insufficiency of kidney function in medicine is considered a serious condition, especially if it develops as a consequence of underlying diseases, and this complicates the course of both diseases. It is difficult if kidney function is impaired. Due to its severe and long-term course, test-confirmed renal failure in women manifests symptoms in acute and chronic types. The disease affects people of different genders and ages, but most often chronic renal failure affects very young women.
Lack of kidney function develops as a consequence of certain somatic diseases leading to glomerular filtration dysfunction. This is the main parameter by which the basic functions of the kidneys are determined. The rate of urine output decreases.
Provoking diseases are considered:
- emotional or nervous shock;
- infectious lesions of other organs;
- unexpected bleeding associated with injury or feminine problems;
- arrhythmia;
- congenital anomalies of the structure of the kidneys and other organs of the genitourinary system;
- malignant neoplasms.
The chronic type of kidney failure in women produces symptoms, especially when the diet is violated, similar to other pathologies:
- diabetes insipidus;
- high blood pressure;
- scleroderma manifestations;
- long-term use of medications due to another disease;
- chronic intoxication;
- helminthic infestations.
One of the main reasons for the development of chronic pyelonephritis is the body’s tendency to form stones in bile ducts, V bladder. Often, the kidneys do not work well in pregnant women, thereby complicating the course of pregnancy, sometimes leading to the death of the fetus.
Acute and chronic course: signs in women
An acute form of inflammation in the kidneys develops almost instantly, within an hour severe pain increases, the woman loses the ability to move, turn, and bend over. The pain is localized either on one side, if the inflammation has affected one kidney, or on both sides, if there is bilateral inflammation. If you take timely measures, consult a doctor, undergo a proper examination, the symptoms of kidney failure in women almost completely disappear, and with treatment, kidney function is restored.
The chronic form does not manifest itself with obvious symptoms; they can be confused with myositis of a simple course. Chronic renal failure manifests itself years later, when treatment leads to an improvement in the patient’s well-being, but restoration of the kidney tissue destroyed over the years of the disease is no longer possible.
The first signs of kidney disease in acute manifestation are completely different for every woman. They are due to the reasons that caused the exacerbation. If it is an infection, then the disease is accompanied by pain in the head and muscles, and chills. Such symptoms give colds, influenza, acute respiratory viral infections, which usually complicate the functioning of the kidneys. Poisoning of intestinal origin is manifested by signs of typical poisoning - nausea, diarrhea, sharp pain in my head. If poisoning occurs, the symptoms will be numbness of the limbs, loss of tactile sensitivity throughout the body, convulsions, and symptoms of jaundice. With nervous shock, signs include pallor skin, perspiration all over the body, drop in blood pressure, poorly palpable pulse, bradycardia.
These symptoms appear at the 1st stage of the disease. When kidney failure is diagnosed in women, the symptoms at stage 2 become more pronounced and severe in manifestation. Appetite is lost, skin itching appears, consciousness is confused. In this state, the person falls into a coma. It is accompanied by swelling of the entire body and weight gain due to the fact that urine is not excreted. Swelling is clearly expressed on the face and can affect the structures of the brain.
Timely and competent assistance from a urologist or nephrologist helps restore urine flow, excess liquid begins to gradually appear. When drug therapy does not produce results at this stage, the disease quickly progresses to the most severe stage, the 3rd stage.
Characteristic here is a strong productive cough, expectoration of pink sputum, as in the lungs and in abdominal cavity pathological fluid accumulates. Because of this, internal bleeding is recorded, which manifests itself as skin hematomas, rapidly growing and turning blue in different shades. The patient loses consciousness, is in a sleepy state, arrhythmia appears, and the smell of ammonia appears from the mouth and from the whole body. At this stage, hemodialysis must be performed, otherwise the patient faces death.
Doctors are especially attentive to the condition of the kidneys in women during pregnancy, so that renal failure does not occur, the symptoms of which include a rapid deterioration in health, severe weakness and severe pain with aching in the lumbar region spine.
Manifestations of chronic renal failure during pregnancy:
- signs of renal dysfunction develop;
- due to internal swelling, the ureters are compressed;
- The rapidly growing uterus puts pressure on the kidneys.
Pregnant women complain about:
- a sharp decrease in daily urine volume;
- increased blood pressure;
- the appearance of large amounts of protein in analyses;
- swelling of the face and legs;
- nausea on an empty stomach, vomiting gastric juice with bile;
- deterioration in general health - lethargy, weakness, pain throughout the head.
Women registered at the consultation are offered immediate hospitalization for medical care. Signs of renal failure in women require treatment with pills in order not only to relieve the symptoms of intoxication, but also to facilitate the functioning of the kidneys.
We must remember! During pregnancy, the kidneys have a double burden and responsibility for providing normal conditions fetal growth. Severe chronic renal failure during pregnancy harms the development of the fetus and can lead to its antenatal death.
Treatment methods for chronic renal failure: especially for women
Renal dysfunction is treated depending on its type and severity of the disease. To solve problems at the acute stage, the cause of inflammation is first eliminated.
The problem is solved:
- therapy using antibiotics in injections, then in tablets;
- medications aimed at eliminating general intoxication of the body;
- measures to regulate the volume of fluid and acid-base balance in a woman’s body;
- hormonal drugs;
- physiotherapy.
The chronic type of renal dysfunction in women is treated with measures aimed at eliminating concomitant diseases that clearly complicate the functioning of the kidneys. Here it is necessary to reduce intoxication and maintain renal activity. Therapeutic measures are aimed at getting rid of acute symptoms the underlying disease, if doctors consider inflammation in the kidneys to be a concomitant complication. With proper treatment, the patient’s general well-being is stabilized, anti-edema procedures are added, and lung functions are constantly monitored.
Avoid extreme complications! Severe manifestations of chronic renal failure require blood filtration, and in extreme cases, a kidney transplant.
Features of renal failure in women
Why the largest number of chronic renal failure diseases is recorded in women follows from the gender characteristics of the structure of the urinary system.
Taken together, all the signs of poor kidney function upset all types of metabolism. First of all, metabolism is disrupted:
- water;
- electrolytes;
- nitrogenous compounds.
Pathology is detected specifically in women, and most often with concomitant chronic diseases. The predisposition of a woman's body to kidney disease directly depends on the anatomy. Urethra in female body wide and short, so pathogens freely enter the urinary tract and create inflammatory processes. The infection travels directly from the bladder through the ureters to the kidneys. There, the infection affects the internal structures of the kidney, disrupting the naturally occurring filtration and excretion of fluid.
Serious changes in the composition of the blood are determined by laboratory tests. Analyzes show the content of metabolic products:
- urea;
- sulfates, chlorides;
- pathogenic microflora;
- creatinine;
- nitrogenous compounds;
- Sahara.
To stabilize the blood condition, immediate hemodialysis is required to prevent oxygen starvation of brain cells. However, the chronic type of kidney disease progresses slowly, without a pronounced clinical picture, which is why women come to the doctor when laboratory test analyzes show extreme depletion of tissue and structural structure of the kidneys, intoxication of the whole body.
In women, chronic renal failure is determined by a short urethra.
Treatment of chronic renal failure with folk remedies
How aids, along with drug therapy, the urologist recommends folk recipes– decoctions, infusions from medicinal plants. They are good in the initial stages, when the acute course is relieved, and follow-up treatment with physiotherapeutic methods and methods of traditional healers is required.
Medicinal plants used:
- horsetail;
- knotweed;
- dog-rose fruit;
- yarrow;
- Birch buds;
- willow bark.
These are the main ones herbal remedies, which are easy to prepare for the winter. However, they have a fairly strong effect on the body, and they should be taken only on the recommendation of a doctor, in small dosages, not in strong infusions and decoctions. Successful infusions are obtained in thermoses. The crushed bark is filled with water at 900C, the thermos must be kept open for a couple of minutes so that the water can absorb air, then screw on the lid and leave overnight. Rosehip and hawthorn fruits are brewed using the same principle. Berries and bark do not like boiling water; they need “living” water with air and normal temperature conditions.
As maintenance therapy for the treatment of renal failure in women with folk remedies, when the symptoms become practically unnoticeable and the tests remain “clean” for a long time, the urologist recommends drinking pharmacy “Kidney tea” for a long time, or brewing corn silk or flowers as tea. St. John's wort, chamomile, thyme, wild strawberry leaf. Pharmacy fees are good, and for many they are excellent in maintaining kidney function during the recovery period.
However, many herbalists are of the opinion that herbs should not be mixed. You should drink one strawberry leaf during the day to understand how well it works in a woman’s body. This will not be so noticeable, but in addition to its cleansing properties for the kidneys, leaves of strawberries, lingonberries, and black currants also have an anti-inflammatory effect on the female genital organs.
Interesting fact! In winter, if there are no supplies medicinal herbs, you can break off twigs from birch, black currant, no more than 2 buds, and brew tea with them or steam them in a thermos. The winter pharmacy has the same powers as during the period of lush summer flowering.
There are acute and chronic renal failure.
Acute renal failure (ARF)- sudden impairment of kidney function with a delay in the excretion of nitrogen metabolism products from the body and a disorder of water, electrolyte, osmotic and acid-base balance. These changes occur as a result of acute, severe disturbances in renal blood flow, GFR, and tubular reabsorption, usually occurring simultaneously.
Acute renal failure occurs when both kidneys suddenly stop functioning. The kidneys regulate the balance of chemicals and fluids in the body and filter waste from the blood into the urine. Acute renal failure can occur due to various reasons, including kidney disease, partial or complete blockage of the urinary tract and decreased blood volume, for example after severe blood loss. Symptoms can develop over several days: the amount of urine output may decrease sharply, and fluid that should be eliminated accumulates entirely in the tissues, causing weight gain and swelling, especially in the ankles.
Acute kidney failure is a life-threatening disease because excessive amounts of water, minerals (particularly potassium) and waste products that are normally excreted in urine accumulate in the body. The disease usually responds well to treatment; Kidney function can be fully restored in a few days or weeks if the cause is correctly identified and appropriate treatment is given. However, acute renal failure due to kidney disease can sometimes lead to chronic renal failure, in which case the prospect of developing the disease depends on the ability to treat the underlying disease.
Currently, several etiological groups of acute renal failure are distinguished.
Prerenal acute renal failure (ischemic)
- shock kidney (trauma, fluid loss, massive tissue breakdown, hemolysis, bacteremic shock, cardiogenic shock). — Loss of extracellular volume (gastroenteric losses, urinary losses, burns). — Loss of intravascular volume or its redistribution (sepsis, bleeding, hypoalbuminemia). - Reduced cardiac output (heart failure, cardiac tamponade, cardiac surgery). — Other causes of decreased GFR (hypercalcemia, hepatorenal syndrome).
Renal acute renal failure.
— Exogenous intoxication (kidney damage from poisons used in industry and everyday life, bites of poisonous snakes and insects, intoxication medicines and radiopaque agents). — Acute infectious-toxic kidney with an indirect and direct effect on the kidneys of the infectious factor — Renal vascular lesions (hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura, scleroderma, systemic necrotizing vasculitis, thrombosis of arteries or veins, atherosclerotic embolism in severe atherosclerosis great vessels- primarily the aorta and renal arteries). — Open and closed injuries kidney — Post-ischemic acute renal failure.
Postrenal acute renal failure.
- Extrarenal obstruction (occlusion of the urethra; tumors of the bladder, prostate, pelvic organs; blockage of the ureters with stones, pus, thrombus; urolithiasis, blockage of tubules with urates in the natural course of leukemia, as well as their treatment, myeloma and gouty nephropathies, treatment with sulfonamides; accidental ligation of the ureter during surgery). — Retention of urination not caused by an organic obstruction (impaired urination due to diabetic neuropathy or as a result of the use of M-anticholinergics and ganglion blockers).
Symptoms
Excreting only small amounts of urine. . Weight gain and swelling of the ankles and face due to fluid accumulation. . Loss of appetite. . Nausea and vomiting. . Itching all over the body. . Fatigue. . Abdominal pain. . Urine that is bloody or dark in color. . Symptoms of the final stage in the absence of successful treatment: shortness of breath due to fluid accumulation in the lungs; unexplained bruising or bleeding; drowsiness; confusion; muscle spasms or cramps; loss of consciousness.
There are four periods in the development of acute renal failure: the period of initial action of the etiological factor, the oligoanuric period, the period of diuresis restoration and recovery.
In the first period, symptoms of the condition leading to acute renal failure predominate. For example, fever, chills, collapse, anemia, hemolytic jaundice are observed in anaerobic sepsis associated with out-of-hospital abortion, or clinical picture general action of one or another poison (acetic essence, carbon tetrachloride, salts of heavy metals, etc.).
The second period - a period of sharp decrease or cessation of diuresis - usually develops soon after the action causative factor. Azotemia increases, nausea, vomiting, coma appear, due to sodium and water retention, extracellular hyperhydration develops, manifested by an increase in body weight, cavitary edema, pulmonary and cerebral edema.
After 2-3 weeks, oligoanuria is replaced by a period of restoration of diuresis. The amount of urine usually increases gradually; after 3-5 days, diuresis exceeds 2 l/day. First, the fluid that accumulated in the body during the period of oligoanuria is removed, and then, due to polyuria, dangerous dehydration occurs. Polyuria usually lasts 3-4 weeks, after which, as a rule, the level of nitrogenous wastes normalizes and a long (up to 6-12 months) period of recovery begins.
Thus, from a clinical point of view, the most severe and life-threatening period for a patient with acute renal failure is the period of oligoanuria, when the disease picture is characterized primarily by azotemia with a sharp accumulation of urea, creatinine, uric acid and electrolyte imbalance (primarily hyperkalemia, as well as hyponatremia, hypochloremia, hypermagnesemia, hypersulfate and phosphatemia), the development of extracellular hyperhydration. The oligoanuric period is always accompanied by metabolic acidosis. During this period, a number of severe complications may be associated with inadequate treatment, primarily with uncontrolled administration saline solutions, when the accumulation of sodium causes first extracellular hydration, and then intracellular hyperhydration, leading to coma. The serious condition is often aggravated by the uncontrolled use of hypotonic or hypertonic solution glucose, which reduces the osmotic pressure of plasma and increases cellular hyperhydration due to the rapid transition of glucose, and subsequently water, into the cell.
During the period of restoration of diuresis due to severe polyuria, there is also a risk of severe complications, primarily due to developing electrolyte disturbances (hypokalemia, etc.).
The clinical picture of acute renal failure may be dominated by signs of cardiac and hemodynamic disorders, full-blown uremic intoxication with severe symptoms gastroenterocolitis, mental changes, anemia. Often the severity of the condition is aggravated by pericarditis, respiratory failure, nephrogenic (overhydration) and cardiac pulmonary edema, gastrointestinal bleeding and especially infectious complications.
To assess the severity of the condition of a patient with acute renal failure, the main importance is indices of nitrogen metabolism, primarily creatinine, the level of which in the blood does not depend on the patient’s nutritional characteristics and therefore more accurately reflects the degree of renal dysfunction. The retention of creatinine usually precedes the increase in urea levels, although the dynamics of the level of the latter is also important for assessing the prognosis in acute renal failure (especially when the liver is involved in the process).
However, in many ways clinical manifestations Acute renal failure, in particular signs of damage to the nervous system and muscles (primarily the myocardium), are associated with disturbances in potassium metabolism. Frequently occurring and quite understandable hyperkalemia leads to an increase in myocardial excitability with the appearance of a high, narrow base and pointed apex T wave on the ECG, slowing down atrioventricular and intraventricular conduction up to cardiac arrest. In some cases, however, instead of hyperkalemia, hypokalemia may develop (with repeated vomiting, diarrhea, alkalosis), the latter is also dangerous for the myocardium.
Causes
. Decreased blood volume due to severe injury resulting in blood loss or dehydration is a common cause of acute kidney failure. Reduced blood flow to the kidneys due to decreased blood volume can lead to kidney damage. . Other kidney diseases, such as acute glomerulonephritis, can cause acute renal failure. . Tumors, kidney stones, or an enlarged prostate may block the ureter or urethra, obstructing the flow of urine and causing kidney damage. . Other diseases can lead to kidney failure, including polycystic kidney disease, systemic lupus erythematosus, diabetes mellitus, congestive heart failure, heart attack, liver disease, acute pancreatitis and multiple myeloma. . Poisoning from heavy metals (cadmium, lead, mercury or gold) can cause kidney damage. . Chemotherapy drugs and some antibiotics such as gentamicin can lead to kidney failure, especially in those who have any kidney disease. . High doses of non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can cause kidney damage. . Contrast agents used in x-rays of blood vessels or organs may stimulate kidney failure in those at risk. . Release of myoglobin protein by muscles as a result of injury, heatstroke or overdose of drugs or alcohol, or as a result of serious infectious disease, can lead to acute renal failure. . Sometimes acute renal failure can develop in women as a complication after childbirth.Diagnostics
. Medical history and physical examination. . Ultrasound examination. . Blood and urine tests. . A kidney biopsy may be done. Under local anesthesia The doctor inserts a needle into the kidney through the back to remove a small sample of tissue for analysis under a microscope.Clarification of the etiological factors of acute renal failure allows for more targeted therapeutic interventions. Thus, prerenal acute renal failure develops mainly when states of shock, characterized by severe microcirculation disorders due to hypovolemia, low central venous pressure and other hemodynamic changes; It is necessary to direct the main therapeutic measures to eliminate the latter. Close in mechanism to these conditions are cases of acute renal failure associated with large loss of fluid and NaCl in severe extensive lesions of the gastrointestinal tract (infections, anatomical disorders) with uncontrollable vomiting, diarrhea, which also determines the range of therapeutic effects. Renal acute renal failure develops in connection with the action of various toxic factors, primarily a number of chemical, medicinal (sulfonamides, mercury compounds, antibiotics) and radiocontrast substances, and can also be caused by the kidney diseases(AGN and nephritis associated with systemic vasculitis). Prevention and treatment of acute renal failure in these cases should include measures that limit the possibility of exposure to these factors, as well as effective methods combating these kidney diseases. Finally, therapeutic tactics for postrenal acute renal failure mainly boil down to the elimination of acute obstructed urine outflow due to urolithiasis, bladder tumors, etc.
It should be kept in mind that the ratios various reasons OPN may vary due to certain features of their effect on the kidneys. Currently, the main group of cases of acute renal failure is still made up of acute shock and toxic kidney injuries, but within each of these subgroups, along with post-traumatic acute renal failure, acute renal failure in obstetric and gynecological pathology (abortion, complications of pregnancy and childbirth), acute renal failure due to blood transfusion complications and the effect of nephrotoxic factors (poisoning with vinegar essence, ethylene glycol), acute renal failure is becoming more frequent, associated with an increase in surgical interventions, especially in older age groups, as well as with the use of new drugs. In endemic areas, the cause of acute renal failure may be viral hemorrhagic fever with kidney damage in the form of severe acute tubulointerstitial nephritis.
Although the study of the mechanisms of development of acute renal failure is devoted big number works, however, the pathogenesis of this condition cannot be considered completely clarified.
However, it has been proven that various etiological variants of acute renal failure are characterized by a number of common mechanisms:
Violation of renal (especially cortical) blood flow and a drop in GFR; . total diffusion of glomerular filtrate through the wall of damaged tubules; . compression of the tubules by edematous interstitium; . near humoral effects(activation of the renin-angiotensin system, histamine, serotonin, prostaglandins, other biological active substances with their ability to cause hemodynamic disturbances and tubular damage); . shunting blood through the juxtamedullary system; . spasm, thrombosis of arterioles.
The resulting morphological changes concern mainly the tubular apparatus of the kidneys, primarily the proximal tubules, and are represented by dystrophy, often severe necrosis of the epithelium, accompanied moderate changes kidney interstitium. Glomerular abnormalities are usually minor. It should be noted that even with the most profound necrotic changes, regeneration of the renal epithelium occurs very quickly, which is facilitated by the use of hemodialysis, which prolongs the life of these patients.
Given the commonality of developing processes, the predominance of one or another link in pathogenesis determines the features of the development of acute renal failure in each of its named variants. Thus, in shock acute renal failure, the main role is played by ischemic damage to the renal tissue; in nephrotoxic acute renal failure, in addition to hemodynamic disorders, the direct effect of toxic substances on the tubular epithelium during their secretion or reabsorption is important; in hemolytic-uremic syndrome, thrombotic microangiopathy predominates.
In some cases, acute renal failure develops as a consequence of the so-called acute hepatorenal syndrome and is caused by severe liver diseases or surgical interventions on the liver and bile ducts.
Hepatorenal syndrome is a variant of acute functional renal failure that develops in patients with severe liver damage (with fulminant hepatitis or advanced cirrhosis of the liver), but without any visible organic changes kidney Apparently, changes in blood flow in the renal cortex of neurogenic or humoral origin play a certain role in the pathogenesis of this condition. Harbingers of the onset of hepatorenal syndrome are gradually increasing oliguria and azotemia. Hepatorenal syndrome is usually distinguished from acute tubular necrosis by a low concentration of sodium in the urine and the absence of significant changes in sediment, but it is much more difficult to differentiate it from prerenal AKI. In doubtful cases, the reaction of the kidneys to the replenishment of the volume of blood volume helps - if renal failure does not respond to an increase in the volume of blood volume, it almost always progresses and leads to death. Developing in the terminal stage arterial hypotension can cause tubulonecrosis, which further complicates the clinical picture.
Treatment
. The underlying cause of kidney failure must be treated. Urgent health care may be required in case of serious damage; it consists of surgery to restore damaged tissue, intravenous administration fluids to completely reverse dehydration, and blood transfusions for severe blood loss. . Surgery may be necessary to stop the urinary tract blockage. . Diuretics may be prescribed to reduce fluid accumulation and increase urine production. . There are many measures that are important for full recovery after rendering urgent help. For example, you may need to limit your fluid intake. . Antibiotics may be prescribed to treat associated bacterial infections; they must be taken for the entire prescribed period. . Blood pressure lowering medications may be prescribed for high blood pressure. . Glucose, sodium bicarbonate, and other substances may be given intravenously to maintain proper levels of these substances in the blood until kidney function is restored. Temporary dialysis, a process of artificially filtering the blood, may be necessary until kidney function is restored. There are several types of dialysis. In hemodialysis, blood is pumped from the body to an artificial kidney, or dialyzer, where it is filtered and then returned to the body. Hemodialysis is usually performed for three to four hours three times a week. The first hemodialysis is carried out for two to three hours for two days in a row. . Peritoneal dialysis is rarely used for acute renal failure. In this procedure, a catheter is inserted into the abdomen and a special fluid called dialysate is pumped through the peritoneum (the membrane lining the abdominal cavity) to remove contaminants from the blood. If necessary, peritoneal dialysis should be performed for 24 hours a day. . Attention! Call your doctor right away if you have symptoms of acute kidney failure, including decreased urine production, nausea, shortness of breath, and swollen ankles.Prevention
Treatment of an illness that may cause acute renal failure.
Chronic renal failure (CRF)- impaired renal function, caused by a significant decrease in the number of adequately functioning nephrons and leading to self-poisoning of the body with products of its own vital activity.
Chronic kidney failure occurs when both kidneys gradually stop functioning. The kidneys contain numerous tiny structures (glomeruli) that filter waste from the blood and store larger substances such as proteins. Unnecessary substances and excess water accumulate in the bladder and are then excreted as urine. In chronic renal failure, the kidneys are gradually damaged over many months or years. As kidney tissue is destroyed by injury or inflammation, the remaining healthy tissue compensates. extra work causes previously undamaged parts of the kidneys to become overloaded, causing more damage until the entire kidney fails to function (a condition known as end-stage renal failure).
The kidneys have a large margin of safety; more than 80 to 90 percent of the kidney may be damaged before symptoms appear (although symptoms may appear sooner if the weakened kidney is subjected to sudden stress, such as infection, dehydration, or use of a drug that damages the kidneys). As excessive amounts of fluid, minerals such as potassium, acids and waste accumulate in the body, chronic kidney failure becomes a life-threatening disease. However, if the underlying disease is treated and further kidney damage can be controlled, the onset of end-stage renal disease may be delayed. End-stage kidney failure is treated with dialysis or a kidney transplant; any of these methods can prolong life and allow a person to lead a normal life.
Various diseases and disorders of the kidneys can lead to the development of chronic renal failure. These include chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney disease, renal tuberculosis, amyloidosis, as well as hydronephrosis due to the presence of various kinds of obstacles to the outflow of urine.
In addition, chronic renal failure can occur not only due to kidney disease, but also for other reasons. Among them are diseases of the cardiovascular system - arterial hypertension, renal artery stenosis; endocrine system- diabetes mellitus and diabetes insipidus, hyperparathyroidism. Chronic renal failure may be caused by systemic diseases connective tissue - systemic lupus erythematosus, scleroderma, etc., rheumatoid arthritis, hemorrhagic vasculitis.
Causes
. Diabetes and hypertension are the most common causes of chronic kidney failure. . Primary kidney diseases such as acute and chronic glomerulonephritis, polycystic kidney disease, or recurrent kidney infections can lead to chronic kidney failure. . High blood pressure can cause kidney damage or be caused by kidney damage. . If left untreated, a tumor, kidney stones or enlarged prostate can block the urinary tract, impair the flow of urine and thus cause kidney damage. . Long-term use of large doses of non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen can lead to chronic kidney failure. . Poisoning from heavy metals such as cadmium, lead, mercury or gold can lead to kidney failure. . Some antibiotics antifungal agents and immunosuppressants can damage the kidney and lead to kidney failure. . Contrast agents used in some types of X-rays can cause kidney failure in patients whose kidneys have been damaged. . Patients who have had one kidney removed are more vulnerable to complications from kidney damage than people who have both kidneys.It should be noted that, regardless of the cause, chronic renal failure is associated, on the one hand, with a decrease in the number of active nephrons and, on the other hand, with a decrease in working activity in the nephron. External manifestations CRF, as well as laboratory signs of renal failure, begin to be detected when 65-75% of nephrons are lost. However, the kidneys have amazing reserve capabilities, because the body’s vital activity is maintained even if 90% of the nephrons die. Compensation mechanisms include increased activity of surviving nephrons and adaptive restructuring of the work of all other organs and systems.
The ongoing process of nephron death causes a number of disorders, primarily of a metabolic nature, on which the patient’s condition depends. These include disorders of water-salt metabolism, retention in the body of waste products, organic acids, phenolic compounds and other substances.
Symptoms
. Frequent urination, especially at night; excreting only small amounts of urine. . General poor health. . Symptoms of end-stage kidney failure resulting from the buildup of waste in the blood (uremia): swelling of the ankles or tissue around the eyes due to fluid buildup; shortness of breath due to fluid accumulation in the lungs; nausea and vomiting; loss of appetite and weight; frequent hiccups; bad smell from mouth; chest and bone pain; itching; yellowish or brownish tint to pale skin; tiny white crystals on the skin; unexplained bruising or bleeding, including bleeding gums; cessation of menstruation in women (amenorrhea); fatigue and drowsiness; confusion; muscle spasms or cramps; loss of consciousness.A characteristic feature CRF is an increase in the volume of urine excreted - polyuria, which occurs even in the early stages with primary damage to the tubular part of the nephron. In this case, polyuria is constant even with limited fluid intake.
Disorders of salt metabolism in chronic renal failure primarily affect sodium, potassium, calcium, and phosphorus. Sodium excretion in urine can be either increased or decreased. Potassium is normally excreted primarily by the kidneys (95%), therefore, with chronic renal failure, potassium can accumulate in the body, despite the fact that the intestines take over the function of removing it. Calcium, on the contrary, is lost, so there is not enough of it in the blood during chronic renal failure.
In addition to water-salt imbalance, the following factors are important in the mechanism of development of chronic renal failure:
Violation of the excretory function of the kidneys leads to the retention of nitrogen metabolism products (urea, uric acid, creatinine, amino acids, phosphates, sulfates, phenols), which are toxic to all organs and tissues and, primarily, to the nervous system;
Violation of the hematopoietic function of the kidneys causes the development of anemia;
The renin-angiotensin system is activated and stabilized arterial hypertension;
The acid-base balance in the blood is disturbed.
As a result, deep dystrophic disorders occur in all organs and tissues.
It should be noted that the most common direct cause of chronic renal failure is chronic pyelonephritis.
With asymptomatic chronic pyelonephritis, chronic renal failure develops relatively late (20 or more years after the onset of the disease). Less favorable is the cyclical course of bilateral chronic pyelonephritis, when extensive manifestations of renal failure occur after 10-15 years, and its early signs in the form of polyuria - already 5-8 years after the onset of the disease. Timely and regular treatment plays an important role inflammatory process, as well as eliminating its immediate cause, if possible.
Chronic renal failure caused by chronic pyelonephritis is characterized by an undulating course with periodic deterioration and improvement of renal function. Deterioration, as a rule, is associated with exacerbations of pyelonephritis. Improvements occur after complete treatment of the disease with restoration of impaired urine outflow and suppression of activity infectious process. Exacerbates renal dysfunction when chronic pyelonephritis arterial hypertension, which often becomes a factor determining the intensity of nephron death.
Urolithiasis also leads to the development of chronic renal failure, usually with late or inadequate treatment, as well as with concomitant arterial hypertension and pyelonephritis with frequent exacerbations. In such cases, chronic renal failure develops slowly, within 10-30 years from the onset of the disease. However, in special forms of urolithiasis, for example, coral kidney stones, the death of nephrons is accelerated. Provoke the development of chronic renal failure in urolithiasis, repeated stone formation, stone large sizes, its long-term presence in the kidney during a latent course of the disease.
At any rate of development, chronic renal failure sequentially passes through a number of stages: latent, compensated, intermittent and terminal. Main laboratory indicator, separating one stage from another, is the clearance of endogenous (own) creatinine, which characterizes the glomerular filtration rate. Normal creatinine clearance is 80-120 ml per minute.
The latent stage of chronic renal failure is detected when glomerular filtration rate (based on creatinine clearance) decreases to 60-45 ml/min. During this period the main clinical signs Chronic renal failure is polyuria and nocturia - passing more urine at night rather than during the day. Maybe lung development anemia. Patients usually do not present any other complaints or note increased fatigue, weakness, and sometimes dry mouth.
The compensated stage is characterized by a decrease in glomerular filtration to 40-30 ml/min. There are also complaints of weakness, drowsiness, increased fatigue, and apathy. Daily urine output usually reaches 2-2.5 liters; increased sodium excretion in the urine may begin, as well as changes in phosphorus-calcium metabolism with the development of the first signs of osteodystrophy. In this case, the level of residual nitrogen in the blood corresponds to upper limits norms.
The intermittent stage is characterized by an undulating course with alternating periods of deterioration and clear improvement after full treatment. The glomerular filtration rate is 23-15 ml/min. The level of residual nitrogen in the blood is persistently increased. Patients constantly complain of weakness, sleep disturbances, and increased fatigue. A typical symptom is anemia.
The terminal stage is characterized by intoxication of the body with its own nitrogenous waste - uremia. The glomerular filtration rate is 15-10 ml/min. Typical symptoms are skin itching, bleeding (nasal, uterine, gastrointestinal, subcutaneous hemorrhages), “uremic gout” with joint pain, nausea, vomiting, loss of appetite, even aversion to food, diarrhea. The skin is pale, yellowish, dry, with traces of scratching and bruises. The tongue is dry Brown, a specific sweetish “uremic” odor emanates from the mouth. Most of these symptoms occur because other organs, such as the skin, gastrointestinal tract etc., they try to take over the function of the kidneys to eliminate nitrogenous wastes and fail to cope with this.
The whole body suffers. Imbalance of sodium and potassium, persistent high blood pressure and anemia lead to deep damage to the heart. With an increase in the amount of nitrogenous waste in the blood, symptoms of damage to the central nervous system increase: convulsive muscle twitching, encephalopathy up to uremic coma. Uremic pneumonia may develop in the lungs at the terminal stage.
Disorders of phosphorus-calcium metabolism cause leaching of calcium from bone tissue. Osteodystrophy develops, which is manifested by pain in bones, muscles, spontaneous fractures, arthritis, compression of the vertebrae and skeletal deformation. Children's growth stops.
There is a decrease in immunity, which significantly increases the body's susceptibility to bacterial infections. One of the most common reasons deaths of patients with end-stage chronic renal failure are purulent complications, up to sepsis, caused by opportunistic bacteria, such as intestinal daddy.
Diagnostics
. Medical history and physical examination. . Blood and urine tests. . Ultrasound examination, computed tomography or magnetic resonance examination of the abdominal area. . A kidney biopsy may be done. Under local anesthesia, the doctor inserts a needle into the kidney through the back to remove a small sample of tissue for analysis under a microscope.Treatment
. Diets low in salt, protein, phosphorus, limited fluid intake, and vitamin supplements may be recommended. . Surgery may be necessary to stop the blockage in the urinary tract. . Blood pressure lowering medications may be prescribed for high blood pressure. . Medicines to treat congestive heart failure may be needed. . Anemia due to kidney disease can be treated with erythropoietin, a medicine that stimulates the formation of blood cells. . Sodium bicarbonate is prescribed to combat excessive acid buildup in the body (renal acidosis). . Calcium phosphate binder and vitamin D supplements are given to prevent secondary hyperparathyroidism, which can lead to further kidney damage. . Dialysis, the process of artificially filtering blood, may be necessary when much of the kidney's function is not being performed. There are several types of dialysis. In hemodialysis, blood is pumped from the body to an artificial kidney, or dialyzer, where it is filtered and then returned to the body. . Hemodialysis should be performed for 9-12 hours weekly (usually in three sessions). . Another method is peritoneal dialysis. There are two types of peritoneal dialysis. In continuous outpatient peritoneal dialysis, the patient has two to three liters of a sterile solution infused into the peritoneum through a catheter, four to five times a day, seven days a week. Automated peritoneal dialysis uses a mechanism to automatically infuse sterile fluid through a catheter into the peritoneum while the patient sleeps. This process usually takes 9 to 12 hours a day. . In case of end-stage renal failure, the patient is offered a kidney transplant as an alternative to dialysis. Most patients who undergo transplantation have a longer life expectancy than patients undergoing dialysis. A successful transplant can cure kidney failure, but potential donors must be carefully screened for compatibility; the best donors are usually family members, but spouses and friends who wish to become donors can also be tested. Kidney donor recipients must take immunosuppressants to prevent transplant rejection. . Attention! Call your doctor if you experience decreased urination, nausea and vomiting, swelling around the ankles, shortness of breath, or any other signs of chronic kidney failure.IN initial stages treatment of chronic renal failure coincides with the treatment of the underlying disease, the goal of which is to achieve stable remission or slow down the progression of the process. If there are obstacles to the outflow of urine, it is optimal to remove them surgically. In the future, while the treatment of the underlying disease is continued, a large role is given to the so-called symptomatic drugs - antihypertensive (pressure-lowering) drugs from the ACE inhibitor group (Capoten, Enam, Enap) and calcium antagonists (Cordarone), antibacterial, vitamin drugs.
An important role is played by dietary restrictions on protein foods - no more than 1 g of protein per kilogram of the patient’s weight. Subsequently, the amount of protein in the diet is reduced to 30-40 g per day (or less), and with a glomerular filtration level of 20 ml/min, the amount of protein should not exceed 20-24 g per day. Table salt also limited to 1 g per day. However, the calorie content of the diet should remain high - depending on the patient’s weight, from 2200 to 3000 kcal (a potato-egg diet without meat and fish is used).
Iron supplements and other medications are used to treat anemia. When diuresis decreases, it is stimulated with diuretics - furosemide (Lasix) in doses of up to 1 g per day. In a hospital setting, in order to improve blood circulation in the kidneys, intravenous drip-concentrated solutions of glucose, hemodez, rheopolyglucin with the introduction of aminophylline, chimes, trental, and papaverine are prescribed. Antibiotics are used with caution in chronic renal failure, reducing doses by 2-3 times; aminoglycosides and nitrofurans are contraindicated in chronic renal failure. For detoxification purposes, gastric lavage, intestinal lavage, and gastrointestinal dialysis are used. The washing liquid can be a 2% solution of baking soda or solutions containing sodium, potassium, calcium, magnesium salts with the addition of soda and glucose. Gastric lavage is performed on an empty stomach, using a gastric tube, for 1-2 hours.
In the terminal stage, the patient is indicated for regular (2-3 times a week) hemodialysis - an artificial kidney machine. The appointment of regular hemodialysis is necessary when the level of creatinine in the blood is more than 0.1 g/l and its clearance is less than 10 ml/min. Kidney transplantation significantly improves the prognosis, however, in the terminal stage, poor organ survival is possible, so the issue of transplanting a donor kidney should be decided in advance.
Prevention
. Treatment potential possible reasons(especially therapy with a drug for high blood pressure blood and careful control of diabetes) can prevent or delay the development of chronic renal failure.Prognosis of chronic renal failure
The prognosis of chronic renal failure has recently become less fatal due to the use of hemodialysis and kidney transplantation, but the life expectancy of patients remains significantly lower than the population average.
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 notice skin manifestations and the functioning of the respiratory system is disrupted.
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 of the 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 the abdominal cavity; - exacerbation is possible chronic diseases, since due to the 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 proper treatment has been carried out, 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 is 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 occurs 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 may indicate a wide range 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 is 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 the salivary glands increase in size. 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 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 of the 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 tint.
- 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.
- Persistent increase in blood pressure that cannot be reduced even with help potent drugs. The course of heart failure also worsens.
- The patient experiences difficulty breathing, congestion occurs in the lungs, which often provokes 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 of dangerous symptoms, you should undergo a course of treatment when the first symptoms of abnormalities in the functioning of the kidneys are detected.
Specific symptoms that help determine chronic renal failure, focusing on the clinical picture of the disease, occur during irreversible processes in the 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
