Renal nephrosclerosis treatment. Nephrosclerosis: symptoms, treatment and types. Atherosclerotic renal scarring

Nephrosclerosis of the kidneys is a pathological condition of an organ in which the standard type of tissue is completely replaced by a connective tissue. The functional component of the new type does not allow the body to perform its functions, since it is not intended for this. The morphology of the renal tissue in this pathology is diametrically changed. The circulatory system also suffers, which leads to the wrinkling of the kidney and the complete loss of its functions.

The prognosis for such a disease is ambiguous, since it depends on the stage at which the pathology was diagnosed. Late detection, the lack of proper therapy leads to the death of the patient.To understand what nephrosclerosis is, you need to turn to the etiology of the disease.

Kidney sclerosis is a pathology that does not proceed as an independent disease, but is an associated pathology. Among the reasons provoking the development of the disease are distinguished:

Hypertension.
Atherosclerotic vascular lesions of the urinary system.
Other pathological disorders of the blood supply to the kidneys.

Depending on the factors that led to the onset of pathology, several types of nephrosclerosis are distinguished.

The cause of nephrosclerosis is a violation of the blood supply to the kidneys, which leads to their dysfunction

Classification

Atherosclerotic vascular lesions, the presence of blood clots are the main reasons for the formation of the first stage of pathology: primary nephrosclerosis.

Primary nephrosclerosis

With this type of kidney sclerosis, the trophic capabilities of the organ tissues are severely impaired. This becomes the cause of ischemic conditions. And in the absence of proper medical care, they provoke a kidney infarction. The potential risk of this pathology is that if the blood supply is completely inhibited, then the excretory system stops functioning. This entails a condition. Such complications are life-threatening for the patient.

The main consequence of primary nephrosclerosis is primary renal wrinkling. This is characteristic of acute hypertension.

In turn, nephroangiosclerosis is divided into several types:

Atherosclerotic nephrosclerosis

A pathological condition that develops as a consequence of an atherosclerotic disease that affects the arterial vessels and arterioles of the kidney. As a result, the lumen of the vessels is strongly narrowed or completely blocked. Degenerative conditions of the organ result from a decrease in transmission capacity due to thickening of the walls of the arteries.

The early stage is asymptomatic, while a characteristic complication of kidney sclerosis is ischemia, as a result of which changes occur on the surface of the organ and scars form. The prognosis for this type is positive, because not all renal tissue is affected by destruction, while continuing to perform its functions normally.

Shriveled kidney

Hypertensive nephrosclerosis

This type of pathology owes its name to the etiological factor that caused the spastic conditions of the vessels. As with the previous form, pathogenesis includes ischemic damage to the organ, as well as the change of normal tissues to connective tissue.

In turn, the hypertensive type of pathology is divided into:

Arteriolosclerotic nephrosclerosis. This is a malignant disease.
Arterionecrotic nephrosclerosis. Benign course.

Involutive form

This form of kidney sclerosis occurs in older patients. This is mainly due to calcium deposits on the walls of blood vessels. With a narrowing of the lumen, the development of the pathological condition proceeds according to the standard scheme.

Secondary nephrosclerosis

The development of this form of the disease is due not only to atherosclerosis, but is also a consequence of other pathologies. Various infectious and inflammatory processes in the kidney system lead to this disease.

Main reasons:

in a chronic course.
in a chronic course.
Severe forms.
Tuberculosis.
Amyloidosis.
Nephropathy in pregnant women.
The consequences of trauma and surgery.

Symptoms

In the early stages, the symptoms of renal sclerosis are practically absent. Diagnosis of pathology occurs after prophylactic tests or during the diagnosis of another disease. In the absence of measures taken, pathology develops and with each subsequent stage of development, the severity of symptoms increases.

In nephrosclerosis, the main clinic refers to functional disorders of the organ, which provides symptoms:

Swelling of the face and lower extremities.
Lumbodynia.
Hypertension associated with headaches. Pain syndrome is practically not overcome by painkillers.
Changes in the physical properties of urine, as well as the presence of various inclusions in it - flocculent sediment, color changes to reddish, turbidity.
Nocturnal enuresis.
A sharp decrease in urine output.
Dry mouth and thirst.
Apathy, weakness, lack of appetite. Also, patients with nephrosclerosis have an aversion to meat foods.
Dermatological disorders.
Losing weight.
Tachycardia, shortness of breath.

Symptoms and manifestations of nephrosclerosis

Such symptoms in adults and children require immediate diagnosis.

Diagnostic procedures

If the first symptoms of pathology appear, then biochemical studies of blood, urine, instrumental studies of the organs of the urinary system are carried out.

Since the risk of developing the disease increases in the presence of chronic pathologies, patients with diabetes mellitus, hypertension, atherosclerosis, pathological weight gain are recommended to take tests once a year and carry out full functional diagnostics.

This includes:

Blood analysis. General and biochemical. Particular attention is paid to creatinine clearance.
Analysis of urine. The density of urine is important.
Ultrasound procedure.
X-ray procedures, including contrast procedures.

Therapy

Treatment of nephrosclerosis is based on two principles. The first is drug therapy, the second is surgery.

When diagnosed with high blood pressure, drugs are selected that reduce blood pressure at the general level. The approach to the selection of funds is individual. Therapy is prescribed only by the attending physician. The choice of medication is based on the characteristics of the patient's body and the possibility of using combinations of funds.

There are several main groups of drugs:

ACE inhibitors.
Angiotensive receptor blockers.

The right diet is crucial. Salt is completely excluded. In some cases, carbohydrates are contraindicated.

The first stage of the disease, diagnosed in time, implies a classic approach to treatment:

Hormone therapy. Prednisolone, methylprednisolone. Dosages are determined by the doctor based on the functionality of the kidney.
Cytostatic agents.
Drugs that improve the functional ability of the urinary system.

If the main cause is atherosclerosis, then medications from the statin group are prescribed. This reduces the level of cholesterol in the blood, which has a beneficial effect on the functioning of the cardiovascular system. And also allows you to stop nephrosclerosis.

If the disease is diagnosed at one of the last stages, when the patient is experiencing serious problems, then the following methods are shown:

Blood dialysis... An effective procedure that purifies the blood from toxins that are not filtered by the kidneys due to illness. Usually up to five procedures are performed. By the third procedure, the patient feels much better.
Peritoneal dialysis... Also an effective method that can be carried out even at home.
Nephrectomy or transplant... It includes a whole range of procedures for adapting a new organ in the patient's body. The consequences of surgery include the possibility of rejection by the patient's immune system.

Knowing what the nephrosclerosis threatens, the patient needs to strictly follow the instructions of the doctors.

Treatment with folk remedies

Treatment of renal nephrosclerosis with folk remedies includes a set of measures aimed at lowering blood cholesterol levels, improving the functional abilities of the kidneys. And also, additional to the main anti-inflammatory and antiseptic therapy of renal diseases with phytopreparations.

Ayurveda is very popular - it is an Indian herbal medicine. The main drug that is often used by patients and prescribed by doctors is Cyston. Treatment with such a remedy is long-term and ensures the normalization of renal pressure, relief of the condition in inflammatory processes and increased diuresis.

Birch buds.
Lingonberry extracts.
A mixture of flax seeds, strawberry leaves, birch buds, nettle leaves, knotweed, horsetail.
Infusion of licorice root.

Pediatric pathology

In a child, kidney nephrosclerosis cannot develop without the presence of congenital organ diseases. This is due to the fact that pathology appears as a result of a large number of damaging factors, the accumulation of negative effects of which takes years. In a child's body, this is impossible.

Preventive measures

Among the preventive measures are:

Diet recommendations. Doctors advise against neglecting fruits and vegetables. It is also not recommended to abuse meat.
Body weight control.
Compliance with the correct water regime.
Playing sports and giving up bad habits.
Self-medication exclusion.
Periodic diagnostic procedures.
No poisoning and chemical intoxication.

Conclusion

What is kidney nephrosclerosis? This is the outcome of diseases that can be successfully treated in the early stages, thereby excluding the development of such a life-threatening pathology. Most of the patients, unfortunately, do not pay attention to the first symptoms, allowing the disease to develop slowly. Only a timely visit to a doctor and correct diagnosis gives a person a chance to live a full life.

Renal nephrosclerosis (Nephrosclerosis) means the replacement of functional parenchymal renal tissue with connective tissue. This tissue cannot perform the function of the parenchyma of the kidneys, therefore, the activity of the organ is radically impaired. The formation of connective tissue in the kidney leads to changes in the blood supply to the kidney. The walls of arteries and arterioles thicken, lose elasticity and cannot fully supply the organ with blood. This leads to a malnutrition of the mini-structures of the renal tissue - glomeruli and tubules - and to their further death. As a result, the kidney decreases in volume (primary shriveled kidney) and does not fulfill its function.

The outcome for this serious disease is different, depending on the timely started high-quality treatment and the correct recovery period.

Recovery occurs if the treatment was carried out in the early stages of the disease. In other cases, it is only possible to achieve stabilization of the state for a certain period (its length depends on many factors) and an improvement in the quality of life. Lack of treatment, untimely or incorrect treatment lead to the progression of the disease and death.

Before dwelling on the features of primary and secondary nephrosclerosis, it is necessary to consider the reasons that lead to the development of this disease.

Causes of nephrosclerosis

Nephrosclerosis is not an independent disease. It develops most often against the background of hypertension, atherosclerosis and other vascular diseases or the kidneys themselves, which causes a disruption in the normal blood supply to the organ. According to the mechanism of development, the following types of nephrosclerosis are distinguished: primary, or hypertensive, and secondary.

The main cause of nephrosclerosis is a violation of the blood supply to the organ, which ultimately leads to its dysfunction.

Primary nephrosclerosis: what is it

The causes of the development of the first form of kidney disease is the narrowing of the renal arteries due to their defeat by atherosclerosis, thrombosis or thromboembolism. As a result, the trophism of renal tissues is disturbed, which leads to renal ischemia (impaired blood supply to the kidney). This complication can lead to an even more serious complication - kidney infarction. The danger of these conditions is that the renal vessels can be completely blocked, and the kidneys stop excreting waste products from the body. Acute renal failure developing in such cases can become a threat to life if the patient is not provided with qualified medical care in time.

The result of primary nephrosclerosis is a primary contracted kidney, which develops in the last stages of hypertension. Constant hypoxia and failure of renal tissue trophism leads to atrophic and dystrophic changes in the organ, with the gradual replacement of the parenchyma with connective tissue.

Classification of primary nephrosclerosis

Primary nephrosclerosis, depending on the reasons that caused it, is divided into such types.

Atherosclerotic

Developing due to the deposition of atherosclerotic plaques on the walls of blood vessels of the whole body, including on the walls of the renal arteries and arterioles. Plaques close the lumen of blood vessels, significantly reduce their elasticity. The walls of the vessels thicken, which also leads to a decrease in their patency. As a result, renal ischemia develops. In the affected kidney, the surface becomes nodular, with ischemic scars. This form of kidney nephrosclerosis is considered less dangerous in the prognosis for the patient, since part of the kidney parenchyma remains unaffected by the process and functions.

Macrodrug for arteriolonephrosclerosis of both kidneys. Signs of pathology are clearly visible: they are compacted, the surface is fine-grained. The section shows a focal lesion of the parenchyma with an increase in adipose tissue

Hypertensive nephrosclerosis

This form of the disease is named in connection with the primary cause of renal vasospasm - hypertension. As a result of vasospasm, kidney ischemia also develops, the parenchyma is replaced by connective tissue. This type of nephrosclerosis is divided into two subtypes: arteriolosclerotic nephrosclerosis and arterio-necrotic. The difference between them is that the first subspecies is not malignant, unlike the second.

Involutive

It develops with age in older people. On the walls of arteries after 50 years, there is a process of calcium deposition, which affects the elasticity of blood vessels and their patency. This leads to a decrease in the blood supply to the kidneys and to ischemia.

Secondary nephrosclerosis

Nephrosclerosis of the kidneys can develop not only due to sclerotic lesions of the renal vessels, but secondarily against the background of inflammatory and dystrophic processes in the renal structures - the renal glomeruli, tubules and stroma of the kidney. Secondary nephrosclerosis and renal scarring are often the result of:

chronic glomerulonephritis;
chronic pyelonephritis;
kidney stone disease;
kidney tuberculosis;
amyloidosis of the kidneys;
diabetic glomerulosclerosis (against the background of diabetes mellitus);
kidney infarction;
severe forms of pregnancy nephropathy;
kidney injury and surgery.

Symptoms of nephrosclerosis

Every tenth inhabitant of the Earth has kidney damage, namely nephrosclerosis in one stage or another of the disease. But many of them are not even aware of their illness. The insidiousness of nephrosclerosis is that at the initial stage it has practically no symptoms. The disease is discovered by chance when passing urine and blood tests. If at this moment you do not pay due attention to the developing disease, then over time it progresses to end-stage renal failure. At this stage, serious complaints appear and symptoms are pronounced. But the moment when the disease could be defeated or stabilized the patient's condition at this stage has already been missed.

It looks like the face of a patient with nephrosclerosis in the stage of developed renal failure

Clinical symptoms in nephrosclerosis appear with impaired renal function:

specific swelling on the face and legs;
pain and discomfort in the lumbar region;
high blood pressure, accompanied by severe headaches that are difficult to relieve with analgesics;
change in the appearance of urine (reddish, brown, foamy, with flakes, cloudy sediment);
frequent urge to urinate, especially at night;
a decrease in the volume of urine excreted per day (less than 500 ml);
constant feeling of thirst;
intolerance to meat food (a feeling of disgust appears);
general weakness, loss of appetite;
shortness of breath, heart palpitations;
itchy skin;
loss of body weight.

If such symptoms or some of them occur in a child or an adult, then it is worthwhile to immediately undergo a nephrological examination.

Diagnostics

The basis of nephrological diagnostics is laboratory tests (urine and blood tests), as well as X-ray diagnostics, ultrasound of the kidneys. These studies must be carried out by each person once a year. In the presence of diseases such as diabetes mellitus, arterial hypertension, vascular atherosclerosis, obesity (a risk group for chronic nephrosclerosis), it is necessary to conduct a deeper study, for example, a test for microalbuminuria, determine the level of creatinine in the blood, perform a test according to Zimnitsky (determination of the relative density of urine ) and carry out other specific studies.

One of the effective diagnostic methods for kidney disease is ultrasound

Treatment

Treatment of renal nephrosclerosis includes two methods: therapeutic and surgical.

In the therapeutic method, medications are used to stabilize blood pressure at a certain level. The drugs are selected on a case-by-case basis. Antihypertensive drugs are taken daily according to a certain scheme to prevent hypertensive crises. With nephrosclerosis in the later stages, antihypertensive drugs should be taken with caution, as they can aggravate the condition. For patients with renal disease, it is an immutable law to adhere to a renal salt-free diet. If the patient's blood tests contain nitrogenous toxins, then the patient needs to limit the intake of animal protein.

In the early stages of the disease, active therapy is indicated: prednisolone, cytostatic drugs. This allows in many cases to stop the progression of the disease and its transition to a more unfavorable stage. As the disease progresses, the renal parenchyma is replaced by connective tissue, therefore, renal failure is formed with the accumulation of toxins in the body and the presence of an overload on the renal glomeruli. In this situation, nephroprotective therapy is prescribed, aimed at preserving renal function.

Today there are modern drugs that inhibit the development of nephrosclerosis and have a beneficial effect on its prognosis. These are angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and other modern drugs. They are prescribed only by a specialist nephrologist after careful medical monitoring of the patient.

With high levels of cholesterol in the blood, statins are prescribed, which normalize fat metabolism and have a beneficial effect on the vascular formations of the kidney. In complex treatment, cardioprotectors are not forgotten. With anemia that accompanies the dialysis stage of nephrosclerosis, artificial erythropoietin preparations are prescribed.

One of the effective modern methods of blood purification is hemodialysis, which allows prolonging the life of patients in the terminal stage of nephrosclerosis.

In the terminal stage of nephrosclerosis, three methods of renal replacement therapy are effective:

hemodialysis, hemodiafiltration;
peritoneal dialysis;
kidney transplant.

Peritoneal dialysis is the purification of blood using a special solution injected into the peritoneum and removed with a catheter after a certain time. The procedure is performed by the patient himself at home.

A kidney transplant (transplant) from a living relative or a cadaveric donor is also today a full-fledged method of replacing an organ that has lost its function. After a kidney transplant, the patient must constantly take medications that suppress their own immunity. This is necessary so that the transplanted organ is not rejected by the body.

To prevent such a serious disease as nephrosclerosis, it is necessary to show your volitional qualities, giving up once and for all bad habits.

Prophylaxis

As you know, the disease is easier to prevent than to cure. This fully applies to such a serious disease as nephrosclerosis. Can you prevent it while the kidneys are still healthy? Yes, if you adhere to the 10 golden rules recommended by nephrologists:

Do not abuse meat and salt. Eat more vegetables and fruits. Refuse canned foods.
Do not allow excess weight, constantly keep it within the age range.
Drink up to 2-3 liters of clean water daily.
Regularly engage in sports that are affordable for age and health.
No smoking or alcohol abuse.
Do not self-medicate, especially drugs such as antibiotics, antispasmodics, pain relievers, diuretics. Do not get carried away with nutritional supplements, "fat burners", advertised, but unproven weight loss products;
Do not come into contact with toxic substances, dyes, fungicides, heavy metals.
Do not get carried away by exposure to the sun, do not overcool.
Constantly monitor blood pressure, blood sugar and cholesterol levels.
Undergo medical examinations annually to monitor the condition of the kidneys.

Finally

As you can see, nephrosclerosis is a serious problem from which no one is immune. And although today there are effective ways to solve it, we see that the later this problem is identified, the less chances of its successful solution, the greater the risk of complications. It should be remembered that even the most modern means of treatment will be effective if the patient himself consciously treats his health.

Most people over forty suffer from a benign form of nephrosclerosis, which means that the blood vessels of the kidneys gradually change, but these changes do not happen as quickly and do not require treatment. For patients with benign nephrosclerosis, it is only required to monitor their condition and take measures to prevent the progression of the disease. In other patients, there is a malignant form of nephrosclerosis, in which case damage to the renal vessels occurs so quickly that medical treatment or even surgery is necessary.

Definition

Nephrosclerosis is the process of replacing the renal parenchyma with connective tissue, which leads to thickening of the walls of the arteries and arterioles in the kidneys. Such arteries cannot normally supply the kidney with blood, there is a malnutrition of the glomeruli and tubules, and in the future, their death and replacement by connective tissue. The kidney decreases in volume (primary shriveled kidney) and begins to lose its function.

Lower back pain indicates possible kidney problems

Disease types

Depending on the cause, there are two types of renal nephrosclerosis:

primary, which occurs as a result of impaired blood supply to the kidneys in such diseases and conditions as hypertension, kidney infarction, venous congestion in the kidneys, etc. Primary nephrosclerosis also often occurs as a result of senile changes in the body;
secondary, which develops against the background of existing kidney diseases (glomerulo- and pyelonephritis, kidney stones, tuberculosis, syphilis, renal amyloidosis, diabetes mellitus), as well as as a result of their injury, or exposure to the body of ionizing radiation.

Primary nephrosclerosis, in turn, is further divided into the following forms:

atherosclerotic;
involutive;
hypertensive.

Also, depending on the course of the process, there are:

benign nephrosclerosis, in which there is a gradual and prolonged deterioration in the function of the renal arteries. First, the inner layer of the walls of the smaller vessels thickens and gradually this thickening spreads to the entire wall, sometimes blocking the central channel of the vessel. Then, fat is deposited in the degenerated tissue of the wall. There is an excess of elastic tissue in large arteries, which can block their channels. Both of these conditions cause impaired blood flow to vital areas in the kidneys, which in turn leads to impaired functioning of the kidney tissue;
malignant nephrosclerosis, in which the above changes develop much faster.

Causes

The cause of nephrosclerosis is a violation of the blood supply to the kidneys, which is the result of a narrowing of the lumen of its vessels. Hypoxia occurs, as a result of which atrophy and degeneration of the renal parenchyma and proliferation of connective tissue develops. Such processes are most often observed in the kidneys with atherosclerosis and hypertension. Also, nephrosclerosis can develop due to the development of inflammatory and dystrophic processes in the kidneys in diseases such as glomerulo- and pyelonephritis, diabetes mellitus, tuberculosis, syphilis, kidney stones, systemic lupus erythematosus, renal amyloidosis.

Sometimes nephrosclerosis can be associated with age-related changes in the renal vascular system.

Symptoms

In the initial stages of nephrosclerosis, symptoms are often absent. The first signs of kidney damage can be observed in urine tests, which will be characterized by poly - and nocturia, the presence of protein in the urine, microhematuria, decreased renal clearance, hypostenuria. Patients complain of increased blood pressure (diastolic blood pressure exceeds 120 mm Hg).

The main symptoms of renal nephrosclerosis include:

visual impairment ;
weight loss;
uremia (accumulation of urea and other nitrogenous compounds in the blood);
attacks of angina pectoris.

Diagnostic methods

First you need to correctly collect anamnesis and analyze the clinical picture. When diagnosing, laboratory methods are also used, including:

, in which an increased level of urea, creatinine and uric acid is detected, a decrease in total protein, in the final stages an increase in potassium, magnesium, phosphorus and sodium;
general urine analysis, which reveals an increased amount of protein, a decrease in the relative density of urine, as well as the presence of red blood cells and cylinders that are absent in the norm;
a complete blood count, which shows a decrease in the level of hemoglobin and platelets.

Among the instrumental research methods, effective are:

ultrasound, which reveals a decrease in the size and function (atrophy) of the cortical layer of the kidneys, as well as the presence of calcifications in the renal parenchyma;
excretory urography of the kidneys, which allows you to identify a decrease in the volume of the kidney and its cortical layer;
angiography of the renal vessels, which determines the narrowing and deformation of the small renal arteries, the unevenness of the kidney contour, thinning of the renal cortex;
kidney scintigraphy, which reveals the uneven distribution of the radioisotope in nephrosclerosis;
Doppler of renal vessels, which detects a slowdown in blood flow in the renal vessels and nephrons;
radionuclide renography, which detects delayed accumulation and excretion by the kidneys of a radiopharmaceutical;
computed tomography of the kidneys;
kidney biopsy.

Treatment methods

First you need to determine the cause and begin treatment of the causative disease. Early therapy includes drugs such as anticoagulants (heparin, warfarin), antiplatelet agents (pentoxifylline, trental, dipyridamole), which improve renal blood supply. Drugs are also used to lower blood pressure, but in the later stages of nephrosclerosis, they should be used with caution. These include ACE inhibitors (captopril, enalapril), calcium antagonists (verapamil, nifedepine), β-adrenergic receptor blockers (atenolol, propranolol), diuretics (furosemide, hypothiazide). Potassium preparations (asparkam, panangin) are also prescribed in order to eliminate salt imbalance. No less important are multivitamin preparations, iron preparations, sorbents.

With the development of III-IV stages of chronic renal failure, when it is impossible to restore kidney function with drug treatment, hemodialysis or kidney transplantation are used. During hemodialysis, the blood of a patient with nephrosclerosis is passed through a special membrane in an artificial kidney apparatus, which ensures the cleansing of the body of toxins and metabolic end products, and normalizes the water-salt balance.

The frequency of hemodialysis procedures depends on the patient's condition and the degree of functional activity of the kidneys. At the time of hemodialysis, the patient is prescribed antihypertensive drugs, vitamins, potassium preparations and other medicines.

Carrying out a hemodialysis procedure for nephrosclerosis

A kidney transplant is a radical method that allows the patient to live their normal life. A donor organ can be taken from a corpse, or from a living donor (for example, from relatives with their consent). After kidney transplant surgery, patients are prescribed special drugs that suppress the activity of the immune system to prevent the rejection of the donor organ.

Doctor's note: it must be remembered that a kidney transplant operation is extremely dangerous, as it can carry many complications, such as bleeding, rejection of the transplanted kidney, and urological complications. Therefore, it is worth resorting to this method of treatment only as a last resort.

If the patient has glomerulonephritis, chronic renal failure, they also resort to hirudotherapy (treatment with medicinal leeches). In this case, leeches are placed in the lumbar zone, the sacrum zone, the lower abdominal and hepatic zones. The advantage is given to the lumbar region. In one session of hirudotherapy, from 2 to 8 leeches are used, depending on the severity of the patient's condition. The course of treatment includes from 7 to 12 procedures, with the first 5 procedures being carried out at intervals of a day, and the next 2 times a week.

In the treatment of kidney nephrosclerosis, traditional medicine is also used, preparing infusions from various medicinal herbs, for example:

it is recommended to drink birch sap, which cleanses the kidneys; alcohol infusion from aspen buds, take 30 drops before meals, diluted in a tablespoon of water;
lingonberry infusion, for the preparation of which they take 1 tablespoon of lingonberry fruits, 200 ml of boiled water, take 1 spoonful 4 times a day;
infusion of strawberry leaves (10 g), birch (20 g), nettle (20 g) and flax seed (50 g). Take before meals, 100 ml 4 times a day;
infusion of licorice, which is prepared from 2 tsp. licorice and one and a half glasses of hot water. The infusion should be drunk during the day in several doses.

Features of nutrition for nephrosclerosis

To achieve the maximum effects of treatment, you must eat properly and rationally. When composing your diet, you must adhere to some rules, namely:

limit protein as it is a substrate for urea production. Among protein foods, you need to give priority to poultry, rabbit, low-fat beef, fish, dairy and sour-milk products, egg white. You should exclude bread, cereals, potatoes from your diet;
for patients with nephrosclerosis, the diet must necessarily include dairy and fish products, but they should not be abused, since they contain a lot of phosphorus;
limit salt as it increases swelling. In the early stages, up to 10-15 g of salt per day is allowed, in the later stages up to 3-7 g. But you should not completely abandon salt, as this can lead to dehydration of patients; include in your diet foods rich in calcium and potassium, calcium is found in peas, beans, green vegetables, whole grain flour. Foods such as raisins, dried apricots, bananas, chocolate are rich in potassium. But in the later stages of nephrosclerosis, foods containing potassium should be limited;
nutrition should provide enough calories and vitamins;
you need to eat 4-5 times a day in small portions.

Doctor's opinion: in the initial stages of nephrosclerosis, when blood pressure is not high and there is no edema yet, water can be left unrestricted. But in the later stages, the volume of fluid should be no more than 800-900 ml per day.

An approximate menu for a patient with nephrosclerosis is as follows:

First breakfast: low-fat boiled fish, grain bread, butter, weak tea with lemon.

Second breakfast: buckwheat porridge with milk, compote.

Lunch: vegetable soup, boiled lean meat (chicken, rabbit, turkey), baked potatoes, fruit juice.

Dinner: rice porridge with dried apricots, dried fruit compote. An hour before bedtime: crackers, jelly.

Forecast

Nephrosclerosis is a chronic disease that lasts for a long time with alternating periods of exacerbations and remissions. Therefore, with good compensation for the underlying disease, subject to the diet and doctor's prescriptions, the patient will be able to reduce the number of periods of exacerbations and lead an active life. But a malignant course of nephrosclerosis is also possible, in which kidney function quickly deteriorates, nephrons die and chronic renal failure sets in, which can be compensated for in the future only with the help of hemodialysis or kidney transplantation.

Prophylaxis

There is no specific prophylaxis for renal nephrosclerosis. The main methods of preventing the progression of the disease are diet, avoidance of physical and mental stress, adequate rest, constant monitoring of blood pressure, and an active lifestyle.

The kidneys are vital organs, without them our body would not be able to function. Therefore, it must be remembered that when taking care of them, the frequency of exacerbations of the underlying disease, which caused the nephrosclerosis, decreases.

The term "renal nephrosclerosis" means a pathology that occurs due to the replacement of the renal parenchyma by connective tissues. There are several types of diseases that arise for various reasons. Symptoms increase as the disease progresses. This affects the methods of treatment of pathology. There are no special preventive measures. Prediction of the course depends on many factors, the main of which is the benignity or malignancy of the disease.

A pathological phenomenon is the process of overgrowth of the kidney parenchyma with connective tissue.

The disease was first diagnosed at the beginning of the 20th century. The reason for the development of nephrosclerosis is the replacement of the parenchyma of the organ with connective tissue, which makes the kidney thicken and becomes wrinkled. Another name for the disease is "shriveled kidney". This leads to a deterioration in the functioning of the organ. Previously, it was believed that the disease is provoked by glomerulonephritis, now experts are inclined that the main causes of the development of renal nephrosclerosis are diabetes mellitus and arterial hypertension. Statistics say that the disease is diagnosed in every 6 people out of 10 thousand.

Back to the table of contents

Types and forms

A shriveled kidney due to education is classified into 2 types:

primary wrinkled kidney (blood supply to the organ worsens due to atherosclerosis, hypertension, or age-related changes that develop in the elderly);
a secondarily wrinkled kidney (due to organ trauma, radiation or other kidney pathologies, for example, pyelonephritis or tuberculosis).

Primary renal sclerosis is:

hypertensive;
involutive;
diabetic;
atherosclerotic.

Hypertensive nephrosclerosis is characterized by a frequent increase in pressure in the vessels when the lumen narrows. The kidney cells do not receive enough oxygen, and the parenchyma of the organ is replaced by connective tissues. Hypertensive nephroangiosclerosis is a disease that affects the small vessels of the kidney. Nephroangiosclerosis of the arteries develops against the background of arterial hypertension. Atherosclerotic nephrosclerosis occurs against the background of arterial stricture, which is caused by a sclerotic plaque. The disease usually does not lead to large-scale damage to the kidney, and its functions are preserved.

In diabetic nephrosclerosis, microangiopathies develop, which lead to complete damage to the organ. Pathology develops in 4 stages:

1st - not accompanied by pronounced symptoms;
2nd (prenephrotic) - characterized by slightly increased blood pressure and changes in blood formulas, which are reflected in the results of general and biochemical analyzes;
3rd (nephrotic) - edema appears and blood pressure rises;
The 4th stage of diabetic nephrosclerosis is accompanied by renal failure and develops for several years.

The course of the disease makes it possible to distinguish the following types of nephrosclerosis:

benign;
malignant.

Benign nephrosclerosis takes a long time to develop. It takes a long time for the function of the artery to be impaired. First, a thickening of the inner layer occurs, which eventually spreads to the entire thickness of the organ wall, which causes a blockage of the vessel. The development of the pathological process leads to a deterioration in blood flow in the kidney, which results in impaired renal function. Malignant nephrosclerosis is characterized by a more rapid development of processes, therefore, timely diagnosis is important, which will help prevent changes in the kidney. The prognosis for benign sclerosis is much better.

Back to the table of contents

Causes of the sclerotic kidney

Structural abnormalities of the kidneys can be a consequence of complications of diabetes, tuberculosis, and other inflammation of internal organs.

thromboembolism;
atherosclerosis;
hypertension.

A shriveled organ in which a secondary lesion has occurred is a consequence of other kidney pathologies:

tuberculosis;
nephropathy of pregnant women;
pyelonephritis;
amyloidosis;
glomerulonephritis;
trauma;
diabetes mellitus.

Back to the table of contents

Pathological anatomy

Sclerotic pathology develops in 2 phases. At the first stage, it is important to determine the disease that is the cause of the sclerotic processes in the organ. At this point, the relationship is easy to find. At the second stage, this is much more difficult, sometimes unrealistic. Shrinkage occurs very quickly, covering more and more kidney tissue. In this case, the organ slightly increases, its surface becomes granular, many irregularities are formed, and scarring of tissues begins. Sometimes the organ shrinks evenly, sometimes not.

The disease can develop in benign and malignant forms. In benign sclerosis of the kidney, individual groups of nephrons shrink, the process develops slowly. Connective tissues first replace the intermediate space, and then atrophied zones. With malignant wrinkling, pathological changes occur faster, which worsens the prognosis. Necrosis of arterioles and capillary glomeruli develops, and many complications arise. Fatal outcome in case of late diagnosis is a frequent occurrence.

Back to the table of contents

Symptoms of the disease

Shrinking of the kidneys is manifested by swelling, pressure surges, and frequent urge to go to the toilet.

In the initial stages, shriveled organs do not make themselves felt at all, or the symptoms are mild. The problem can only be diagnosed by blood and urine tests, which show small changes in the functioning of the organ. The main symptoms appear at a late stage. The first symptoms are:

increased urination;
increased urination;
the presence of protein in the urine;
high blood pressure;
swelling.

In addition, there are:

symptoms of damage to the heart and blood vessels;
Iron-deficiency anemia.

Back to the table of contents

Risk of kidney nephrosclerosis in a child

Sclerotic kidney disease in a child cannot be diagnosed. The development of pathological changes that lead to wrinkling is facilitated by prolonged exposure to unfavorable factors. If the baby has congenital abnormalities of the kidneys and genitourinary system, the risk of developing nephrosclerosis increases, so it is important to carefully examine such children.

Back to the table of contents

Diagnostic methods

When a patient visits a doctor, he first of all collects an anamnesis and a visual examination of the patient. After analyzing the symptoms of the disease, the specialist palpates the patient's abdominal cavity. All these methods make it possible to assume a certain diagnosis and understand in what perspective to continue the research.

Laboratory diagnostic methods:

blood biochemistry (there is an increase in the level of urea, creatine, a decrease in protein in the later stages, sodium, magnesium, potassium, phosphorus can be increased);
a general blood test (hemoglobin and platelet levels are lowered);
general urine analysis (protein in urine is increased, the density of the substance decreases, erythrocytes and cylinders are visualized, which should not be in urine).

The diagnosis cannot be made without instrumental research methods:

Ultrasound (on the monitor during ultrasound it is seen that the size of the organ is less than normal, atrophy of the cortex is observed);
angiography of the vessels of the organ (places of narrowing and deformation that have occurred in small vessels are visualized, the cortical substance becomes thinner, the contour of the organ changes);
excretory urography (iodine-containing substances are injected, thus it can be seen that the organ and its cortical substance are less than normal);
vascular Doppler (blood flow in the nephrons and vessels is slower);
scintigraphy (it can be seen that the isotope is not evenly distributed);
CT scan;
radionuclide renography;
biopsy and histological analysis of a biopsy (a macro specimen is used).

Back to the table of contents

Treatment methods

Sclerotic changes begin to heal only after diagnosis. If the signs have not yet manifested and the disease is at an early stage, the patient may be prescribed treatment with the following medications:

Early deformations of the structure of the kidneys can be stopped with pills, and later ones - only with surgery.

anticoagulants (for example, "Heparin");
potassium preparations to normalize the salt balance (for example, "Asparkam");
antiplatelet agents that improve blood flow (for example, "Trental");
multivitamins;
vitamin D;
iron preparations;
sorbents.

Means are also used that help reduce blood pressure, but their use at a later stage, when the kidney is shriveled, is highly undesirable:

calcium antagonists (eg Verapimil);
diuretics (for example, "Furosemide");
blockers of adrenergic receptors (for example, "Propranolol").

If kidney sclerosis is diagnosed in the latter stages, drug treatment is ineffective. The patient needs hemodialysis or surgery. The essence of hemodialysis is that the blood of a patient whose kidneys have shrunken is passed through a special filter of an artificial kidney. This ensures the purification of the blood from toxic substances and the normalization of the salt balance. The frequency of hemodialysis is determined by the patient's condition and the degree of renal dysfunction. The procedure is accompanied by pharmaceutical treatment.

Surgical treatment for patients who have a drying out of the kidney is carried out by means of its transplantation. This is one of the few types of transplantation when an organ can be removed not only from a corpse, but also from a living person. At the same time, this is an extremely difficult operation. During the recovery period, the patient is recommended complete rest, the use of medications, which inhibit the protective mechanisms of the immune system. Signs of glomerulonephritis or kidney failure can sometimes be treated with hirudotherapy (leeches). Leeches are placed in the lumbar region in an amount of up to 8 pieces. The duration of the course of treatment is 7-12 times (5 procedures every other day, and the rest - once a week).

Back to the table of contents

Power features

A change in the parenchyma of the right or left kidney requires an indispensable change in nutrition. You need to eat in small portions many times a day. Protein should be limited. From protein products it is better to choose meat, milk, fermented milk products, egg white. It is not recommended to eat porridge, potatoes or bread. The diet should include fish as it is rich in phosphorus.

To prevent such a symptom as edema, it is necessary to limit the amount of salt, but not give it up completely. Nutrition should be rational. It should contain a lot of vitamins. The diet encourages the use of seaweed, buckwheat, nuts and mineral waters, where there is a lot of magnesium. If the patient has a secondary disease, it is necessary to drink up to 3 liters of water per day, which cannot be done if there are signs of heart or vascular problems.

Back to the table of contents

Traditional treatment

It is possible to help the kidneys recover from nephrosclerosis with infusions and decoctions from natural ingredients.

Treatment with folk remedies cannot be the only type of therapy used. It is forbidden to use folk remedies without first consulting a doctor. Healers say that the symptoms of the disease can be alleviated by using the following medicines:

Birch juice;
lingonberry infusion;
alcohol infusion from aspen buds;
decoction of flaxseed (5 boxes), strawberry leaves (1 box), birch (2 boxes) and nettle (2 boxes) leaves;
licorice root in the infusion.

Back to the table of contents

Recovery Predictions

The diagnosis of nephrosclerosis suggests different outcomes. Since this is a chronic pathology, in which remissions and exacerbations constantly occur, with compensation for the pathology of one kidney, dietary nutrition and following the recommendations of the attending physician, the number of attacks can be reduced. In this case, the patient will lead a normal life and will not lose his ability to work. The prognosis for the outcome of malignant renal wrinkling is not so favorable, since nephrons die and renal failure develops. Usually, the patient is waiting for constant hemodialysis or transplantation. Failure to do so is fatal.

Back to the table of contents

Disease prevention

There are no special preventive measures that can make sure that the kidney does not shrink. Doctors recommend adhering to proper nutrition, not overstraining yourself, and rest. Get enough sleep. An important point is adhering to an active lifestyle. You should monitor your blood pressure and consult a doctor in a timely manner if you feel unwell.

Most people over forty suffer from a benign form of nephrosclerosis, which means that the blood vessels of the kidneys gradually change, but these changes do not happen as quickly and do not require treatment. For patients with benign nephrosclerosis, it is only required to monitor their condition and take measures to prevent the progression of the disease. In other patients, there is a malignant form of nephrosclerosis, in which case damage to the renal vessels occurs so quickly that medical treatment or even surgery is necessary.

Definition

Nephrosclerosis is the process of replacing the renal parenchyma with connective tissue, which leads to thickening of the walls of the arteries and arterioles in the kidneys. Such arteries cannot normally supply the kidney with blood, there is a malnutrition of the glomeruli and tubules, and in the future, their death and replacement by connective tissue. The kidney decreases in volume (primary shriveled kidney) and begins to lose its function.

Lower back pain indicates possible kidney problems

Disease types

Depending on the cause, there are two types of renal nephrosclerosis:

primary, which occurs as a result of impaired blood supply to the kidneys in such diseases and conditions as atherosclerosis, hypertension, kidney infarction, venous congestion in the kidneys, etc. Primary nephrosclerosis also often occurs as a result of senile changes in the body;
secondary, which develops against the background of existing kidney diseases (glomerulo- and pyelonephritis, kidney stones, tuberculosis, syphilis, renal amyloidosis, diabetes mellitus), as well as as a result of their injury, or exposure to the body of ionizing radiation.

Primary nephrosclerosis, in turn, is further divided into the following forms:

atherosclerotic;
involutive;
hypertensive.

Also, depending on the course of the process, there are:

benign nephrosclerosis, in which there is a gradual and prolonged deterioration in the function of the renal arteries. First, the inner layer of the walls of the smaller vessels thickens and gradually this thickening spreads to the entire wall, sometimes blocking the central channel of the vessel. Then, fat is deposited in the degenerated tissue of the wall. There is an excess of elastic tissue in large arteries, which can block their channels. Both of these conditions cause impaired blood flow to vital areas in the kidneys, which in turn leads to impaired functioning of the kidney tissue;
malignant nephrosclerosis, in which the above changes develop much faster.

Causes

The cause of nephrosclerosis is a violation of the blood supply to the kidneys, which is the result of a narrowing of the lumen of its vessels. Hypoxia occurs, as a result of which atrophy and degeneration of the renal parenchyma and proliferation of connective tissue develops. Such processes are most often observed in the kidneys with atherosclerosis and hypertension. Also, nephrosclerosis can develop due to the development of inflammatory and dystrophic processes in the kidneys in diseases such as glomerulo- and pyelonephritis, diabetes mellitus, tuberculosis, syphilis, kidney stones, systemic lupus erythematosus, renal amyloidosis.

Sometimes nephrosclerosis can be associated with age-related changes in the renal vascular system.

Symptoms

In the initial stages of nephrosclerosis, symptoms are often absent. The first signs of kidney damage can be observed in urine tests, which will be characterized by poly - and nocturia, the presence of protein in the urine, microhematuria, decreased renal clearance, hypostenuria. Patients complain of increased blood pressure (diastolic blood pressure exceeds 120 mm Hg).

The main symptoms of renal nephrosclerosis include:

visual impairment ;
blood in the urine;
weight loss;
uremia (accumulation of urea and other nitrogenous compounds in the blood);
attacks of angina pectoris.

Diagnostic methods

First you need to correctly collect anamnesis and analyze the clinical picture. When diagnosing, laboratory methods are also used, including:

biochemical blood test, which reveals an increased level of urea, creatinine and uric acid, a decrease in total protein, in the final stages an increase in potassium, magnesium, phosphorus and sodium;
general urine analysis, which reveals an increased amount of protein, a decrease in the relative density of urine, as well as the presence of red blood cells and cylinders that are absent in the norm;
a complete blood count, which shows a decrease in the level of hemoglobin and platelets.

Among the instrumental research methods, effective are:

ultrasound, which reveals a decrease in the size and function (atrophy) of the cortical layer of the kidneys, as well as the presence of calcifications in the renal parenchyma;
excretory urography of the kidneys, which allows you to identify a decrease in the volume of the kidney and its cortical layer;
angiography of the renal vessels, which determines the narrowing and deformation of the small renal arteries, the unevenness of the kidney contour, thinning of the renal cortex;
kidney scintigraphy, which reveals the uneven distribution of the radioisotope in nephrosclerosis;
Doppler of renal vessels, which detects a slowdown in blood flow in the renal vessels and nephrons;
radionuclide renography, which detects delayed accumulation and excretion by the kidneys of a radiopharmaceutical;
computed tomography of the kidneys;
kidney biopsy.

Treatment methods

First you need to determine the cause and begin treatment of the causative disease. Early therapy includes drugs such as anticoagulants (heparin, warfarin), antiplatelet agents (pentoxifylline, trental, dipyridamole), which improve renal blood supply. Drugs are also used to lower blood pressure, but in the later stages of nephrosclerosis, they should be used with caution. These include ACE inhibitors (captopril, enalapril), calcium antagonists (verapamil, nifedepine), β-adrenergic receptor blockers (atenolol, propranolol), diuretics (furosemide, hypothiazide). Potassium preparations (asparkam, panangin) are also prescribed in order to eliminate salt imbalance. No less important are multivitamin preparations, iron preparations, sorbents.

With the development of III-IV stages of chronic renal failure, when it is impossible to restore kidney function with drug treatment, hemodialysis or kidney transplantation are used. During hemodialysis, the blood of a patient with nephrosclerosis is passed through a special membrane in an artificial kidney apparatus, which ensures the cleansing of the body of toxins and metabolic end products, and normalizes the water-salt balance.

The frequency of hemodialysis procedures depends on the patient's condition and the degree of functional activity of the kidneys. At the time of hemodialysis, the patient is prescribed antihypertensive drugs, vitamins, potassium preparations and other medicines.

Carrying out a hemodialysis procedure for nephrosclerosis

A kidney transplant is a radical method that allows the patient to live their normal life. A donor organ can be taken from a corpse, or from a living donor (for example, from relatives with their consent). After kidney transplant surgery, patients are prescribed special drugs that suppress the activity of the immune system to prevent the rejection of the donor organ.

Doctor's note: it must be remembered that a kidney transplant operation is extremely dangerous, as it can carry many complications, such as bleeding, rejection of the transplanted kidney, and urological complications. Therefore, it is worth resorting to this method of treatment only as a last resort.

If the patient has glomerulonephritis, chronic renal failure, they also resort to hirudotherapy (treatment with medicinal leeches). In this case, leeches are placed in the lumbar zone, the sacrum zone, the lower abdominal and hepatic zones. The advantage is given to the lumbar region. In one session of hirudotherapy, from 2 to 8 leeches are used, depending on the severity of the patient's condition. The course of treatment includes from 7 to 12 procedures, with the first 5 procedures being carried out at intervals of a day, and the next 2 times a week.

In the treatment of kidney nephrosclerosis, traditional medicine is also used, preparing infusions from various medicinal herbs, for example:

it is recommended to drink birch sap, which cleanses the kidneys; alcohol infusion from aspen buds, take 30 drops before meals, diluted in a tablespoon of water;
lingonberry infusion, for the preparation of which they take 1 tablespoon of lingonberry fruits, 200 ml of boiled water, take 1 spoonful 4 times a day;
infusion of strawberry leaves (10 g), birch (20 g), nettle (20 g) and flax seed (50 g). Take before meals, 100 ml 4 times a day;
infusion of licorice, which is prepared from 2 tsp. licorice and one and a half glasses of hot water. The infusion should be drunk during the day in several doses.

Features of nutrition for nephrosclerosis

To achieve the maximum effects of treatment, you must eat properly and rationally. When composing your diet, you must adhere to some rules, namely:

limit protein as it is a substrate for urea production. Among protein foods, you need to give priority to poultry, rabbit, low-fat beef, fish, dairy and sour-milk products, egg white. You should exclude bread, cereals, potatoes from your diet;
for patients with nephrosclerosis, the diet must necessarily include dairy and fish products, but they should not be abused, since they contain a lot of phosphorus;
limit salt as it increases swelling. In the early stages, up to 10-15 g of salt per day is allowed, in the later stages up to 3-7 g. But you should not completely abandon salt, as this can lead to dehydration of patients; include in your diet foods rich in calcium and potassium, calcium is found in peas, beans, green vegetables, whole grain flour. Foods such as raisins, dried apricots, bananas, chocolate are rich in potassium. But in the later stages of nephrosclerosis, foods containing potassium should be limited;
nutrition should provide enough calories and vitamins;
you need to eat 4-5 times a day in small portions.

Doctor's opinion: in the initial stages of nephrosclerosis, when blood pressure is not high and there is no edema yet, water can be left unrestricted. But in the later stages, the volume of fluid should be no more than 800-900 ml per day.

An approximate menu for a patient with nephrosclerosis is as follows:

First breakfast: low-fat boiled fish, grain bread, butter, weak tea with lemon.

Second breakfast: buckwheat porridge with milk, compote.

Lunch: vegetable soup, boiled lean meat (chicken, rabbit, turkey), baked potatoes, fruit juice.

Dinner: rice porridge with dried apricots, dried fruit compote. An hour before bedtime: crackers, jelly.

Forecast

Nephrosclerosis is a chronic disease that lasts for a long time with alternating periods of exacerbations and remissions. Therefore, with good compensation for the underlying disease, subject to the diet and doctor's prescriptions, the patient will be able to reduce the number of periods of exacerbations and lead an active life. But a malignant course of nephrosclerosis is also possible, in which kidney function quickly deteriorates, nephrons die and chronic renal failure sets in, which can be compensated for in the future only with the help of hemodialysis or kidney transplantation.

Prophylaxis

There is no specific prophylaxis for renal nephrosclerosis. The main methods of preventing the progression of the disease are diet, avoidance of physical and mental stress, adequate rest, constant monitoring of blood pressure, and an active lifestyle.

The kidneys are vital organs, without them our body would not be able to function. Therefore, it must be remembered that when taking care of them, the frequency of exacerbations of the underlying disease, which caused the nephrosclerosis, decreases.

Nephrosclerosis of the kidneys is a pathology accompanied by the death of nephrons and replacement of the parenchyma with connective tissue. In connection with such pathological changes, the kidneys are not able to function successfully, purifying the blood from toxins and decay products.

Also, due to such pathological processes, the renal organ is significantly reduced, wrinkled, and subsequently provokes the onset of renal failure.

Nephrosclerosis of the kidney is a disease that is quite "young" by medical standards, since it was discovered at the beginning of the last century.

At the same time, a close connection between two pathological processes was tracked and scientifically proven, one of which is hypertension, and the second is renal vascular sclerosis.

Causes and classification of pathology

Depending on what causes provoked the pathology, nephrosclerosis is classified into primary and secondary.

The primary form of nephrosclerosis of the kidney occurs against the background of a violation of the blood supply to the parenchyma, which is typical for those patients who are characterized by a frequent increase in blood pressure, as well as those who are diagnosed with atherosclerosis.

Renal nephrosclerosis

Also, the primary type of nephrosclerosis develops if the patency of the renal arteries is impaired, as the cause of such disorders is thrombosis, thromboembolism.

Blockage of the renal veins can be triggered by renal infarction and venous congestion. Violation of blood circulation, respectively, the occurrence of nephrosclerosis is often diagnosed in the elderly.

Secondary nephrosclerosis occurs after damage to the renal organs by some other pathological processes. Most often, pathologies such as pyelonephritis, glomerulonephritis, amyloidosis, and diabetes mellitus act as provocateurs of nephrosclerosis.

Negative effects of ionizing radiation can provoke secondary nephrosclerosis.

If, for some reason, the kidneys are injured, the patient, after a short period of time, may show signs of nephrosclerosis.

Doctors classify primary nephrosclerosis of the kidney into three separate forms: involutive, hypertensive, atherosclerotic.

Such a disease is classified into two more varieties, depending on the course of the pathological process.

Ultrasound angiography

If the functions of the renal veins are accompanied by persistent deterioration, but only gradual and at the same time rather slow, doctors indicate a benign form of nephrosclerosis.

In benign nephrosclerosis, the walls of the renal arteries thicken, after which fat begins to accumulate near them, as a result of which the lumen of the renal veins decreases, blood flow is practically blocked.

In this regard, the blood circulation of the kidneys is impaired, as a result of which their functioning is seriously impaired. The malignant form of nephrosclerosis of the kidney develops rapidly, so the patient begins to feel the corresponding symptoms faster and just as quickly needs emergency treatment.

Symptoms

With nephrosclerosis, the symptoms, unfortunately, do not appear immediately, but only at the last stages of the pathological process. In this regard, patients often seek help from a doctor only when the disease has already acquired irreversible processes.

Nephrosclerosis can be detected by laboratory tests. A large amount of protein is found in the urine, signs of hematuria. The density of the urinary fluid is markedly reduced. Also, in the process of diagnosis, polyuria and nocturia are detected.

Urine protein test

The process of polyuria is characterized by an excessive increase in the total volume of excreted urine, in most cases the amount of daily urine exceeds two liters.

Nocturia is characterized by an increase in the number of urinary processes precisely at night, a third of the excreted daily urine falls precisely during this period.

Patients are faced with the appearance of puffiness, which at the very beginning appears only on the face, but subsequently spreads to the whole body. The patient's condition begins to deteriorate, and in connection with renal ischemia, patients begin to additionally seriously worry about arterial hypertension.

Due to the fact that arterial hypertension is accompanied by a malignant nature, it is very difficult to respond to any medical therapy. For this reason, patients are faced with some additional complications that entail health risks.

In particular, coronary insufficiency may occur, due to the fact that the left ventricle of the heart takes on increased loads.

Patients often become hostages of such a dangerous comorbidity as strokes.

Nephrosclerosis can be the culprit for vision problems. Pathology provokes retinal detachment, as well as edema of the papilla of the optic nerve, and subsequently its complete atrophy, which leads to blindness.

Of course, another symptom of nephrosclerosis is pain concentrated in the lumbar region, which is characteristic of many kidney pathologies.

Diagnostics

In order to identify pathological processes, make the correct diagnosis, doctors refer the patient to a diagnostic examination of the kidneys.

When carrying out diagnostic measures, laboratory tests of urine and blood are mandatory.

Blood analysis

Nephrosclerosis is indicated by an increase in protein in the urinary fluid, detection of red blood cells, and a decrease in urine density. When conducting a biochemical blood test, on the contrary, a decrease in the amount of protein in the blood is revealed.

Also, an increase in the amount of urea and creatinine is detected in the blood. If laboratory diagnostics is carried out when the pathology has reached the last stages, an increase in the growth of magnesium is found in the blood, as well as potassium, which is not excreted in the urine during urination.

When conducting a general blood test, a patient may notice a decrease in the level of hemoglobin, along with an increase in the number of leukocytes, which is the main sign of body poisoning.

However, doctors are not limited to the results of laboratory tests only. The patient is also referred for instrumental diagnostics.

Ultrasound examination creates conditions for the doctor to be able to analyze the size of the renal cortex, examine the salt deposits in the parenchyma, and assess the functioning of the renal organs.

The patient can be referred for urography, during which images of the organ are taken, on the basis of which it is possible to identify a change in the size of the kidneys in nephrosclerosis, and also to detect salt deposits.

Angiography

Angiography is another type of kidney diagnosis that focuses on assessing the renal veins and arteries. In the course of its implementation, the fracture of the arterial branches is revealed, which indicates the development of kidney nephrosclerosis.

Doppler of renal vessels is used to assess blood flow. Radiography demonstrates the performance of the renal glomeruli and urinary tubules.

Computed tomography is accompanied by high information content, because thanks to its capabilities, it is possible to obtain a complete picture of pathological changes in the organ. When it is carried out, it is possible to reveal a change in the size of the kidneys, their contour, the structure and state of the vessels.

To clarify the malignant or benign form of nephrosclerosis, the patient is recommended to undergo a kidney biopsy, which involves taking the kidney tissue for analysis.

Medical help

With nephrosclerosis of the kidneys, treatment, first of all, is directed at eliminating the pathology or cause that provoked the onset of the disease.

If the root cause is not eliminated, it is impossible to hope for a cure for nephrosclerosis in the future. It is very important to develop a scheme for conducting therapeutic measures, thanks to which it will be possible to restore the functioning of the kidneys.

Diuretics

The patient is obliged to tune in to a sufficiently long treatment, since a short-term course will not eliminate all the problems that have arisen.

Doctors prescribe medications that work to prevent blood clots. Also shown are drugs, the reception of which favors vasodilation.

Patients are prescribed diuretics to get rid of puffiness. Due to the fact that nephrosclerosis is accompanied by arterial hypertension, doctors prescribe drugs that help lower blood pressure.

However, such drugs are prescribed with great care. The urologist scrupulously calculates the exact dosage, since a sharp drop in blood pressure can, on the contrary, negatively affect the patient's health.

The issues of regulating the water-salt balance in the body are necessarily considered. To maintain immunity, doctors recommend using multivitamin complexes.

In nephrosclerosis, the wrinkled kidney is not able to function properly, as a result of which chronic renal failure occurs at 3-4 stages of pathology.

This dangerous kidney disease is characterized by the fact that waste products cannot be excreted naturally from the body. For this reason, the patient needs artificial blood filtration.

Such patients are prescribed hemodialysis with a frequency that depends on the individual characteristics of the human body.

The only option for avoiding hemodialysis is kidney transplantation.

In order to increase the effectiveness of conservative treatment, the patient is advised to adhere to a special diet, as well as observe the correct daily routine, which should provide sufficient time for rest.

Patients whose kidneys have malfunctioned should not engage in heavy physical labor.

So, nephrosclerosis is a dangerous disease if the patient ignores its treatment in the early stages of the development of pathology. Only with strict observance of all the prescriptions of doctors is it possible to reduce the number of emerging exacerbations, increase the performance of the kidneys, restore their functioning, respectively, to avoid the occurrence of renal failure.

Not a single kidney disease passes without a trace, any pathological process in the kidney leads to damage and death of its structural and functional units - nephrons. The loss of single nephrons does not affect the functions of the organ in any way. With the mass death of the renal structures, they are replaced by connective tissue, while the function of the kidney is lost.

The process of replacing functioning nephrons with connective tissue is nephrosclerosis. This is not an independent disease, but a possible outcome of any pathological processes in the kidney. The outcome of nephrosclerosis is a complete loss of function, a decrease in size and ultimately shrinkage of the kidney. Sometimes doctors even replace the term "nephrosclerosis" with the concept of "shriveled kidney", in fact it is the same thing.

Causes of nephrosclerosis

Atherosclerosis of the renal arteries will sooner or later lead to nephrosclerosis.

There are two forms of this pathology: primary and secondary wrinkled kidney.

Primary nephrosclerosis is caused by vascular damage and impaired blood supply to the renal tissue as a result of hypertension, atherosclerosis of the renal vessels and kidney infarctions, and impaired venous outflow. The structure of the kidneys undergoes sclerotic changes with age; by the age of 70, the number of active renal structural units in the kidneys decreases by 30-40%.
The secondary form of the disease occurs as a result of damage to the renal parenchyma with prolonged glomerulonephritis, chronic pyelonephritis, urolithiasis, autoimmune processes, diabetes mellitus, amyloidosis, syphilis, renal tuberculosis, and severe nephropathy in pregnant women and organ trauma can lead to nephrosclerosis.

In recent decades, hypertension and diabetes mellitus are considered the main causes of this pathology, although glomerulonephritis was in the lead literally 20 years ago.

The main symptoms of nephrosclerosis

The disease can last for tens of years, while the deterioration of kidney function occurs gradually, and the symptoms at first do not bother patients much. A doctor is often consulted with the appearance of edema, impaired urination and signs of arterial hypertension. With such symptoms, changes in the kidneys are often irreversible, and the function of the organ is already significantly reduced.

Violation of urination

This symptom includes polyuria (excessive urination - 2 liters per day or more) and nocturia (an increase in the number and volume of urination at night).

In severe nephrosclerosis, polyuria is replaced by oliguria, when the amount of urine, on the contrary, decreases sharply. Anuria (complete absence of urine may indicate end-stage renal failure).

Also, an impurity of blood appears in the urine, and it turns into the color of meat slops - this symptom is called macrohematuria.

Arterial hypertension

If the blood supply to the kidneys is disturbed, a protective mechanism is turned on, aimed at increasing the pressure in the renal vessels, as a result of which substances that increase the pressure in the entire bloodstream are released into the blood. With nephrosclerosis, arterial hypertension reaches very high values, hypertensive crises are possible with an increase in systolic pressure up to 250-300 mm Hg. Art., while reducing the pressure is very difficult.

Edema

Retention of fluid in the body leads to the appearance of edema. They first appear on the face in the morning hours and pass after a while. Then they gradually go down, fingers on hands swell (patients pay attention that they cannot take off rings in the morning) and shins (do not put on shoes, do not fasten boots). With the progression of the disease, edema spreads throughout the body, anasarca occurs - generalized edema of subcutaneous fat, soft tissues, in the worst case, and internal organs.

Pulmonary edema (cardiac asthma) occurs as a result of an overload of the heart due to the increased amount of fluid in the body. The result is heart failure and stagnation of blood in the pulmonary capillaries. The patient has shortness of breath, cough, sweating, cyanosis (blue skin), increased heart rate and respiratory rate during an attack. Cardiac asthma is a serious complication that can be fatal if left untreated.

Stages of nephrosclerosis

There are 2 periods in the development of this pathology:

In the first phase, there are no manifestations of nephrosclerosis, however, the patient has and may progress one or more diseases leading to the replacement of the normal renal parenchyma with connective tissue. During this period, changes characteristic of kidney damage already appear in the analyzes of urine and blood.
Symptoms characteristic of nephrosclerosis, and, accordingly, renal failure, appear in the second stage of the process, when changes in the structure of the kidneys can be detected using ultrasound and other instrumental research methods.

Also, depending on the course of the pathological process, malignant and benign forms of nephrosclerosis are distinguished.

Fortunately, the overwhelming majority of patients have the second form of the disease, in which the process progresses slowly; with successful treatment of the underlying disease, the progression of nephrosclerosis can be slowed down.

In a malignant course, nephrosclerosis progresses rapidly and over several years can lead to a complete loss of renal function, severe renal failure and condemn the patient to lifelong hemodialysis. Such an unfavorable outcome can be observed in malignant arterial hypertension and eclampsia in pregnant women.

Diagnostics of the nephrosclerosis

With nephrosclerosis, corresponding changes will be found in the general analysis of urine.

Since the symptoms of a shriveled kidney appear at later stages, it is very important to identify this pathology with the help of an examination as early as possible, since the effectiveness of treatment in this case will be much higher. Taking the patient's history plays an important role.

General urine analysis. Any kidney examination, of course, begins with a urinalysis, with initial nephrosclerosis, the following abnormalities can be detected: a decrease in the relative density of urine, the appearance of protein, single red blood cells and cylinders.
Blood tests. In the clinical analysis of blood, a decrease in the level of hemoglobin and platelets is possible. In biochemical - a decrease in the amount of total protein, an increase in the level of urea, creatinine, uric acid and sodium. An increase in glucose and cholesterol levels should be alarming.

Such changes in urine and blood tests are very nonspecific and can be observed not only with kidney disease. However, the combination of such deviations in the results of laboratory tests, with a history of factors that can lead to kidney damage, makes the doctor think about further diagnosis.

For examination, many instrumental methods are used, such as ultrasound, excretory urography (X-ray of the kidneys with a contrast agent), angiography, computed tomography, radioisotope studies, etc. All of them reveal a decrease in kidney size, the presence of calcium deposits, impaired blood flow in the renal vessels and others changes indicating the proliferation of connective tissue. A biopsy can give an exact answer about the condition of the renal parenchyma.

Nephrosclerosis treatment

There is no specific therapy aimed at treating nephrosclerosis. Treatment of the disease is necessary, which led to damage to the kidneys and death of nephrons, followed by their replacement with connective tissue. That is why not only a nephrologist, but also a specialized specialist is engaged in the treatment of patients with nephrosclerosis.

In addition to therapy aimed at treating the underlying disease, patients need to follow a diet. It is recommended to limit the amount of protein, table salt, the diet should have enough vitamins and mineral salts. In the absence of arterial hypertension and edema, fluid and protein restriction is not required.

In end-stage renal failure, when both kidneys have lost their functions, hemodialysis is indicated for patients. The only way out in this situation is kidney transplantation, in recent years this operation has been successfully carried out in Russia, and for the citizens of our country it is free.

Which doctor to contact

A nephrologist deals with the treatment of kidney diseases and their complications, in particular, nephrosclerosis and renal failure. If necessary, consultations of other specialists are prescribed: a cardiologist (with high blood pressure), an endocrinologist (with diabetes), a vascular surgeon (with renal artery atherosclerosis), a urologist (with urolithiasis), an infectious disease specialist (with suspected renal tuberculosis). You can get a referral for a kidney examination by contacting a therapist with appropriate complaints.

Nephrosclerosis is a disease caused by the replacement of the renal parenchyma with connective tissue, which contributes to the hardening and wrinkling of the organ. As a result of this pathological process, kidney function is impaired. In medicine, there is another name for such a pathology - a shriveled kidney.

Kidney nephrosclerosis is of 2 types, depending on the mechanism of development:

primary, arising from a violation of the blood supply to the tissue of the organ, due to hypertension, atherosclerosis and other vascular diseases;
secondary, which accompanies some renal diseases, for example, nephritis, congenital malformations.

This pathological condition occurs not only in humans, but also in animals. For example, nephrosclerosis in cats can occur without obvious clinical signs: the temperature is normal, but weakness, lethargy, increased thirst, and weight loss are observed. To identify the disease as early as possible, you need to conduct a urinalysis and ultrasound.

Disease types

There is a classification of pathologists, which is based on both the cause of its development and its main manifestations.

1. Hypertensive nephrosclerosis(arteriolosclerotic), which has a primary developmental mechanism, arises from the regular high pressure in the vessels and narrowing of their lumen. As a result of insufficient blood circulation in the organ, cellular hypoxia grows and the atrophied parenchyma of the kidneys is replaced by connective tissue.

The hypertensive type of the disease can occur in two forms, depending on the symptoms - benign and malignant.

Arteriolosclerotic nephrosclerosis of a benign form is often combined with atherosclerosis of the renal artery. Although this form can be compensated, over time, dystrophy of most nephrons leads to renal failure. The malignant form is characterized by fibrinoid necrosis of arterioles and glomerular capillaries, hemorrhages, and protein atrophy of the epithelial tissue of the tubules. This form leads to renal failure faster than the benign form and is more often fatal if hemodialysis is not carried out on time.

2. Atherosclerotic nephrosclerosis caused by stricture of the artery of the kidney atherosclerotic plaque. Usually the pathology is one-sided. The connective tissue replaces the wedge-shaped atrophied areas, as a result of which the organ becomes coarse, but this does not greatly affect its functionality due to the small volume of the lesion. With this stenosis, renal vascular hypertension usually develops.

3. Diabetic nephrosclerosis(DN) is characterized by microangiopathies that completely affect the organ. At the first stage, this complication is difficult to diagnose due to the lack of obvious symptoms. With late diagnosis, the disease leads to irreversible results.

Diabetic nephrosclerosis has several stages:

the first stage is diagnosed only by the method of determining the rate of filtration by the glomeruli of various substances (for example, creatinine or insulin) or by the method of detecting microalbuminuria (low albumin level).
The 2nd stage is prenephrotic, which, in addition to the above diagnostic signs, also has microhematuria (a small number of red blood cells in the urine), and blood pressure also rises slightly.
3rd stage - nephrotic, which has visual symptoms - edema and sharply increased blood pressure. In the general study of urine, proteinuria and cyllinduria can be detected.
The 4th stage of deabetic nephrosclerosis appears several years after the onset of proteinuria. Chronic renal failure is connected to it. Clinical signs are severe swelling, regular hypertensive crises, muscle weakness, nausea, sometimes vomiting, itching on the skin.

Common signs and symptoms of nephrosclerosis

Symptoms of nephrosclerosis at the initial stage of the disease are poorly expressed. Changes can be detected only with the help of laboratory diagnostics (for example, in the analysis of urine, polyuria, nocturia, protein and erythrocytes in the urine, reduced density are determined). Gradually, clinical symptoms appear - swelling in the face, and then throughout the body.

As a result of the resulting decompensated arterial hypertension, the following complications arise:

strokes;
overloaded work of the left ventricle of the heart;
optic atrophy or complete blindness, retinal detachment is also possible.

General principles of therapy

Treatment of nephrosclerosis includes antihypertensive and diuretic drugs (for example, hypothiazide, 30-50 mg per day) if the disease is benign. A special diet with a limited amount of protein foods and salt is also prescribed. It is regularly monitored how the renal structures cope with their functions.

Treatment of renal nephrosclerosis is necessarily carried out in stationary conditions if the pathology is malignant. In this case, it is necessary to use antihypertensive drugs with caution, so as not to further aggravate the patient's condition. Usually, arterial embolization is performed or the affected part of the organ is removed. After that, the patient needs hemodialysis or kidney transplant. In the malignant form of the disease, the life expectancy of patients is about a year.

Materials from the section Vitamins, minerals, amino acids

What to do if Apple TV won't turn on or how to flash the set-top box in DFU mode

What to do if Apple TV won't turn on or how to flash the set-top box in DFU mode

Instagram login to my page without registration from a computer or phone for free

Instagram login to my page without registration from a computer or phone for free