home Audience 12 Kidney disease syndromes. Chronic kidney pathologies - clinical picture. Kidney diseases in women - types

Kidney disease syndromes. Chronic kidney pathologies - clinical picture. Kidney diseases in women - types

Kidney diseases are manifested by a number of symptoms; it is not always possible to predict their sequence. The kidneys provide the process of excretion harmful substances from the body, thereby causing normal functioning all organs and systems.

Common Causes of Kidney Disease

The following factors can lead to kidney tissue damage:

benign neoplasms or;
abnormalities of intrauterine development;
infections of bacterial and viral origin;
autoimmune lesions;
bad habits;
metabolic disorders;

According to statistics, kidney disease is diagnosed in 3.5% of the population and more often in women, which is associated with the characteristic structure of female genitourinary organs. Quite often doctors diagnose:

kidney cysts and other neoplasms;
hydronephrosis;

Signs of kidney problems

Kidney problems may include the following symptoms:

Which doctor should I see if I have kidney disease?

Symptoms of pathological kidney damage can vary in intensity and can be present in a variety of combinations. To find out the level of health of the urinary system, you need to undergo a full examination by a nephrologist or urologist. As part of this examination, the following is carried out:

After the examination results are received, the doctor will prescribe a competent and effective treatment– you need to undergo a full course of therapy to stabilize kidney function.

June 28, 2017 Doctor

Pyelonephritis, urolithiasis, glomerulonephritis - all these are kidney diseases, with different patterns of occurrence. But, if neglected or untreated, pathologies of the urinary system lead to chronic renal failure. At chronic renal failure treatment comes down to permanent dialysis or kidney transplantation.

Etiology of diseases

The main factor in the occurrence of painful reactions from the kidneys is hypothermia of the body. The direct function of purifying the blood is disrupted, which leads to intoxication and further development of kidney diseases, which can progress to the chronic stage. There are other reasons:

metabolic disorders associated with an unbalanced diet and an abundance of unhealthy foods;
excess alcohol contributes to destruction healthy cells and leads to dehydration;
sharp jumps in body weight have an adverse effect on the kidneys, since these organs are located in a specific fat layer that retains heat. Weight loss affects the filtration capacity of the kidneys.

The cause of the disease can also be congenital pathologies of the urinary system.

General symptoms of diseases

All kidney diseases are caused by a characteristic pain syndrome in lumbar region, which radiates down the abdomen. In case of urolithiasis, pain manifests itself as renal colic, in other cases – sensations of discomfort.

Kidney diseases are easily recognized by the following symptoms:

Hematuria is the presence of blood in the urine. This condition can be caused by urolithiasis, pyelonephritis, tumors or kidney injuries. In this case, you may observe:

microhematuria - blood is not visually detected, only with the help of multiple increases in urine is it possible to see inclusions;
macrohematuria – blood clots visible without special devices.

A urine test with hematuria may indicate an affected area of the urinary system. Thus, a worm-shaped clot indicates damage to the urinary tract or ureter, and shapeless inclusions in the urine indicate damage to the bladder.

Hypertension is an increase in blood pressure due to renal pathologies, not accompanied by headaches and dizziness. Taking drugs to reduce indicators, in most cases, does not produce results. This indicates dysfunction of the renal arteries. An angiogram is ordered to identify vascular abnormalities.
Decreased (oliguria) amount daily norm urine due to:

acute renal failure as a consequence of glomerulonephritis;
adenomas;
urolithiasis;
kidney infection.

An increase (polyuria) in urine outflow is characterized by damage to the tubules or tissues:

pyelonephritis;
hypokalemia.

These symptoms may indicate such serious illnesses, such as diabetes mellitus or chronic renal failure. When making a diagnosis, the level of creatinine and urea in the blood, as well as glucose levels, should be taken into account.

Dysuria or pain when urinating occurs when the urinary system becomes infected with harmful bacteria.
The main symptom of kidney disease is pain stupid character in the lumbar region, regardless of the patient’s body position or mobility. So-called “renal colic” can be noticed with any pathology of the urinary system. The pain will differ only in intensity and time frame.
External manifestations:

edema reactions occur in morning time after sleep, swelling is most often observed on lower eyelids or in the form of puffiness of the face. At severe forms lesions: swelling of the legs, less often the arms;
the skin changes shade to an unhealthy color, depending on developing pathology. Glomerulonephritis is characterized by dry skin, and a yellow tint indicates renal failure.

Laboratory signs

Signs of kidney disease can appear not only physically, but also in laboratory tests of urine and blood. Chemical research urine indicates disturbances in the urinary system as follows:

excess protein concentration – proteinuria.

Extrarenal - occurs when infectious diseases(cystitis, pyelitis, urethritis) and renal - originates in the parenchyma (pyelonephritis, glomerulonephritis, amyloidosis, kidney tuberculosis);

increased levels of glucose, bilirubin and ketone bodies should normally be absent;
excess urobilinogen indicates damage to the kidney parenchyma;
the presence of squamous epithelium in men indicates the presence of urethritis or prostatitis; in women, the indicator is metaplasia of the urinary tract. Epithelial cells are found in excess during intoxication and acute infectious processes;
leukocytes and erythrocytes should be absent in the urine sediment. If they are detected, a diagnosis of suspected unstable kidney function is made;

Major kidney diseases

Pyelonephritis

One of the most common diseases can be called pyelonephritis - inflammation that occurs in the renal pelvis due to the ingress of bacteria. There are two ways of infection: through blood or due to stagnation of urine. The main symptom is pain in the lumbar area, difficulty urinating, and general weakness.

Acute course of pyelonephritis in the absence adequate treatment may progress to a chronic stage, which is characterized by asymptomatic development and severe consequences, including renal failure.

Glomerulonephritis

Damage to the renal glomeruli and the inability of the kidney to function normally mainly characterizes glomerulonephritis. There is a primary disease, which arose directly in the internal organ, and a secondary one, which developed through another disease.

When an infection occurs, the body produces antibodies to fight, due to certain actions, immune reaction becomes completely opposite. Antibodies together with pathogens provoke kidney damage.

Symptoms of the disease are accompanied by acute pain, high blood pressure, edematous reactions, nausea, and hematuria. The disease is extremely serious, so it is necessary to strictly follow all the doctor’s recommendations on nutrition and therapy.

Urolithiasis disease

Stones crystallize in the urinary system as a result of correct exchange substances, that is, it is violated water-salt balance body. The passage of stones is associated with the occurrence renal colic and hematuria. With the natural outflow of urine, stones move and can clog the ureter or scratch the walls of blood vessels, thereby causing infection.

Therefore, it is important to carry out on time diagnostic procedures to determine further treatment for urolithiasis, since chemical composition stone (urate, phosphate, oxalate) further therapy depends.

Ignoring symptoms and lack of proper treatment can lead to final kidney dysfunction - chronic renal failure, when the internal organs of the urinary system do not fully perform their function of excreting urine and filtering blood.

Thus, ischemic kidney disease occurs, in which internal organ is at the terminal stage of the disease and is not able to fully function. Most often, people over 60 years of age with primary disease atherosclerosis.

Kidney ailments during pregnancy

Pregnancy means work female body for two. Kidneys are susceptible physiological changes: the pelvis dilates, the ureters and bladder are subject to pressure from the enlarging uterus, thereby limiting the excretion of urine. The absence of normal urine outflow contributes to stagnation of urine and the proliferation of infections. Therefore, during pregnancy, regular urine and blood tests are required to prevent the development of kidney pathologies.

The main kidney diseases in pregnant women are:

Pyelonephritis is an infectious lesion of the pyelocaliceal zone of the kidneys, which can be caused by Escherichia coli, yeast-like fungi and various coccal bacteria. Lack of treatment may lead to severe consequences By premature birth, to infection of the fetus and the development of hydronephrosis.
Cystitis is an inflammatory reaction of the bladder, which is accompanied by severe symptoms: constant urge and pain when urinating, pulling, sharp pain V groin area. Timely treatment will not allow the infection to pass further urinary system to the kidneys, which can lead to pyelonephritis.

The urinary system during pregnancy is most susceptible to the development of pathologies, after the cardiovascular system. Therefore, it is unacceptable to overcool, and at the first signs of an infectious disease, a doctor’s consultation is necessary.

exclude sedentary lifestyle life, to prevent stagnation of urine;
adherence to a therapeutic diet, the main feature of which is a decrease in the amount of protein foods, an increase in the amount of fiber, and drinking plenty of fluids;
decoctions and teas from medicinal plants can cleanse the body of toxins.

If you have kidney disease, you should try to avoid hypothermia, and if you have a cold, do not carry it on your feet, so as not to cause complications. You should not self-medicate if renal colic occurs; only a doctor can determine the real reason illness and prescribe the appropriate course of treatment.

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Kidneys are one of the main filters of the body. Blood plasma is filtered through them, turning first into primary and then into secondary urine, which carries away excess nitrogenous waste and mineral salts. Normally, the internal environment of the kidneys is sterile.

However, microflora often appears in the kidneys, causing inflammation. This is facilitated by developmental anomalies (expansion of the pyelocaliceal apparatus). Among the reasons renal pathologies autoimmune processes, tumors, structural abnormalities.

The structural unit of the kidney is the nephron, which is represented by a vascular glomerulus surrounded by a capsule and a system of tubules. The glomerulus filters the blood, and partial reverse suction sodium, potassium and chlorine ions.

Clinical classification of kidney diseases

Glomerulopathies are the predominant lesions of the glomeruli.

Acquired: inflammatory (glomerulonephritis) and dystrophic (diabetic or hepatic glomerulosclerosis, amyloidosis).
Hereditary: hereditary amyloidosis, Alport syndrome (nephritis with blindness), lipoid nephrosis.

Tubulopathies are pathologies with predominant involvement of the tubules.

Acquired obstructive: myeloma and gouty kidney.
Acquired necrotic: necrotizing nephrosis.
Hereditary ones develop against the background of deficiencies in various enzymatic systems: phosphate diabetes, Albright's syndrome, tubulopathy with nephrolithiasis.

Kidney stromal diseases– acquired inflammations such as pyelonephritis or tubulo interstitial nephritis.

Kidney abnormalities:

polycystic disease,
kidney underdevelopment,
kidney prolapse.

Kidney tumors:

renal cell carcinoma
kidney adenoma
transitional cell carcinoma
pelvic cancer
nephroblastoma (in children).
metastases to the kidneys of pancreatic tumors, blood cancer.

Metabolic pathologies: urolithiasis disease.

Vascular accidents: renal artery thrombosis, renal infarction.

Symptoms of kidney disease

Pain

At kidney diseases located in the lumbar region or side. For different pathologies, the intensity of pain will be different.

So the most intolerable sharp pains gives an attack of urolithiasis when the urinary tract is blocked by a stone. In this case, the pain will be not only in the projection of the kidney, but also along the ureter on the anterior abdominal wall. There will also be a reflection of pain in the groin and genitals. Painful sensations increase with movement and decrease at rest.
Torsion of the renal pedicle with a wandering kidney also gives intense pain. When the kidney prolapses (nephroptosis), lower back pain occurs during physical activity or when lifting heavy objects.
Inflammatory diseases, accompanied by swelling of the kidney tissue, give long-term aching, dull pain in the lower back, which is sometimes perceived as heaviness in the side. When tapping on the kidney area, the pain intensifies.
Late stages of primary kidney tumors or metastatic lesions cause pain of varying intensity.

Urinary disorders (dysuria)

These are often the first symptoms of kidney disease, characteristic of most kidney pathologies. This may be increased frequency of urination (with pyelonephritis), their pain (pyelonephritis, urolithiasis), frequent false urges(pyelonephritis), frequent night urination (glomerulonephritis, pyelonephritis).

Changes in the daily rhythm of urination (frequent nighttime and rare daytime urination), called nocturia (with glomerulonephritis), are also observed.
Polyuria - when more urine is excreted than normal (2-3 liters), for example, when emerging from acute renal failure, into the polyuric stage of chronic renal failure.
Oligouria is a decrease in the volume of urine in one portion or per day (with interstitial nephritis, glomerulonephritis).
Anuria is acute urinary retention (with acute or chronic renal failure, blockage of the urinary tract with a stone, interstitial nephritis).

Changes in urine indicate problems in the kidneys

Cloudiness of urine visible to the eye is characteristic of inflammatory diseases kidneys (pyelonephritis, glomerulonephritis) due to the appearance of protein in the urine. Similar phenomena will be observed during the disintegration of renal tumors or the rupture of an abscess or carbuncle of the kidney. Such symptoms of kidney disease in women can be masked by gynecological problems.

Urine the color of meat slop is characteristic of bleeding against the background of urolithiasis, in some forms of glomerulonephritis. Similar symptoms in men can be caused by urological pathologies, so differential diagnosis is required.
Dark urine is a consequence of an increase in its concentration. It can become like this during inflammation.
Urine that is too light may be due to a decrease in the ability of the kidneys to concentrate it. This occurs in chronic pyelonephritis, although this can also happen normally with a significant drinking load.

A rise in temperature accompanies infectious processes

Pyelonephritis will give a temperature of up to 38-39, and with apostematous nephritis (abscess or carbuncle of the kidney), the temperature can rise even higher.

Blood pressure surges

They are characteristic of glomerulonephritis, when damage to the glomerular vessels leads to spasm of the arteries. Also when congenital anomalies renal vessels may experience increased blood pressure. The third case when it is observed arterial hypertension– torsion of the vascular pedicle of the vagal kidney.

Nausea and vomiting

Reflex nausea and vomiting accompany pyelonephritis, surges in blood pressure, and chronic renal failure, in which poisoning with nitrogenous waste occurs.

Edema

This is a common manifestation of kidney diseases (see). They are divided into nephritic and nephrotic.

Nephritic - the result of a rise in blood pressure, against the background of which the liquid part of the blood enters the intercellular space. They are located on the face, in the eyelid area and most often occur in the afternoon. Quite soft and easily removed with diuretics (see). They are typical for intersticial nephritis (for example, against the background of intolerance to non-steroidal anti-inflammatory drugs) or the early stages of glomerulonephritis.
Nephrotic edema is a consequence of an imbalance of protein fractions. They develop due to the difference in oncotic pressure after a night's sleep. Such swelling is located on the face. Later - on the legs and arms, lower back. IN advanced cases The lower back may swell. Front abdominal wall or develop continuous edema (anasarca) with accumulation of fluid in the peritoneal cavity, pericardial sac, pleural cavity. These swellings are denser, take longer to develop and are more difficult to remove. They can be observed in glomerulonephritis and chronic renal failure.

Skin changes

They are presented by pallor against the background of anemia (due to impaired production of erythropoietin by the kidneys) with glomerulonephritis. , dryness and “powderiness” develop against the background of chronic renal failure due to the accumulation of nitrogenous bases in the blood.

Renal syndromes

Numerous manifestations of kidney diseases are often combined into several syndromes, that is, complexes that are characteristic of different pathologies.

Nephritic syndrome

It is characteristic of infectious nephritis (usually post-streptococcal glomerulonephritis), mesangioproliferative glomerulonephritis, Berger's disease. Secondarily, this symptom complex develops against the background of systemic lupus erythematosus (lupus nephritis). This syndrome can also be a consequence of radiation exposure or a reaction to vaccines.

There is always blood in the urine (macrohematuria - when blood is visible to the eye - in about a third of all cases, or microhematuria, which is determined only by urine analysis), see.
Edema is characteristic of eighty percent of patients. This is a nephritic type of edema. In the afternoon, the eyelids swell, and by night, swelling appears on the legs (see).
Approximately 80% of patients have elevated blood pressure, which in advanced cases can be complicated by rhythm disturbances and pulmonary edema.
Half of the patients experience a decrease in daily urine volume and thirst.
More rare manifestations of the syndrome include: nausea, vomiting, appetite disorders, weakness, headaches, pain in the lower back or abdomen. Very rarely there is an increase in temperature.

Nephrotic syndrome

Characteristic of diseases with damage to the renal tubules (see tubulopathies).

Edema is characteristic of 100% of cases of nephrotic syndrome. They are dense and are described in the section nephrotic edema.
Protein excretion in urine exceeds 3.5 grams per day.
A biochemical blood test determines a decrease in total protein due to albumin, an increase in lipids (cholesterol above 6.5 mmol per liter).
There may be a decrease in urine production (oliguria) of up to 1 liter per day.
Patients often have dry skin, dull hair, and pallor.
A number of situations are manifested by nausea, vomiting, and abdominal pain.

Acute renal failure syndrome

This acute disorder everyone renal functions, as a result of which water, electrolyte and nitrogen metabolism are disrupted. This condition develops against the background of interstitial nephritis, acute necrosis of the renal tubules, and thrombosis of the renal arteries. In some cases the process is reversible.

Let's consider the clinic of acute interstitial nephritis. This pathology is a consequence of non-infectious inflammation of the tubules and interstitial tissue of the kidneys. The main reasons are:

taking non-steroidal anti-inflammatory drugs (for example, aspirin)
poisoning with substitute alcohol
taking antibiotics (penicillins, gentamicin, kanamycin, cephalosporins), sulfonamides
immunosuppressants (azathioprine), allopurinol, warfarin.
This disease can also develop against the background of acute infection with streptococcus, as a manifestation of systemic diseases (lupus, Sjögren's syndrome, transplant rejection)
In cases of poisoning with vinegar, heavy metals, and aniline, interstitial nephritis also develops.

Manifestations of the disease occur 2-3 days after taking medications or infection. There is a decrease in the amount of urine, and then an acute cessation of its production and excretion. In this case, swelling is not typical. Patients have headaches and nausea. Weakness, dull pain in the lower back. Less often – rises in temperature, itchy skin and blotchy skin rashes.

With the reverse development of the condition, excessive urination occurs (polyuria) and renal function is restored. In case of an unfavorable outcome, the kidneys become sclerotic and their function is not restored, turning into chronic renal failure.

Chronic renal failure (CRF)

This is the outcome of a long course of renal pathologies, in which the place of nephrons is gradually taken by connective tissue. As a result, the kidneys lose their functions and, as a result of severe chronic renal failure, the patient may die from poisoning by products of protein metabolism. This is how most chronic glomerulonephritis, renal amyloidosis, kidney tumors and nephronecrosis end against the background of thrombosis or ischemia of the renal tissue. Large ones, polycystic, also lead to kidney shutdown. Diabetes mellitus or atherosclerosis of the renal arteries also lead to a similar syndrome.

Chronic renal failure is characterized by a gradual increase in the number and severity of manifestations. The more glomeruli have died, and the lower the glomerular filtration rate, the more severe the symptoms.

Skin when initial stages pale due to anemia against the background of low production of erythropoietin by the kidneys. As urinary pigments are retained in the tissues, the skin acquires a yellowish tint and the urine becomes lighter. Then comes skin itching, dry skin and “uremic frost” or “powder” of urea crystals. Secondary pustular skin infections due to scratching and loss of local immunity are common.
Phosphorus-calcium metabolism is also disrupted against the background of increased synthesis of hormones from the parthyroid glands, which break down more easily. Secondary gout may also develop due to deposition in the joints and soft tissues uric acid crystals.
The nervous system is usually depressed. Patients are prone to depression, and some experience outbursts of anger or aggression. Peripheral nervous system when affected, it produces polyneuropathy (a sensation of goosebumps on the skin, sensory and motor activity limbs). Muscle twitching or muscle pain may occur.
Persistent arterial hypertension appears, difficult to respond to drug treatment. In some cases, patients suffer cerebral hemorrhages or heart attacks.
Patients also experience heart rhythm disturbances, shortness of breath, and inflammation of the heart muscle. On late stages characterized by damage to the pericardial sac (pericarditis) with a peculiar (“funeral” pericardial friction noise).
Irritation of the mucous membranes of the upper respiratory tract Patients with urea may suffer from inflammation of the larynx, trachea, and bronchi. There are cases of pulmonary edema.
Appetite decreases, ammonia-like breath appears. Nausea and vomiting and weight loss may develop. Ulcerations of the oral mucosa, esophagus and stomach are common.

For severe stages of chronic renal failure patients not receiving hemodialysis or without a kidney transplant die.

Kidney diseases in children

Symptoms of kidney disease in children are identical to those in adults, but may be more subtle, especially in early childhood (up to three years). In addition, children are characterized by some types of tumors that are not found in adults due to high mortality rate V childhood(nephroblastoma). In children, inflammatory renal pathologies occur more easily due to the lower tone of the urinary tract and underdevelopment of their walls, as well as the relatively wider calyces and renal pelvis.

Manifestations of certain kidney diseases

Acute pyelonephritis

Characterized by a rise in temperature against the background of acute infectious process(damage to staphylococcus, E. coli). Typical dull aching or pressing pain in the lower back, weakness, lethargy, nausea, and sometimes vomiting. Pain appears at the end of urination or after it. Characterized by darkening of the urine and its turbidity. Episodes of nighttime urges are noted. Protein appears in a urine test; there may be red blood cells (see). Blood tests are characterized by accelerated ESR, leukocytosis, and a shift of the formula to the left.

Chronic pyelonephritis

Has a long-term course with episodes of exacerbations according to the type acute nephritis and remissions, when changes can only appear in urine tests and excretory urography. Known hypertensive and anemic variants chronic pyelonephritis(cm. ).

Kidney tuberculosis

It does not have any clear specific manifestations. In the early stages, the patient may feel unwell, with a temperature of up to 37.5. As the disease develops, dull aching pain in the lower back occurs on the affected side, visible to the eye blood in the urine, urinary disorders. If the kidney begins to fall apart, the pain can be severe, resembling. Gross hematuria is typical only for 15-20% of patients, the same number of patients suffer from high blood pressure in the later stages of the disease.

In urine analysis, protein, leukocytes, and red blood cells appear. Bacteriological examination of urine for Mycobacterium tuberculosis becomes decisive in diagnosis. Also take into account radiological signs lung lesions, contact with tuberculosis. Immunospecific blood reactions (PCR) are informative in approximately 90% of patients. Tuberculosis is not visible on ultrasound.

Diffuse chronic glomerulonephritis

This autoimmune pathology, in which immune complexes attack the glomeruli of the kidney.
The hypertensive variant is characterized by a persistent increase in lower (diastolic) pressure.
With the nephrotic variant, edema syndrome is observed in combination with a large loss of protein in the urine and a decrease in blood proteins.
The combined form gives nephrotic syndrome and persistent arterial hypertension.
Berger's disease (hematuria) includes blood in the urine, increased blood pressure, and swelling.
The urinary or latent form manifests itself only in changes in tests (microhematuria and traces of protein in the urine).
With a long course of glomerulonephritis, the clinic of chronic renal failure is added to the main manifestations.

Kidney cancer

It can flow hidden for a long time and is often only a laboratory find (see). When the ESR accelerates in blood tests, and there are red blood cells and protein in the urine. In the later stages, dull pain in the lower back appears, which becomes sharp and pronounced as the kidney tissue disintegrates. Anemia, signs of intoxication (weakness, loss of appetite, weight loss) and low-grade fever (up to 37.9) may appear. Very large tumors may compress the inferior vena cava, causing swelling of the legs or liver.

Basic methods for diagnosing kidney diseases

If kidney disease is suspected, the following list of examinations is usually prescribed:

Clinical blood test.
Blood chemistry ( total protein, protein electrophoresis, lipid spectrum or cholesterol, creatinine, urea, prothrombin index, electrolytes, C-reactive protein, circulating immune complexes)
General urine analysis. If necessary, according to Nechiporenko (more accurate urinary sediment in 1 ml of urine), Zimnitsky test (clarification of the concentration function of the kidneys).
For men, a three-glass urine sample. For women - examination by a gynecologist.
Calculation of glomerular filtration rate based on creatinine clearance (24-hour urine analysis).
Excretory urography with contrast agents(excretory and concentration functions are determined).
(neoplasms, stones, enlargement collecting system, interstitial edema, necrosis, developmental abnormalities, kidney prolapse).
Plain radiography in two positions (for nephroptosis).
Less commonly, kidney scintigraphy or tomography (usually to clarify the location of the tumor).

Thus, the manifestations of renal pathologies are diverse and not always specific. Therefore, at the first doubt about the health of your kidneys, it is advisable to consult a general practitioner or urologist and undergo at least a simple examination. Timely diagnosis and treatment can not only get rid of the disease, but also improve the quality of life in the future and prolong life itself.

According to statistics, various diseases kidney disease affects up to 3.5% of residents Russian Federation, and most of them are women. This fact can only be explained physiological characteristics structure of the female body. However, men are also often diagnosed kidney diseases, which in their case are more difficult to treat.

Symptoms in adults, both men and women, can be very diverse and they are not limited to just tingling or pain in the part of the lower back where the kidneys are anatomically localized. Common signs diseases that should alert you can be called unusual color And bad smell urine, a significant increase in body temperature and blood pressure, as well as general weakness, dry mouth, constant thirst and In addition, as a result of laboratory analysis, blood and protein may be found in the urine. This may indicate disturbances in the functioning of the kidneys and the development of pathological process. External signs urological diseases are swelling of the face, limbs, as well as accumulation of fluid in abdominal cavity.

In addition, signs of kidney disease may be reflected in deviations from the daily norm in the amount of urine excreted. Normal for an adult healthy person- 2 liters of urine per day. But some kidney diseases can provoke an increase in this amount, or, conversely, a decrease. Therefore such side symptom, like thirst, can be caused precisely by excessive excretion of fluid from the body by the kidneys. All of the above first signs of kidney disease should be a reason to consult a urologist. Having made a diagnosis in time, he will prescribe appropriate treatment. You cannot ignore the signs of kidney disease, and even more so, self-medicate.

IN medical practice All urological problems are usually divided into three groups, each of which has its own, features kidney diseases:

Inflammatory processes in the kidneys. These include pyelonephritis, glomerulonephritis, renal failure, urosepsitis, paranephritis;
Renal foreign formations. These are sand and stones;
Difficulty in the flow of urine. It occurs with hydronephrosis, polyuria, acute and anuria.

All signs of kidney disease inflammatory in nature accompany such general symptoms, How periodic increase body temperature more than 38 degrees, pronounced skin color of an unnaturally sallow or jaundiced color, decreased appetite, frequent headaches, fatigue, nausea and vomiting, high pressure. In this case, the patient experiences constant aching pain in the lumbar region. It is difficult for him to walk, move, or turn his body to the sides, as pain is felt with every movement.

The formation of sand or kidney stones is a rather insidious disease and difficult to diagnose. Symptoms of this disease may not appear for years, the patient feels well and has no special complaints about his health. Only much later, during education large quantity sand or large kidney stones, a person begins to feel pain characteristic of the course of inflammatory processes. The pain is very sharply felt upon palpation, that is, palpation of the kidney. The urine of such patients is cloudy and can be very rich, almost brown in color, as there is blood in it.

Symptoms of obstructed urine flow vary depending on the type of disease. With anuria, urine does not enter the bladder at all due to many processes, for example, damage to the renal parenchyma, an inflammatory process, or as a result of an obstruction to the outflow of urine. Frequent, painful urination in small portions is characteristic of dysuria. When there is bursting pain in the lower abdomen with imperative characteristic urges, accompanied by the inability to satisfy the need.

But a person most often finds out suddenly that he has advanced kidney disease. A typical example: Marina, 32 years old, suffered from a severe flu, after which a strange weakness remained in her body. The doctor wrote out a referral for biochemical analysis blood. When Marina came for the results, she was given... a referral for hemodialysis (the procedure is prescribed when the kidneys stop working).

They hit the heart

The kidneys are a dumb organ, explains Lyudmila Rozhinskaya, head. Department of the Federal State Budgetary Institution "Endocrinological Research Center".- The first symptoms appear when the kidneys stop working. You can suspect a problem at an early stage using a blood test - but this can be done by a competent doctor. In our country, nephrologists are a unique profession; patients usually learn about their existence either from the Internet or after they are admitted to the hospital... with a heart attack.

In case of renal failure, excess calcium forms in the blood - it settles on the walls of blood vessels and narrows them. Therefore, in patients with renal failure mortality from cardiovascular disorders at 30-40 years old is the same as in people without kidney pathology at 60-80 years old.

By the way, the rapid development of nephrology in the world began after a large-scale study in the USA found out that chronic disease kidney disease affects 12% of Americans (coronary heart disease affects 10% of the population). But if heart patients are under medical supervision, then only 20% of kidney patients see a doctor, and 90% of them die from a heart attack before reaching a diagnosis.

The best treatment is moving?

Help for kidney patients is an expensive type of medical care; a patient on dialysis costs the state more than a cancer patient. The cost of one procedure is 6,800 rubles; such procedures must be completed 3 times a week in a hospital. For life. If, of course, you manage to get there.

- The provision of dialysis for Russians is 212 people per 1 million population (tens of times lower than in developed countries), - explains Natalya Tomilina, head of the department of nephrology - Moscow State Medical University named after. Evdokimov.

Treatment of kidney patients is paid for from the local budget. Only rich regions can do this; residents from other places cannot get treatment.

The same thing applies to transplantation. There are several advanced transplant centers in Russia - in Moscow, Krasnodar, St. Petersburg. But they only treat “their” patients. It is easier for a person living in Vologda to get a kidney transplant in Pakistan than in St. Petersburg. Therefore, the most accessible type of treatment for a person with kidney disease is moving to a region that is prosperous in this regard.

It is possible to reduce the cost of treating kidney patients if the disease is detected at an early stage. Nephrologists “punch through” screening of patients at risk - patients with hypertension, atherosclerosis, obesity and diabetes mellitus. They need to do an ultrasound of the kidneys, a urine test and a biochemical blood test once a year. And patients themselves should be more attentive to themselves.

What triggers kidney disease

Obesity- with an excess of adipose tissue, components begin to be produced that reduce vascular tone, and excess fat puts mechanical pressure on the kidneys, complicating their work.

Dramatic weight loss- the kidneys are located in a fatty protective capsule. When losing weight, the fat layer becomes thinner and the kidneys become vulnerable.

Diabetes- because of high content Blood sugar levels increase the load on the kidneys and they are quickly depleted.

Smoking and alcohol- alcohol dehydrates the body, the blood thickens, this forces the kidneys to work in emergency mode. Smoking introduces toxic substances into the body.

Hypothermia- the main cause of pyelonephritis ( acute inflammation). Symptoms - elevated temperature, lower back pain, painful urination. The disease is caused by failure to maintain personal hygiene, abuse of spicy, fatty and smoked foods, and viral diseases transmitted to the legs.

Hypertension- leads to damage and disruption of the renal vessels.

Symptoms of the disease

pay attention to appearance - with kidney disease, there is often swelling in the morning on the face (bags under the eyes) and on the legs, which disappears in the evening. The skin becomes pale, dry, with a yellowish tint.
Lower back pain - common symptom for infectious diseases (pyelonephritis) and for obstruction of urine outflow (hydronephrosis).
Unexplained weakness, fatigue, headaches and fever- a consequence of metabolic disorders and the inflammatory process.
Changes in the color, odor, and amount of urine produced should be alarming.