home Audience 2 Development of eclampsia due to kidney damage. Renal Eclampsia: Symptoms, Causes, Treatment, Diagnosis

Development of eclampsia due to kidney damage. Renal Eclampsia: Symptoms, Causes, Treatment, Diagnosis

Basic clinical syndromes for kidney diseases:

Edema syndrome

The mechanism of occurrence of renal edema is complex, therefore it is not correct to explain their occurrence only by a decrease in plasma oncotic pressure due to the loss of protein in the urine. According to their origin, renal edema is nephritic and nephrotic. The first are observed in patients with glomerulonephritis in acute and chronic stages disease, but without the presence of

They are due to the following factors:

primary retention of sodium and water due to damage to the glomeruli;
increased capillary permeability in glomerilonephritis due to activation autoimmune processes and damage to the main substance connective tissue, increasing hyaluronidase activity;
increase in hydrostatic pressure;
activation of the renin-angiotensin-aldosterone system. Increased production of aldosterone by the adrenal glands further increases the retention of sodium ions in the body, and this automatically leads to water retention in the bloodstream and tissues;
overproduction of antidiuretic hormone by the posterior lobe of the pituitary gland.

Nephrotic edema most often develops with inflammatory or degenerative lesion tubules. It is in nephrotic syndrome that the leading mechanism for the development of edema is severe hypoproteinemia due to massive loss of protein in the urine. The result is a decrease in oncotic pressure in the bloodstream and the release of fluid into the surrounding tissues. Particularly persistent swelling occurs when several mechanisms are activated simultaneously.

Renal edema in classic version localized on the face and appear in the morning. The skin over them is pale, their consistency is soft, loose, and mobile. With large edema, they spread throughout the body and are often cavitary.

Arterial hypertension syndrome (hypertensive syndrome)

In kidney diseases, secondary arterial hypertension, so-called renal hypertension. Hypertensive syndrome occurs:

as a result of damage to the kidney parenchyma (with glomerulonephritis or pyelonephritis, nephrosclerosis) - this is renoparenchymal, or truly nephrogenic hypertension;
in case of pathology of the vessels feeding the kidneys, this is renovascular (renovascular) hypertension;
in case of disturbances in the outflow of urine, this is reflux hypertension.

Development mechanism renal hypertension, especially renoparenchymatous, is complex. Some differences have been found depending on morphological form glomerulonephritis. Regardless of the damaging factor (damage to the vessel or inflammatory process in the area of the glomeruli), ischemia of the renal parenchyma occurs, including the juxta-glomerular apparatus of the kidney, located in the glomeruli.

As a result, the production of renin is activated, thereby increasing the activity of angiotensin-converting enzyme, leading to increased production of angiotensin-2, a powerful pressor factor. Angiotensin-2 increases arteriolar spasm, which sharply increases peripheral resistance. The production of aldosterone by the adrenal glands and antidiuretic hormone is activated, which leads to sodium and water retention.

The selective accumulation of sodium ions in the walls of blood vessels, which also attracts water, has been proven. The resulting swelling of the vascular wall leads to a significant and persistent increase in peripheral resistance, which automatically sharply increases blood pressure. At the same time, a decrease in the production of depressor factors (kallikrein, prostaglandins, antirenin, angiotensinase, bradykinin, etc.) has been proven. The clinical manifestations of renal hypertension are generally the same as with primary (essential) arterial hypertension.

Features of renal hypertension:

There is always a clinical picture of kidney damage (glomerulonephritis, pyelonephritis, amyloidosis, nephrosclerosis, congenital or acquired stenosis renal artery and etc.).
In 20% of cases, there is a rapid, malignant course that is difficult to treat.
Mainly increases diastolic pressure due to pronounced spasm of peripheral vessels.
Specific changes in the fundus: spasm of retinal arterioles and exudative changes in the form of numerous flocculent spots; retina with a grayish background, disc swelling optic nerves; small and large hemorrhages at the posterior pole of the eyeball, a “star” figure in the area of the visual spot.

Renal eclampsia syndrome

Eclampsia is most often observed in acute diffuse glomerulonephritis and nephropathy of pregnancy. In the pathogenesis of eclampsia, the main importance is given to:

increased intracranial pressure;
swelling of brain tissue;
vasospasm cerebral vessels.

Attacks of eclampsia usually occur during periods of severe edema and increased blood pressure. Seizures are triggered by eating salty foods and large quantity liquids.

The first signs of an approaching attack of eclampsia are unusual lethargy and drowsiness. Then a strong one appears headache, vomiting, short-term loss of vision (amaurosis), speech (aphasia), transient paralysis, clouding of consciousness, increased blood pressure, decreased pulse. Then frequent (every 30 seconds - 1 minute) tonic and clonic convulsions appear.

During an attack, the patient's face becomes cyanotic and swells. jugular veins, eyes roll upward, tongue biting is noted, foam flows from the mouth. The pupils are dilated and do not respond to light, eyeballs hard. Involuntary defecation and urination are often observed.

Seizures renal eclampsia usually lasts several minutes. Patients often die from cerebral edema or cerebral hemorrhage.

Renal colic syndrome

Renal colic most often develops with, less often with kinking of the ureter, nephroptosis, or kidney tumor. Pathogenesis: reflex spasm of the ureter due to irritation of its wall with a stone and stretching renal pelvis, which is caused by a violation of the outflow of urine from it.

Renal colic has a characteristic clinical picture. Suddenly, usually after walking or jolting, strong, cramping pain, localized in that half lumbar region where the stone is located. The pain spreads down the ureter, into the groin area, and into the genitals. They are sharp in nature.

During an attack, the patient is extremely restless, screams, moans, and cannot find a place for himself. Renal colic is accompanied by nausea, repeated vomiting that does not bring relief, a feeling of fullness in the abdomen, bloating, and symptoms of functional intestinal obstruction.

Along with the pain, the following phenomena develop: frequent urination, pain and difficulty urinating. The amount of urine excreted is reduced, and at the end of the attack it is increased.

Changes in the urine are detected: single fresh red blood cells, and sometimes severe hematuria. “Urine sand” and small stones can be found in the urine. But during an attack it may not contain pathological impurities if there is a complete blockage of the ureter. The duration of the attack ranges from several minutes to 2-3 or more hours.

When examining the patient, the body temperature is normal, sharp pain is detected when palpating the lumbar region and positive symptom Pasternatsky. Confirmation of the diagnosis of renal colic with urolithiasis Usually the typical clinical picture of the disease, changes in urinary sediment and radiography and ultrasound data are used.

In case of acute or chronic nephritis It is important to monitor your condition in order to prevent complications such as renal eclampsia. The disease often occurs in children with nephrotic syndrome, which lasts for a long time. Also, this disease is often suffered by pregnant women with nephropathy.

Description of the problem

Renal eclampsia is characterized by peculiar convulsions that are similar to epileptic seizures, but have a different basis, causes and nature of the disease. In this case, attacks appear against the background of serious kidney diseases. Blood circulation in the brain is impaired due to swelling of the brain tissue and microcirculation disorders occur. This occurs due to water and sodium retention.

Causes of the syndrome and pathogenesis

Renal eclampsia syndrome occurs against the background of acute nephritis. The reason for this is increased blood pressure, which causes spasms of cerebral vessels. Because of this, blood circulation in the brain is disrupted, and swelling occurs in it. Also significantly increases spinal and intracranial pressure. Some experts believe that renal eclampsia occurs due to blood pressure, which leads to cerebral ischemia. Others argue that increased intracranial pressure causes swelling in the brain. Acute nephritis most often affects children at the age of 7-9 years. It is during this period that it is extremely necessary to monitor their health and in case of seizures be able to provide emergency assistance. From one to three years of age, people are less likely to suffer from this disease, and in infancy it happens extremely rarely.

Symptoms

The syndrome is characterized convulsive attacks, a person may lose consciousness at such moments. Unreasonable lethargy of the body occurs, appetite disappears, urination becomes rare. The disease is also accompanied by headache, nausea and vomiting. Vision often deteriorates and sometimes disappears completely. Seizure attacks can occur suddenly or after the above symptoms. The disease includes the following stages:

Time before cramps. During this period, the muscles of the face and eyelids are seized by spasms. The stage lasts about 30 seconds.
Tonic cramps (muscle tension). The duration of this stage is from 10 to 30 seconds.
Clonic convulsions (varies muscle tone). At this stage, the patient may rush from side to side. Duration - up to 2 minutes.
Comatose period when the patient comes to his senses.

During stages 1-3, a person has poor control of himself and faints. The pulse and pressure rise, the pupils stop responding to light. During such attacks, it is necessary to fix the tongue so that it does not sink or the patient does not bite it. You may foam at the mouth and the veins in your neck will be swollen. It also happens that during an attack (most often at the 4th stage), a person may involuntarily wet himself or be unable to hold back his feces. The attack lasts several minutes and can happen 2-3 times or up to 40 times a day.

Gradually the patient regains consciousness, but for some time he remains in a foggy state. After the attack, the patient does not remember anything about his condition; at first he thinks and speaks inhibited. But such consequences do not always occur; some may experience an attack while conscious, and sometimes it can lead to coma.

Eclampsia during pregnancy

The syndrome is very common in pregnant women, as well as in women in postpartum period when it happens huge pressure on the body, in particular on the kidneys. It is important for women to know about the presence of the disease and monitor their health. Failure to consult a doctor in a timely manner can lead to termination of pregnancy (the fetus will die due to lack of oxygen). The life of a woman is also endangered, as she may die from cerebral or pulmonary edema.

If cramps appear in the first or early second trimester, the woman is advised to terminate the pregnancy. On later when the fetus is considered full-term, C-section. Sometimes it happens that along with an attack, the labor activity. Most often, attacks occur against the background severe pain during childbirth and after childbirth this problem stops and no longer bothers the woman. If the disease occurs after childbirth, a complication may appear in the form of renal failure.

Diagnostics

Patients suffering from the disease must be under the supervision of a doctor or follow bed rest. Diagnosis becomes difficult when the person experiencing such attacks is not in the clinic or at home. Therefore, it is difficult for a doctor to immediately distinguish renal eclampsia from other diseases that are accompanied by seizures, for example, epilepsy. The differences with eclampsia are in the consequences - the brain swells, blood pressure increases noticeably. Epilepsy can be distinguished by this sign - the patient has bite marks on the tongue from previous seizures. Eclampsia can happen once and is not chronic.

This disease is often confused with hypertensive encephalopathy and uremic coma. With cerebral hemorrhage, with which eclampsia is often confused, there is no “renal” history, no edema, and the urine does not change. The disease can be diagnosed after the patient has received assistance from health care workers. It is recommended to take blood tests, urine tests, biochemical analysis. The patient must undergo an ultrasound scan of the kidneys.

Urgent Care

A patient with such symptoms needs emergency care. First of all, provide physical protection so that the person does not cause bodily injury to himself. Call an ambulance immediately. Then the patient should be placed on left side. It is important to expand oral cavity using a spoon wrapped in gauze. This action is required to avoid tongue sticking or biting. Need to carry out indirect massage heart, if the patient's heartbeat is abnormal. After a seizure, mucus, vomit and foam from the mouth are removed. When the first emergency support is provided, the patient is transferred to the department intensive care or anesthesiology.

Treatment of renal eclampsia

When signs of an imminent seizure appear, it is important for the patient to provide rest (preferably bed rest), significantly reduce the amount of liquid drunk, and reduce salt intake.

It is important to eat for the first time after an attack light food, for example, eat fruits that are not heavy on the body. It is recommended to drink up to half a liter of jelly or compote per day. Often in such cases, 300-500 ml of blood is drained. More often, doctors prescribe a 25% solution of magnesium sulfate. But it is important to be careful this drug so as not to exceed the dose.

To reduce intracranial pressure, a spinal tap is performed. It is very important to do this procedure slowly so that there is no sudden drop in pressure. This treatment is aimed at reducing seizures, lowering pressure in the brain and reducing swelling. To prevent attacks from recurring, the doctor prescribes narcotic or sedatives. When the attacks stop, the patient must adhere to a special diet, in which the amount of sodium chloride intake is reduced to 4 grams and the daily fluid intake is 1 liter.

Encephalopathic syndrome, accompanied by convulsions, loss of consciousness, sharp increase blood pressure, cerebral edema has in medical practice name: renal eclampsia. Given pathological condition occurs against the background of nephritis, pregnancy and some other diseases. To prevent severe consequences it is important to diagnose the pathology in a timely manner, take necessary measures on her treatment.

Disease concept

Eclampsia is caused by circulatory disorders due to swelling of brain tissue and a decrease in blood microcirculation in it. At serious illnesses kidneys, acute nephritis, swelling of the brain tissue develops due to water and sodium retention. In pregnant women, the condition is associated with generalized spasm of the cerebral arteries and the formation of intravascular blood clots.

Renal eclampsia in pregnant women is called severe toxicosis, accompanied by a sharp increase in blood pressure. In the absence of a literate medical treatment and emergency care, the condition carries a risk to the life of the mother and fetus.

Causes

The mechanism of development of eclampsia is not fully understood. It is known that the main provoking factor is a strong increase in blood pressure. This causes cerebral vascular spasm and disruption of normal blood circulation. According to the study, it was found that the following factors provoke the disease:

acute impairment of the kidneys and vascular system;
diabetes;
bearing a child in at a young age(15 – 18 years) or after 35;
pregnancy interval more than 10 years;
systemic lupus erythematosus;
genetic predisposition to the disease;
excess body weight;
multiple pregnancy;
attacks of eclampsia in previous pregnancies.

Renal eclampsia develops mainly in pregnant women in the third trimester

Against the background of arterial spasms during childbearing, women develop renal failure, cerebral ischemia occurs. At the same time, blood flow is significantly reduced, which is accompanied by an increase in blood viscosity. This leads to increased tissue permeability and swelling. The combination of these factors leads to hemorrhages in tissues various organs, in particular in the brain.

Symptoms

Eclampsia is always accompanied by a sharp increase in blood pressure. As a result, hemorrhages occur, from which many patients die.

The prodromal period of the disease is accompanied by the following manifestations:

In terms of vision, many patients note the appearance of a veil before the eyes, flickering spots, blurred vision, and double images.

The prodromal period does not last long or is completely absent. An attack of eclampsia occurs suddenly, sometimes developing against the background of normal health. The duration of the acute course of the disease is 2–3 days, but there are short-term attacks that often go unnoticed.

An attack of eclampsia lasts from 1 to 3 minutes and has several stages:

The preconvulsive stage lasts about 30–40 seconds, accompanied by twitching of the facial muscles.
Tonic spasms – spasm of the muscles of the whole body is noted. The patient often loses consciousness, pupils dilate, turn blue skin(10 – 30 sec).
Clinical convulsions - the patient has difficulty breathing, often foaming at the mouth. Duration up to 2 minutes.
The comatose period is a gradual return to consciousness, often accompanied by urinary and fecal incontinence. Sometimes it comes death caused by asphyxia, cerebral hemorrhages, pulmonary edema.

After the attack, the patient’s consciousness is confused, speech is difficult. More often than not, patients do not remember what happened to them. Sometimes it occurs anxiety patient after a seizure, nervousness, aggressiveness, attempts to escape, refusal medical care.

If signs of renal eclampsia develop, you should consult a doctor as soon as possible

Attacks of eclampsia are rarely isolated; more often the attack is repeated several times during the day. The above clinical manifestations are not always noted. Sometimes an attack occurs short-term nature, occurs with the patient’s full consciousness or its short-term loss. In this case, renal eclampsia syndrome is accompanied by the following symptoms:

Strong headache;
decreased vision;
lethargy;
twitching of facial muscles, eyelids;
decrease in some reflexes.

Important! If an attack occurs, you must call an ambulance as soon as possible. A timely reaction will help avoid many negative consequences.

Diagnosis of eclampsia

An attack of eclampsia occurs suddenly and is accompanied by acute course, seizures and others characteristic manifestations. The purpose of diagnosis is to identify not eclampsia itself, but its precursors. The following measures are used for this:

Detection of late toxicosis in pregnant women. Precursors of eclampsia include frequent headaches, blurred vision, nausea, vomiting, irritability, anxiety, or, conversely, apathy. Women often experience itchy skin, hot flashes, difficulty in nasal breathing. However, it is not necessary to have all the above-described signs. The risk of a seizure is often indicated by one or more of these.
To identify pathology, the patient's medical history must be studied. The provoking factors of eclampsia are hypertension, pathologies of cardio-vascular system, diabetes mellitus, kidney disease.
Study of laboratory parameters of blood and urine.
Blood pressure control. The risk of developing eclampsia is indicated by maintaining high values (140/90 or higher) for 6 or more hours.

During pregnancy it is carried out ultrasonography fetus and placenta to assess their condition. Cardiotocography and Dopplerography are used to determine the presence of fetal hypoxia.

Diagnosis of the disease requires integrated approach using instrumental methods research

Computer and magnetic resonance imaging allows one to assess the condition of a woman’s brain. To exclude pulmonary edema, a chest x-ray is prescribed.

Emergency care for eclampsia

If an attack of eclampsia occurs at home, it is important to provide first aid first aid before the ambulance arrives. First of all, the physical safety of the patient should be ensured, since during convulsions the patient often injures himself. The patient should be placed on the left side, with a spoon wrapped in a bandage placed in the mouth to avoid the tongue from sinking. If a decrease in pulse rate and heartbeat is noted, it is necessary to perform an indirect cardiac massage. If there is vomiting, mucus, or foam, it is necessary to clean the patient’s oral cavity. Often the patient’s life depends on how competently and timely emergency care was provided.

The life of a patient with renal eclampsia depends on the correct provision of first aid to a patient.

Treatment of eclampsia in pregnant women

The main method of treating pathology is delivery. In a full-term pregnancy, labor is induced immediately after the mother’s condition returns to normal. For periods of less than 37 weeks, the issue of premature birth if eclampsia is accompanied by a significant risk to the health of the mother and child. If the threat is low, therapy is aimed at stabilizing the mother’s well-being, which has a positive effect on the condition of the fetus.

If symptoms are mild, it is allowed ambulatory treatment with strict implementation of the following activities:

strict bed rest;
increasing the amount of fluid consumed;
reducing salt in the diet;
examination by a doctor every 2–3 days.

At acute symptoms the woman is hospitalized. During the first few hours of hospital stay, stabilization therapy is carried out, including the following medications:

calcium gluconate;
magnesium sulfate.

The dose of magnesium is determined depending on general condition patient, reflexes, blood pressure level, amount of magnesium in blood serum. Sometimes magnesium sulfate causes fetal lethargy or hypotension, but Negative consequences are rare.

Treatment of pathology during pregnancy requires a special approach taking into account the condition of the mother and child

With absence therapeutic effect from the use of magnesium sulfate, patients are prescribed Valium or Hydralazine in the form of droppers.

If delivery is necessary, the method is determined in accordance with the woman’s condition. If no complications arise, labor is induced by administering an Oxytocin solution. If natural delivery is not possible, a caesarean section is performed.

Possible complications

An attack of eclampsia causes the following complications:

development of pulmonary edema;
aspiration pneumonia;
heart failure;
cerebral hemorrhages;
stroke, paralysis;
temporary blindness due to retinal detachment;
to whom;
psychoses.

Important! The most serious complication is death due to cerebral edema.

Prevention

To prevent eclampsia, measures should be taken to prevent late toxicosis in pregnant women. They are carried out in the third trimester of pregnancy and include the following recommendations:

before pregnancy, it is important to cure chronic diseases;
regular visits to antenatal clinics during pregnancy;
blood pressure control;
periodic urine testing to determine protein levels;
identification and timely treatment late gestosis;
if your blood pressure increases, you need to take medications prescribed by your doctor;
elimination of stress and emotional tension;
diet;
frequent walks in the fresh air;
quality rest and sleep of at least 8 – 9 hours.

Prevention of renal eclampsia consists of preventing late toxicosis, proper nutrition

Renal eclamptic attacks - common occurrence among pregnant women and patients suffering from nephritis and other kidney pathologies. A positive prognosis for the patient is possible with timely treatment of eclampsia and its competent prevention. In the absence of medical care, severe complications and death of the patient often occur.

Causes, symptoms

Renal eclampsia is a syndrome that manifests itself as loss of consciousness, convulsions, and is caused by spasm of cerebral arterioles and edema. Renal eclampsia is observed in patients with acute illness kidneys, can also occur with exacerbation of nephropathy in a pregnant woman.

Renal eclampsia occurs during a period of increased blood pressure and pronounced edema. Its symptoms are increased intracranial pressure, swelling of brain tissue, and cerebral vasospasm.

Attacks are provoked by unlimited fluid intake and the patient’s consumption of salty foods in large quantities.

Clinical picture of the attack

Almost always, a seizure is preceded by drowsiness and lethargy. A severe headache appears and dizziness may occur. The patient's consciousness becomes clouded, he may begin to delirium or see hallucinations, and sometimes there is a short-term loss of consciousness. Nausea appears, blood pressure rises quickly, and swelling increases. Vision is also upset: spots may flash before the patient’s eyes, a veil may appear, and sometimes vision simply drops sharply.

Seizures always occur suddenly. They are strong tonic contractions, which are abruptly replaced by strong clonic convulsions. The patient's face becomes cyanotic, the neck veins swell, the tongue is bitten, and foam flows from the mouth. The eyes roll back or slant to the side, the pupils do not respond to light, and the eyeballs are hard. Blood pressure is elevated, as is the temperature, and the pulse is intense, but rare. Sometimes there may be involuntary urination. Such attacks usually last for several minutes, the number of seizures also varies - from 1-2 to 10 or more.

After the attacks, the patient calms down and remains for some time in a state of stupor, stupor, or even coma. When he comes to, he doesn't remember anything. After a seizure, lethargy, difficulty speaking, and amaurosis remain for some time. True, such a clinical picture is not always present. Sometimes the patient may not even lose consciousness at all.

Differential diagnosis and treatment

Renal eclampsia is differentiated from seizures of other origins. Similar seizures are observed in epilepsy. True, with epilepsy, swelling does not occur, blood pressure does not increase, and attacks are observed for many years. Edema is also not expressed when hypertensive encephalopathy, with which renal eclampsia can be confused. Convulsions can also occur during uremic coma. True, in this case there is chronic kidney disease, slow development of seizures, signs of uremic intoxication. It is sometimes necessary to differentiate coma during eclampsia from hemorrhage in the brain. True, with a cerebral hemorrhage, the patient has no renal history, no edema is observed, but there is focal symptoms, which include paralysis and paresis.

Diagnosis is carried out after first aid. The patient passes general tests blood, urine, biochemical blood test, ultrasound of the kidneys.

The diagnosis of renal eclampsia is an indicator for hospitalization. Treatment is aimed at eliminating seizures, reducing swelling, and lowering blood pressure. An attack is blocked if the patient undergoes a spinal or suboccipital puncture and releases a certain amount cerebrospinal fluid. At the same time, intracranial pressure decreases and the patient comes to his senses. Bloodletting and intravenous administration of magnesium sulfate help with attacks, which also lowers blood pressure and reduces swelling of the brain. After stopping the attack, the doctor prescribes the patient an achloride diet, and then a diet containing limited intake of sodium chloride to 3-4 g and liquid to 1 liter per day.

May 5, 2017 Doctor

Eclampsia is understood as severe complication gestosis in pregnant women, one of the forms of late toxicosis. But renal eclampsia is also typical for other categories of patients suffering from various nephrological pathologies.

Description and reasons

In the presence of nephropathy in pregnant women, nephritis in other categories of people, the development of renal eclampsia is possible. This is an encephalopathic syndrome associated with a sharp increase blood pressure, narrowing cerebral vessels and impaired blood supply to the brain and spinal cord. Now the disease accompanies no more than 0.3-1% of cases of kidney damage; it occurs more often in pregnant women, in childhood up to 7 years of age it is almost not diagnosed.

Eclampsia develops mainly with acute diffuse glomerulonephritis. Other causes of pathology may be:

kidney diseases during pregnancy;
late toxicosis of pregnancy;
exacerbation of chronic glomerulonephritis.

Can provoke the onset of an attack generous reception salty foods, uncontrolled fluid intake. The attack begins when there is severe swelling and increased blood pressure. Due to water and sodium retention, arterial spasm and subsequent ischemia occur ( oxygen starvation) brain tissue. Intracranial and spinal pressure increases, cerebral edema develops with seizures and other severe symptoms.

How does the syndrome manifest?

The duration of each attack of renal eclampsia is several minutes, but the number of attacks may vary. The development of the syndrome occurs in four stages:

Precursor stage (preconvulsant). Lasts up to 20-30 seconds, the patient begins to twitch the facial muscles.
Stage of tonic convulsions (30 seconds). They spread to all large muscles of the body due to muscle tension.
Stage of clonic convulsions (2 minutes). Foaming at the mouth, activation of convulsions, loss of consciousness, breathing problems.
Comatose or resolving stage. The patient may come to his senses, or fall into a coma or die (the outcome depends on the assistance provided, the severity of eclampsia, etc.).

Usually the disease develops at the peak of acute glomerulonephritis, less often - after swelling has decreased. At the warning stage, in addition to isolated twitching of the facial muscles, headaches, nausea, and blurred vision may occur. Later vomiting and increased pain syndrome, “flies” flash before the eyes, vision is blurred. A state of stupor may occur, at the same time the pressure increases and the heart rate decreases.

During convulsions, the patient is often unconscious. There is pallor and bluish discoloration of the facial skin, wheezing, dilated pupils, involuntary release of feces and urine, and tongue biting. After returning consciousness or emerging from a coma, a person remains confused in thoughts, speech, memory impairment, aggressiveness, anxiety, and often temporary loss of vision. Later major brain functions are being restored.

First aid to a patient

Urgent Care should be provided at home, before the ambulance arrives, although many patients with acute nephritis are already in the hospital of a medical institution. You need to act this way:

Lay the person on a flat surface on his left side, ensure physical safety.
Place a spoon wrapped in gauze in your mouth to prevent your tongue from sticking out.
Unfasten the collar, remove constrictive clothing, open the window.
If necessary, do artificial respiration, indirect cardiac massage.

Upon arrival of the ambulance, the patient is often put under anesthesia, since the treatment is under general anesthesia will be most effective.

How is eclampsia treated?

Diagnosis is based on characteristic clinical picture coupled with a history of acute or chronic kidney disease, as well as nephropathy in pregnant women. The diagnosis can be confirmed by measuring blood pressure (above 140-90), monitoring blood tests (impaired kidney function) and urine (proteinuria - increased protein in the urine).

During the period of warning signs, it will help to prevent an attack strict restriction salts, liquids, taking blood pressure medications. At the peak of an attack, the following measures are taken to reduce cerebral edema:

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bloodletting (up to 400-500 ml of blood);
injection of magnesium solution into a vein;
infusion of glucose, diuretics, aminophylline, antihypertensive drugs;
foot baths, mustard plasters on calves.

Usually such measures lead to the relief of the attack, the patient regains consciousness. If these treatments are ineffective, urgently perform spinal tap. After stabilization of the condition, physiotherapy, blood pressure medications and angioprotectors are recommended, special diet. Treatment of the underlying disease will help prevent subsequent attacks.

Possible complications and prevention

The most serious complication is death due to respiratory arrest, cerebral edema, acute renal or heart failure, or stroke. Also, severe consequences of renal eclampsia can be aspiration pneumonia, pulmonary edema, paralysis and paresis, retinal detachment, psychosis, hemorrhages and cerebral hematomas.

An important measure to prevent renal eclampsia is timely treatment of kidney disease. Special attention should be given to pregnant women at risk - with late toxicosis, increased protein in the urine, hypertension and edema. It is recommended that such women be placed in a hospital until delivery. In general, for prevention it is necessary to observe proper diet, water regime, eliminate stress, undergo regular examinations and control all chronic diseases.

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