Symptoms of kidney failure. Diagnosis of renal failure. Stages of progression of chronic renal failure
Kidney failure- a pathological condition that occurs in various diseases and is characterized by a violation of all kidney functions.
The kidney is an organ of the urinary system. Its main function is the formation of urine. 
It goes like this:
- Blood entering the kidney vessels from the aorta reaches the glomerulus from the capillaries, surrounded by a special capsule (Shumlyansky-Bowman capsule). Under high pressure, the liquid part of the blood (plasma) with substances dissolved in it seeps into the capsule. This is how primary urine is formed.
- Primary urine then moves through the convoluted tubule system. Here, water and substances necessary for the body are absorbed back into the blood. Secondary urine is formed. Compared to the primary one, it loses in volume and becomes more concentrated, only harmful metabolic products remain in it: creatine, urea, uric acid.
- From the tubular system, secondary urine enters the renal calyces, then into the pelvis and into the ureter.
- Excretion of harmful metabolic products from the body.
- Regulation of blood osmotic pressure.
- Hormone production. For example, renin, which is involved in the regulation of blood pressure.
- Regulation of the content of various ions in the blood.
- Participation in hematopoiesis. The kidneys secrete the biologically active substance erythropoietin, which activates the formation of erythrocytes (red blood cells).
Causes of kidney failure
Causes of acute renal failure
Classification of acute renal failure, depending on the causes:- Prerenal. Caused by impaired renal blood flow. The kidney does not receive enough blood. As a result, the process of urine formation is disrupted, and pathological changes occur in the kidney tissue. Occurs in approximately half (55%) of patients.
- Renal. Associated with pathology of renal tissue. The kidney receives enough blood, but cannot produce urine. Occurs in 40% of patients.
- Postrenal. Urine is produced in the kidneys, but cannot flow out due to an obstruction in the urethra. If an obstruction occurs in one ureter, the function of the affected kidney will be taken over by the healthy one - renal failure will not occur. This condition occurs in 5% of patients.
In the picture: A - prerenal renal failure; B - postrenal renal failure; C - renal renal failure.Causes of acute renal failure:
| Prerenal |
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| Renal |
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| Postrenal |
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Causes of chronic renal failure
Symptoms of kidney failure
Symptoms of acute renal failure
Symptoms of acute renal failure depend on the stage:- initial stage;
- stage of decrease in daily urine volume to less than 400 ml (oliguric stage);
- stage of restoration of urine volume (polyuric stage);
- stage full recovery.
| Stage | Symptoms |
| Initial | At this stage, there is no renal failure as such yet. The person is concerned about the symptoms of the underlying disease. But disturbances in the kidney tissue are already occurring. |
| Oliguric | Renal dysfunction increases and the amount of urine decreases. Due to this, harmful metabolic products are retained in the body, and disturbances occur. water-salt balance. Symptoms:
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| Polyuric | The patient's condition returns to normal, the amount of urine increases, usually even more than normal. At this stage, dehydration and infections may develop. |
| Full recovery | Final restoration of kidney function. Usually lasts from 6 to 12 months. If during acute renal failure a large part of the kidney tissue was turned off, then complete recovery is impossible. |
Symptoms of chronic renal failure
- At the initial stage, chronic renal failure has no manifestations. The patient feels relatively normal. Typically, the first symptoms appear when 80%-90% of the kidney tissue ceases to perform its functions. But before this time, a diagnosis can be made if an examination is carried out.
- Usually appear first general symptoms: lethargy, weakness, increased fatigue, frequent malaise.
- Urine excretion is impaired. More of it is produced per day than it should be (2-4 liters). Because of this, dehydration may develop. There is frequent urination at night. In the later stages of chronic renal failure, the amount of urine decreases sharply - this is a bad sign.
- Nausea and vomiting.
- Muscle twitching.
- Skin itching.
- Dryness and bitter feeling in the mouth.
- Stomach ache.
- Diarrhea.
- Nose and stomach bleeding due to decreased blood clotting.
- Hemorrhages on the skin.
- Increased susceptibility to infections. Such patients often suffer from respiratory infections, pneumonia.
- On late stage: the condition worsens. Attacks of shortness of breath and bronchial asthma occur. The patient may lose consciousness or fall into a coma.
Diagnosis of kidney failure
| Diagnostic method | Acute renal failure | Chronic renal failure |
| General urine analysis | A general urine test for acute and chronic renal failure can reveal:
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| Bacteriological examination of urine | If the renal dysfunction was caused by an infection, the pathogen will be detected during the study. This analysis also makes it possible to identify an infection that has occurred against the background of renal failure and determine the sensitivity of the pathogen to antibacterial drugs.  |
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| General blood analysis | In acute and chronic renal failure, changes in the general blood test are revealed:
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| Blood chemistry | Helps evaluate pathological changes in the body caused by impaired renal function. In a biochemical blood test in acute renal failure, changes can be detected:
| In case of chronic renal failure in biochemical analysis changes in the blood are usually detected:
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| These methods allow you to examine the kidneys, their internal structure, renal calyces, pelvis, ureters, and bladder. In acute renal failure, CT, MRI and ultrasound are most often used to find the cause of narrowing of the urinary tract.  |
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| Doppler ultrasound | Ultrasonography, during which blood flow in the vessels of the kidneys can be assessed. | |
| Radiography chest | It is used to identify disorders of the respiratory system and some diseases that may cause renal failure.
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| Chromocystoscopy |
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| Kidney biopsy | The doctor obtains a piece of kidney tissue and sends it to the laboratory for examination under a microscope. Most often this is done using a special thick needle, which the doctor inserts into the kidney through the skin. Biopsy is resorted to in doubtful cases when it is not possible to establish a diagnosis.
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| Electrocardiography (ECG) | This study is mandatory for all patients with acute renal failure. It helps to identify heart problems and arrhythmias.  |
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| Zimnitsky test | The patient collects all urine during the day into 8 containers (each for 3 hours). Determine its density and volume. The doctor can evaluate the state of kidney function and the ratio of daytime and nighttime urine volumes. | |
Treatment of kidney failure
Acute renal failure requires immediate hospitalization of the patient in a nephrology hospital. If the patient is in serious condition, he is placed in the intensive care unit. Therapy depends on the causes of renal dysfunction. For chronic renal failure, therapy depends on the stage. At the initial stage, treatment of the underlying disease is carried out - this will help prevent severe renal dysfunction and make it easier to cope with them later. When the amount of urine decreases and signs of renal failure appear, it is necessary to combat pathological changes in the body. And during the recovery period, you need to eliminate the consequences.
Directions for treatment for renal failure:
| Direction of treatment | Events |
| Eliminating the causes of prerenal acute renal failure. |
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| Eliminating the causes of renal acute renal failure |
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| Eliminating the causes of postrenal acute renal failure | It is necessary to remove the obstacle that interferes with the outflow of urine (tumor, stone, etc.). Most often, this requires surgical intervention. |
| Eliminating the causes of chronic renal failure | Depends on the underlying disease. |
| Measures to combat disorders that occur in the body during acute renal failure |
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| Elimination of water-salt imbalances |
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| Fighting blood acidification | The doctor prescribes treatment when the acidity (pH) of the blood drops below the critical value of 7.2. A sodium bicarbonate solution is injected intravenously until its concentration in the blood rises to certain values and the pH rises to 7.35. |
| Fighting Anemia | If the level of red blood cells and hemoglobin in the blood decreases, the doctor prescribes blood transfusions and epoetin (a drug that is an analogue of the kidney hormone erythropoietin and activates hematopoiesis). |
| Hemodialysis, peritoneal dialysis | Hemodialysis and peritoneal dialysis are methods of purifying the blood of various toxins and unwanted substances. Indications for acute renal failure:
In peritoneal dialysis, a blood purification solution is injected into abdominal cavity. As a result of the difference in osmotic pressure, it absorbs harmful substances. It is then removed from the abdomen or replaced with a new one.
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| Kidney transplant | Kidney transplantation is carried out in case of chronic renal failure, when severe disorders occur in the patient’s body, and it becomes clear that it will not be possible to help the patient in other ways. The kidney is taken from a living donor or a cadaver. After the transplant, a course of therapy with drugs that suppress the immune system is administered to prevent rejection of the donor tissue.
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Diet for acute renal failure
Prognosis for renal failure
Prognosis for acute renal failure
Depending on the severity of acute renal failure and the presence of complications, from 25% to 50% of patients die.The most common causes of death:
- Damage to the nervous system - uremic coma.
- Severe circulatory disorders.
- Sepsis is a generalized infection, “blood poisoning”, in which all organs and systems are affected.
Prognosis for chronic renal failure
Depends on the disease against which the kidney function was impaired, the age, and the condition of the patient’s body. Since hemodialysis and kidney transplantation began to be used, patient deaths have become less frequent.Factors that worsen the course of chronic renal failure:
- arterial hypertension;
- incorrect diet when food contains a lot of phosphorus and protein;
- high protein content in the blood;
- increased function of the parathyroid glands.
- kidney injury;
- urinary tract infection;
- dehydration.
Prevention of chronic renal failure
If you start on time correct treatment a disease that can lead to chronic renal failure, then kidney function may not be affected or, at least, its impairment will not be as severe.Some drugs are toxic to kidney tissue and can lead to chronic renal failure. You should not take any medications without a doctor's prescription.
Most often, kidney failure develops in people suffering from diabetes, glomerulonephritis, and arterial hypertension. Such patients need to be constantly monitored by a doctor and undergo timely examinations.
There are acute and chronic renal failure.
Acute renal failure (ARF)- sudden impairment of kidney function with a delay in excretion of nitrogen metabolism products from the body and a disorder of water, electrolyte, osmotic and acid-base balance. These changes occur as a result of acute, severe disturbances in renal blood flow, GFR, and tubular reabsorption, usually occurring simultaneously.
Acute renal failure occurs when both kidneys suddenly stop functioning. Kidneys regulate balance chemical substances and fluids in the body and filter waste from the blood, excreting it in the urine. Acute renal failure can occur due to various reasons, including kidney disease, partial or complete blockage of the urinary tract and decreased blood volume, for example after severe blood loss. Symptoms can develop over several days: the amount of urine output may decrease sharply, and fluid that should be eliminated accumulates entirely in the tissues, causing weight gain and swelling, especially in the ankles.
Acute kidney failure is a life-threatening disease because excessive amounts of water, minerals (particularly potassium) and waste products that are normally excreted in urine accumulate in the body. The disease usually responds well to treatment; Kidney function can be fully restored in a few days or weeks if the cause is correctly identified and appropriate treatment is given. However, acute renal failure due to kidney disease can sometimes lead to chronic renal failure, in which case the prospect of developing the disease depends on the ability to treat the underlying disease.
Currently, several etiological groups of acute renal failure are distinguished.
Prerenal acute renal failure (ischemic)
- shock kidney (trauma, fluid loss, massive tissue breakdown, hemolysis, bacteremic shock, cardiogenic shock). — Loss of extracellular volume (gastroenteric losses, urinary losses, burns). — Loss of intravascular volume or its redistribution (sepsis, bleeding, hypoalbuminemia). — Reduced cardiac output(heart failure, cardiac tamponade, heart surgery). — Other causes of decreased GFR (hypercalcemia, hepatorenal syndrome).
Renal acute renal failure.
— Exogenous intoxication (kidney damage from poisons used in industry and everyday life, bites of poisonous snakes and insects, intoxication medicines and radiopaque agents). — Acute infectious-toxic kidney with an indirect and direct effect on the kidneys of the infectious factor — Renal vascular lesions (hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura, scleroderma, systemic necrotizing vasculitis, thrombosis of arteries or veins, atherosclerotic embolism in severe atherosclerosis of the great vessels — primarily aorta and renal arteries). — Open and closed kidney injuries. — Post-ischemic acute renal failure.
Postrenal acute renal failure.
- Extrarenal obstruction (occlusion of the urethra; tumors of the bladder, prostate, pelvic organs; blockage of the ureters with stones, pus, thrombus; urolithiasis disease, blockade of tubules with urates in the natural course of leukemia, as well as their treatment, myeloma and gouty nephropathy, treatment with sulfonamides; accidental ligation of the ureter during surgery). — Retention of urination not caused by an organic obstruction (impaired urination due to diabetic neuropathy or as a result of the use of M-anticholinergics and ganglion blockers).
Symptoms
Excreting only small amounts of urine. . Weight gain and swelling of the ankles and face due to fluid accumulation. . Loss of appetite. . Nausea and vomiting. . Itching all over the body. . Fatigue. . Abdominal pain. . Urine that is bloody or dark in color. . Symptoms final stage Without successful treatment: shortness of breath due to fluid accumulation in the lungs; unexplained bruising or bleeding; drowsiness; confusion; muscle spasms or cramps; loss of consciousness.
There are four periods in the development of acute renal failure: the period of initial action of the etiological factor, the oligoanuric period, the period of diuresis restoration and recovery.
In the first period, symptoms of the condition leading to acute renal failure predominate. For example, fever, chills, collapse, anemia, hemolytic jaundice are observed in anaerobic sepsis associated with out-of-hospital abortion, or clinical picture general action of one or another poison (acetic essence, carbon tetrachloride, salts heavy metals etc.).
The second period - a period of sharp decrease or cessation of diuresis - usually develops soon after the action causative factor. Azotemia increases, nausea, vomiting, coma appear, due to sodium and water retention, extracellular hyperhydration develops, manifested by an increase in body weight, cavitary edema, pulmonary and cerebral edema.
After 2-3 weeks, oligoanuria is replaced by a period of restoration of diuresis. The amount of urine usually increases gradually; after 3-5 days, diuresis exceeds 2 l/day. First, the fluid that accumulated in the body during the period of oligoanuria is removed, and then, due to polyuria, dangerous dehydration occurs. Polyuria usually lasts 3-4 weeks, after which, as a rule, the level of nitrogenous wastes normalizes and a long (up to 6-12 months) period of recovery begins.
Thus, from a clinical point of view, the most severe and life-threatening period for a patient with acute renal failure is the period of oligoanuria, when the disease picture is characterized primarily by azotemia with a sharp accumulation of urea, creatinine, uric acid in the blood and electrolyte imbalance (primarily hyperkalemia, as well as hyponatremia , hypochloremia, hypermagnesemia, hypersulfate and phosphatemia), the development of extracellular hyperhydration. The oligoanuric period is always accompanied by metabolic acidosis. During this period a number severe complications may be associated with inadequate treatment, primarily with uncontrolled administration saline solutions, when the accumulation of sodium causes first extracellular hydration, and then intracellular hyperhydration, leading to coma. A serious condition is often aggravated by the uncontrolled use of a hypotonic or hypertonic glucose solution, which reduces the osmotic pressure of the plasma and increases cellular hyperhydration due to the rapid transition of glucose, and subsequently water, into the cell.
During the period of restoration of diuresis due to severe polyuria, there is also a risk of severe complications, primarily due to developing electrolyte disturbances (hypokalemia, etc.).
The clinical picture of acute renal failure may be dominated by signs of cardiac and hemodynamic disorders, advanced uremic intoxication with severe symptoms of gastroenterocolitis, mental changes, and anemia. Often the severity of the condition is aggravated by pericarditis, respiratory failure, nephrogenic (overhydration) and cardiac pulmonary edema, gastrointestinal bleeding and especially infectious complications.
To assess the severity of a patient’s condition with acute renal failure, the main importance is indices of nitrogen metabolism, primarily creatinine, the level of which in the blood does not depend on the patient’s nutritional characteristics and therefore more accurately reflects the degree of renal dysfunction. The retention of creatinine usually precedes the increase in urea levels, although the dynamics of the level of the latter is also important for assessing the prognosis in acute renal failure (especially when the liver is involved in the process).
However, in many ways, the clinical manifestations of acute renal failure, in particular signs of damage to the nervous system and muscles (primarily the myocardium), are associated with disturbances in potassium metabolism. Frequently occurring and quite understandable hyperkalemia leads to an increase in myocardial excitability with the appearance of a high, narrow base and pointed apex T wave on the ECG, slowing down atrioventricular and intraventricular conduction up to cardiac arrest. In some cases, however, instead of hyperkalemia, hypokalemia may develop (with repeated vomiting, diarrhea, alkalosis), the latter is also dangerous for the myocardium.
Causes
. Decreased blood volume due to severe injury resulting in blood loss or dehydration is a common cause of acute kidney failure. Reduced blood flow to the kidneys due to decreased blood volume can lead to kidney damage. . Other kidney diseases, such as acute glomerulonephritis, can cause acute renal failure. . Tumors, kidney stones, or an enlarged prostate can block the ureter or urethra, obstructing the flow of urine and causing kidney damage. . Other diseases can lead to kidney failure, including polycystic kidney disease, systemic lupus erythematosus, diabetes mellitus, congestive heart failure, heart attack, liver disease, acute pancreatitis and multiple myeloma. . Heavy metal poisoning (cadmium, lead, mercury or gold) can cause kidney damage. . Chemotherapy drugs and some antibiotics such as gentamicin can lead to kidney failure, especially in those who have any kidney disease. . High doses Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can cause kidney damage. . Contrast agents, used in x-ray blood vessels or organs, may stimulate kidney failure in those at risk. . The release of the protein myoglobin by muscles as a result of injury, heat stroke, or an overdose of drugs or alcohol, or as a result of a serious infectious disease, can lead to acute kidney failure. . Sometimes acute renal failure can develop in women as a complication after childbirth.Diagnostics
. Medical history and physical examination. . Ultrasound examination. . Blood and urine tests. . A kidney biopsy may be done. Under local anesthesia, the doctor inserts a needle into the kidney through the back to remove a small sample of tissue for analysis under a microscope.Clarification of the etiological factors of acute renal failure allows for more targeted therapeutic interventions. Thus, prerenal acute renal failure develops mainly in shock conditions, characterized by severe microcirculation disorders due to hypovolemia, low central venous pressure and other hemodynamic changes; It is necessary to direct the main therapeutic measures to eliminate the latter. Close in mechanism to these conditions are cases of acute renal failure associated with large loss of fluid and NaCl in severe extensive lesions of the gastrointestinal tract (infections, anatomical disorders) with uncontrollable vomiting, diarrhea, which also determines the range of therapeutic effects. Renal acute renal failure develops due to the action of various toxic factors, primarily a number of chemical, medicinal (sulfonamides, mercury compounds, antibiotics) and radiocontrast substances, and can also be caused by renal diseases themselves (angina and nephritis associated with systemic vasculitis). Prevention and treatment of acute renal failure in these cases should include measures that limit the possibility of exposure to these factors, as well as effective methods combating these kidney diseases. Finally, therapeutic tactics for postrenal acute renal failure mainly boil down to the elimination of acute obstructed urine outflow due to urolithiasis, bladder tumors, etc.
It should be borne in mind that the ratios of various causes of acute renal failure may vary due to certain features of their effect on the kidneys. Currently, the main group of cases of acute renal failure is still made up of acute shock and toxic kidney injuries, but within each of these subgroups, along with post-traumatic acute renal failure, acute renal failure in obstetric and gynecological pathology (abortion, complications of pregnancy and childbirth), acute renal failure due to blood transfusion complications and the effect of nephrotoxic factors (poisoning with vinegar essence, ethylene glycol), acute renal failure is becoming more frequent, associated with an increase in surgical interventions, especially in older people age groups, as well as using new medicines. In endemic areas, the cause of acute renal failure may be viral hemorrhagic fever with kidney damage in the form of severe acute tubulointerstitial nephritis.
Although a large number of studies have been devoted to the study of the mechanisms of development of acute renal failure, the pathogenesis of this condition cannot be considered completely clarified.
However, it has been proven that various etiological variants of acute renal failure are characterized by a number of common mechanisms:
Violation of renal (especially cortical) blood flow and a drop in GFR; . total diffusion of glomerular filtrate through the wall of damaged tubules; . compression of the tubules by edematous interstitium; . a number of humoral effects (activation of the renin-angiotensin system, histamine, serotonin, prostaglandins, other biological active substances with their ability to cause hemodynamic disturbances and tubular damage); . shunting blood through the juxtamedullary system; . spasm, thrombosis of arterioles.
The morphological changes that arise in this case concern mainly the tubular apparatus of the kidneys, primarily the proximal tubules, and are represented by dystrophy, often severe necrosis of the epithelium, accompanied by moderate changes in the interstitium of the kidneys. Glomerular abnormalities are usually minor. It should be noted that even with the most profound necrotic changes, regeneration of the renal epithelium occurs very quickly, which is facilitated by the use of hemodialysis, which prolongs the life of these patients.
Given the commonality of developing processes, the predominance of one or another link in pathogenesis determines the features of the development of acute renal failure in each of its named variants. Thus, in shock acute renal failure, the main role is played by ischemic damage to the renal tissue; in nephrotoxic acute renal failure, in addition to hemodynamic disorders, the direct effect of toxic substances on the tubular epithelium during their secretion or reabsorption is important; in hemolytic-uremic syndrome, thrombotic microangiopathy predominates.
In some cases, acute renal failure develops as a consequence of the so-called acute hepatorenal syndrome and is caused by serious illnesses liver or surgical interventions on the liver and biliary tract.
Hepatorenal syndrome is a variant of acute functional renal failure that develops in patients with severe liver damage (fulminant hepatitis or advanced liver cirrhosis), but without any visible organic changes in the kidneys. Apparently, changes in blood flow in the renal cortex of neurogenic or humoral origin play a certain role in the pathogenesis of this condition. Harbingers of the onset of hepatorenal syndrome are gradually increasing oliguria and azotemia. Hepatorenal syndrome is usually distinguished from acute tubular necrosis by a low concentration of sodium in the urine and the absence of significant changes in sediment, but it is much more difficult to differentiate it from prerenal AKI. In doubtful cases, the reaction of the kidneys to the replenishment of the volume of blood volume helps - if renal failure does not respond to an increase in the volume of blood volume, it almost always progresses and leads to death. Developing in the terminal stage arterial hypotension can cause tubulonecrosis, which further complicates the clinical picture.
Treatment
. The underlying cause of kidney failure must be treated. Urgent health care may be required in case of serious damage; it consists of surgery to restore damaged tissue, intravenous administration fluids to completely reverse dehydration, and blood transfusions for severe blood loss. . Surgery may be necessary to stop the urinary tract blockage. . Diuretics may be prescribed to reduce fluid accumulation and increase urine production. . There are many measures that are important for full recovery after treatment. urgent assistance. For example, you may need to limit your fluid intake. . Antibiotics may be prescribed to treat associated bacterial infections; they must be taken for the entire prescribed period. . Blood pressure lowering medications may be prescribed for high blood pressure. . Glucose, sodium bicarbonate, and other substances may be given intravenously to maintain proper levels of these substances in the blood until kidney function is restored. Temporary dialysis, a process of artificially filtering the blood, may be necessary until kidney function is restored. There are several types of dialysis. In hemodialysis, blood is pumped from the body to an artificial kidney, or dialyzer, where it is filtered and then returned to the body. Hemodialysis is usually performed for three to four hours three times a week. The first hemodialysis is carried out for two to three hours for two days in a row. . Peritoneal dialysis is rarely used for acute renal failure. In this procedure, a catheter is inserted into the abdomen and a special fluid called dialysate is pumped through the peritoneum (the membrane lining the abdominal cavity) to remove contaminants from the blood. If necessary, peritoneal dialysis should be performed for 24 hours a day. . Attention! Call your doctor right away if you have symptoms of acute kidney failure, including decreased urine production, nausea, shortness of breath, and swollen ankles.Prevention
Treatment of an illness that may cause acute renal failure.
Chronic renal failure (CRF)- impaired renal function, caused by a significant decrease in the number of adequately functioning nephrons and leading to self-poisoning of the body with products of its own vital activity.
Chronic kidney failure occurs when both kidneys gradually stop functioning. The kidneys contain numerous tiny structures (glomeruli) that filter waste from the blood and store it in the blood. large substances, such as proteins. Unnecessary substances and excess water accumulate in bladder and then excreted as urine. In chronic renal failure, the kidneys are gradually damaged over many months or years. Because the kidney tissue is destroyed as a result of damage or inflammation, the remaining healthy tissue compensates for her work. The extra work puts previously undamaged parts of the kidneys under strain, causing more damage until the entire kidney fails to function (a condition known as end-stage renal failure).
The kidneys have a large margin of safety; more than 80 to 90 percent of the kidney may be damaged before symptoms appear (although symptoms may appear sooner if the weakened kidney is subjected to sudden stress, such as infection, dehydration, or use of a drug that damages the kidneys). As excessive amounts of fluid, minerals such as potassium, acids and waste accumulate in the body, chronic kidney failure becomes a life-threatening disease. However, if the underlying disease is treated and further kidney damage can be controlled, the onset of end-stage renal disease may be delayed. End-stage kidney failure is treated with dialysis or a kidney transplant; any of these methods can prolong life and allow a person to lead a normal life.
The development of chronic renal failure can be caused by various diseases and renal dysfunction. These include chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney disease, renal tuberculosis, amyloidosis, as well as hydronephrosis due to the presence of various kinds of obstacles to the outflow of urine.
In addition, chronic renal failure can occur not only due to kidney disease, but also for other reasons. Among them are diseases of the cardiovascular system - arterial hypertension, renal artery stenosis; endocrine system - diabetes mellitus and diabetes insipidus, hyperparathyroidism. CRF can be caused by systemic diseases connective tissue- systemic lupus erythematosus, scleroderma, etc., rheumatoid arthritis, hemorrhagic vasculitis.
Causes
. Diabetes mellitus and hypertension are the most common causes of chronic kidney failure. . Primary kidney diseases such as acute and chronic glomerulonephritis, polycystic kidney disease, or recurrent kidney infections can lead to chronic kidney failure. . High blood pressure can cause kidney damage or be caused by kidney damage. . If left untreated, a tumor, kidney stones or enlarged prostate can block the urinary tract, impair the flow of urine and thus cause kidney damage. . Long term use large doses Non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen can lead to chronic renal failure. . Poisoning from heavy metals such as cadmium, lead, mercury or gold can lead to kidney failure. . Some antibiotics, antifungals, and immunosuppressants can damage the kidney and lead to kidney failure. . Contrast agents used in some types of X-rays can cause kidney failure in patients whose kidneys have been damaged. . Patients who have had one kidney removed are more vulnerable to complications from kidney damage than people who have both kidneys.It should be noted that, regardless of the cause, chronic renal failure is associated, on the one hand, with a decrease in the number of active nephrons and, on the other hand, with a decrease in working activity in the nephron. External manifestations of chronic renal failure, as well as laboratory signs renal failure, begin to be detected with the loss of 65-75% of nephrons. However, the kidneys have amazing reserve capabilities, because the body’s vital activity is maintained even if 90% of the nephrons die. Compensation mechanisms include increased activity of surviving nephrons and adaptive restructuring of the work of all other organs and systems.
The ongoing process of nephron death causes a number of disorders, primarily of a metabolic nature, on which the patient’s condition depends. These include disorders of water-salt metabolism, retention in the body of waste products, organic acids, phenolic compounds and other substances.
Symptoms
. Frequent urination, especially at night; excreting only small amounts of urine. . General bad feeling. . Symptoms of end-stage kidney failure resulting from the buildup of waste in the blood (uremia): swelling of the ankles or tissue around the eyes due to fluid buildup; shortness of breath due to fluid accumulation in the lungs; nausea and vomiting; loss of appetite and weight; frequent hiccups; bad smell from mouth; chest and bone pain; itching; yellowish or brownish tint to pale skin; tiny white crystals on the skin; unexplained bruising or bleeding, including bleeding gums; cessation of menstruation in women (amenorrhea); fatigue and drowsiness; confusion; muscle spasms or cramps; loss of consciousness.A characteristic feature CRF is an increase in the volume of urine excreted - polyuria, which occurs even in the early stages with primary damage to the tubular part of the nephron. In this case, polyuria is constant even with limited fluid intake.
Disorders of salt metabolism in chronic renal failure primarily affect sodium, potassium, calcium, and phosphorus. Sodium excretion in urine can be either increased or decreased. Potassium is normally excreted primarily by the kidneys (95%), therefore, with chronic renal failure, potassium can accumulate in the body, despite the fact that the intestines take over the function of removing it. Calcium, on the contrary, is lost, so there is not enough of it in the blood during chronic renal failure.
In addition to water-salt imbalance in the mechanism of development of chronic renal failure important belongs to the following factors:
Violation of the excretory function of the kidneys leads to the retention of nitrogen metabolism products (urea, uric acid, creatinine, amino acids, phosphates, sulfates, phenols), which are toxic to all organs and tissues and, primarily, to the nervous system;
Violation of the hematopoietic function of the kidneys causes the development of anemia;
The renin-angiotensin system is activated and arterial hypertension is stabilized;
The acid-base balance in the blood is disturbed.
As a result, deep dystrophic disorders occur in all organs and tissues.
It should be noted that the most common direct cause of chronic renal failure is chronic pyelonephritis.
With asymptomatic chronic pyelonephritis, chronic renal failure develops relatively late (20 or more years after the onset of the disease). Less favorable is the cyclical course of bilateral chronic pyelonephritis, when full-blown manifestations of renal failure appear 10-15 years later, and its early signs in the form of polyuria occur 5-8 years after the onset of the disease. Important role belongs to the timely and regular treatment of the inflammatory process, as well as the elimination of its immediate cause, if possible.
Chronic renal failure caused by chronic pyelonephritis is characterized by an undulating course with periodic deterioration and improvement of renal function. Deterioration, as a rule, is associated with exacerbations of pyelonephritis. Improvements occur after complete treatment of the disease with restoration of impaired urine outflow and suppression of activity infectious process. Arterial hypertension aggravates renal dysfunction in chronic pyelonephritis, which often becomes a factor determining the intensity of nephron death.
Urolithiasis also leads to the development of chronic renal failure, usually with late or inadequate treatment, as well as with concomitant arterial hypertension and pyelonephritis with frequent exacerbations. In such cases, chronic renal failure develops slowly, within 10-30 years from the onset of the disease. However, in special forms of urolithiasis, for example, coral kidney stones, the death of nephrons is accelerated. The development of chronic renal failure in urolithiasis is provoked by repeated stone formation, a large stone, its long-term presence in the kidney with hidden current diseases.
At any rate of development, chronic renal failure sequentially passes through a number of stages: latent, compensated, intermittent and terminal. The main laboratory indicator separating one stage from another is the clearance of endogenous (own) creatinine, which characterizes the glomerular filtration rate. Normal creatinine clearance is 80-120 ml per minute.
The latent stage of chronic renal failure is detected when glomerular filtration rate (based on creatinine clearance) decreases to 60-45 ml/min. During this period, the main clinical signs of chronic renal failure are polyuria and nocturia - discharge more urine at night rather than during the day. Maybe lung development anemia. Patients usually do not present any other complaints or note increased fatigue, weakness, and sometimes dry mouth.
The compensated stage is characterized by a decrease in glomerular filtration to 40-30 ml/min. There are also complaints of weakness, drowsiness, increased fatigue, and apathy. Daily urine output usually reaches 2-2.5 liters; increased sodium excretion in the urine may begin, as well as changes in phosphorus-calcium metabolism with the development of the first signs of osteodystrophy. In this case, the level of residual nitrogen in the blood corresponds to upper limits norms.
The intermittent stage is characterized by an undulating course with alternating periods of deterioration and clear improvement after full treatment. The glomerular filtration rate is 23-15 ml/min. The level of residual nitrogen in the blood is persistently increased. Patients constantly complain of weakness, sleep disturbances, and increased fatigue. A typical symptom is anemia.
The terminal stage is characterized by intoxication of the body with its own nitrogenous waste - uremia. The glomerular filtration rate is 15-10 ml/min. Typical signs are itchy skin, bleeding (nasal, uterine, gastrointestinal, subcutaneous hemorrhages), “uremic gout” with joint pain, nausea, vomiting, loss of appetite, even aversion to food, diarrhea. The skin is pale, yellowish, dry, with traces of scratching and bruises. The tongue is dry, brown in color, and a specific sweetish “uremic” odor emanates from the mouth. For the most part, these symptoms arise because other organs, for example, the skin, gastrointestinal tract, etc., try to take over the function of the kidneys to eliminate nitrogenous waste and cannot cope with it.
The whole body suffers. Imbalance of sodium and potassium, persistent high blood pressure and anemia lead to deep damage to the heart. With an increase in the amount of nitrogenous waste in the blood, symptoms of damage to the central nervous system increase: convulsive muscle twitching, encephalopathy, up to uremic coma. Uremic pneumonia may develop in the lungs at the terminal stage.
Disorders of phosphorus-calcium metabolism cause leaching of calcium from bone tissue. Osteodystrophy develops, which is manifested by pain in bones, muscles, spontaneous fractures, arthritis, compression of the vertebrae and skeletal deformation. Children's growth stops.
There is a decrease in immunity, which significantly increases the body's susceptibility to bacterial infections. One of the most common causes of death in patients with end-stage chronic renal failure is purulent complications, up to sepsis, caused by opportunistic bacteria, such as intestinal daddy.
Diagnostics
. Medical history and physical examination. . Blood and urine tests. . Ultrasound examination, computed tomography or magnetic resonance examination of the abdominal area. . A kidney biopsy may be done. Under local anesthesia, the doctor inserts a needle into the kidney through the back to remove a small sample of tissue for analysis under a microscope.Treatment
. Diets low in salt, protein, phosphorus, limited fluid intake, and vitamin supplements may be recommended. . Surgery may be necessary to stop the blockage in the urinary tract. . Blood pressure lowering medications may be prescribed for high blood pressure. . Medicines to treat congestive heart failure may be needed. . Anemia due to kidney disease can be treated with erythropoietin, a medicine that stimulates the formation of blood cells. . Sodium bicarbonate is prescribed to combat excessive accumulation of acids in the body (renal acidosis). . Calcium phosphate binder and vitamin D supplements are given to prevent secondary hyperparathyroidism, which can lead to further kidney damage. . Dialysis, the process of artificially filtering blood, may be necessary when much of the kidney's function is not being performed. There are several types of dialysis. In hemodialysis, blood is pumped from the body to an artificial kidney, or dialyzer, where it is filtered and then returned to the body. . Hemodialysis should be performed for 9-12 hours weekly (usually in three sessions). . Another method is peritoneal dialysis. There are two types of peritoneal dialysis. In continuous outpatient peritoneal dialysis, the patient has two to three liters of a sterile solution infused into the peritoneum through a catheter, four to five times a day, seven days a week. Automated peritoneal dialysis uses a mechanism to automatically infuse sterile fluid through a catheter into the peritoneum while the patient sleeps. This process usually takes 9 to 12 hours a day. . In case of end-stage renal failure, the patient is offered a kidney transplant as an alternative to dialysis. Most patients who undergo transplantation have longer duration life compared to patients undergoing dialysis. A successful transplant can cure kidney failure, but potential donors must be carefully screened for compatibility; the best donors are usually family members, but spouses and friends who wish to become donors can also be tested. Kidney donor recipients must take immunosuppressants to prevent transplant rejection. . Attention! Call your doctor if you experience decreased urination, nausea and vomiting, swelling around the ankles, shortness of breath, or any other signs of chronic kidney failure.In the initial stages treatment of chronic renal failure coincides with the treatment of the underlying disease, the goal of which is to achieve stable remission or slow down the progression of the process. If there are obstacles to the outflow of urine, it is optimal to remove them surgically. In the future, against the backdrop of continued treatment of the underlying disease, a large role is given to the so-called symptomatic remedies- antihypertensive (pressure-lowering) drugs ACE inhibitors(capoten, enam, enap) and calcium antagonists (cordarone), antibacterial, vitamin agents.
An important role is played by dietary restrictions on protein foods - no more than 1 g of protein per kilogram of the patient’s weight. Subsequently, the amount of protein in the diet is reduced to 30-40 g per day (or less), and with a glomerular filtration level of 20 ml/min, the amount of protein should not exceed 20-24 g per day. Table salt also limited to 1 g per day. However, the calorie content of the diet should remain high - depending on the patient’s weight, from 2200 to 3000 kcal (a potato-egg diet without meat and fish is used).
Iron supplements and other medications are used to treat anemia. When diuresis decreases, it is stimulated with diuretics - furosemide (Lasix) in doses of up to 1 g per day. In a hospital setting, in order to improve blood circulation in the kidneys, intravenous drip-concentrated solutions of glucose, hemodez, rheopolyglucin with the introduction of aminophylline, chimes, trental, and papaverine are prescribed. Antibiotics are used with caution in chronic renal failure, reducing doses by 2-3 times; aminoglycosides and nitrofurans are contraindicated in chronic renal failure. For detoxification purposes, gastric lavage, intestinal lavage, and gastrointestinal dialysis are used. The washing liquid can be a 2% solution of baking soda or solutions containing sodium, potassium, calcium, magnesium salts with the addition of soda and glucose. Gastric lavage is performed on an empty stomach, using a gastric tube, for 1-2 hours.
In the terminal stage, the patient is indicated for regular (2-3 times a week) hemodialysis - an artificial kidney machine. The appointment of regular hemodialysis is necessary when the level of creatinine in the blood is more than 0.1 g/l and its clearance is less than 10 ml/min. Kidney transplantation significantly improves the prognosis, however, in the terminal stage, poor organ survival is possible, so the issue of transplanting a donor kidney should be decided in advance.
Prevention
. Treatment potential possible reasons(especially drug therapy for high blood pressure and careful control of diabetes) may prevent or delay the development of chronic kidney failure.Prognosis of chronic renal failure
The prognosis of chronic renal failure has recently become less fatal due to the use of hemodialysis and kidney transplantation, but the life expectancy of patients remains significantly lower than the population average.
Kidney failure in humans is a pathology of the kidneys, in which they completely stop producing urine or partially lose this ability.
Without treatment, the disease progresses and leads to fatal outcome. Unfortunately, in the initial stages the disease manifests itself weakly, so many people turn to the doctor when it is no longer possible to restore the functioning of the organ.
What is kidney failure: symptoms, treatment with traditional and traditional methods– the article will tell you about all this.
There are 2 degrees of renal failure: chronic and acute.
In the acute form, the function of the organ is disrupted suddenly, but this condition is reversible if treatment is started in time.
Statistics say that the incidence of this type of deficiency reaches 200 cases per 1 million population.
Half of them need . Since the 1990s, there has been a steady trend towards an increase in the number of patients with renal pathology. The acute form becomes not a single-organ disease, but part of the multiple organ failure syndrome.
No treatment sharp look failure progresses to the chronic stage. In this case, over the course of several years, the patient experiences an alternation of exacerbations and remissions. The chronic form is characterized by a gradual ability to form urine and excrete it. Develops as a result of the slow death of nephrons. According to statistics, the prevalence of this disease is 450 cases per 1 million population.
Depending on the pathogenesis, renal failure is divided into the following types:
Causes
Kidney failure has various causes.
The acute form most often develops as a result of:
- acute poisoning household chemicals, lead compounds, food industry products, medicines. Bites from poisonous insects and snakes can also lead to serious illness;
- injury:
- a sharp decrease in blood circulation in the vessels of the kidneys during collapse, thrombosis, shock, embolism of the renal artery, pathological heart function. Renal heart failure may develop;
- sudden blockage of the urinary tract by a tumor or stone.
- acute inflammatory process in the kidneys. For example, with pyelonephritis, glomerulonephritis;
- infectious diseases that occur with renal syndrome.
Chronic deficiency is caused by the following reasons:
- vascular disorders that are accompanied by abnormal renal blood flow. For example, a group of hemorrhagic vasculitis, rheumatism and lupus erythematosus;
- long-term course of hypertension;
- long-term inflammatory processes in the kidneys, which lead to the destruction of tubules and glomeruli. Typically, pyelonephritis and glomerulonephritis lead to organ failure;
- metabolic disorders that occur with gout, amyloidosis and diabetes;
- conditions in which the flow of urine is disrupted. For example, tumors of the pelvis;
- congenital abnormalities of the structure and function of the kidneys, which lead to the fact that the renal structures do not function fully. This is underdevelopment, polycystic disease, narrowing of the arteries of the kidneys;
- late diagnosis acute course insufficiency.
Kidney failure in diabetes mellitus occurs due to excess weight, so obese people often try to lose a couple of kilograms with the help of the hypoglycemic drug Metformin. If you take this drug incorrectly, kidney problems may develop as a side effect.
It is best to use glucose-lowering medications after consulting a doctor.Symptoms
When an organ is affected, signs appear indicating failure of either complete absence its functions.
The main symptom of the development of the acute form is a sharp reduction in the volume of urine per day.
With oliguria, less than 400 milliliters of urine comes out. When anuria occurs, the daily volume of urine does not exceed 50 milliliters.
There is also a decrease in appetite, nausea and vomiting appear, which does not bring relief. The patient becomes drowsy and lethargic, and is constantly suffering from shortness of breath.
As a result of changes in water-salt metabolism, pathological disorders of the heart and blood vessels appear. The skin turns pale, sagging, and becomes dry. The muscles also weaken and quickly lose tone. The face swells, the hair splits and breaks. From oral cavity felt bad smell ammonia. Excess fluid begins to be eliminated through the intestines and stomach. The stool is liquid, dark in color, and foul-smelling. Swelling appears and grows rapidly.
Patients often experience disturbances of consciousness
The kidneys remove substances neutralized by the liver from the blood. In case of acute deficiency, all metabolites are not released, but continue to circulate throughout the body, including in the brain. Therefore, the patient often experiences disturbances of consciousness: clouding, stupor, coma. The mood changes: a depressive state occurs, euphoria.
Organ failure chronic manifests itself not only as a disorder of diuresis, but also as a violation of all kidney functions.
Signs of chronic kidney failure are as follows:
- persistent increase in blood pressure;
- the skin turns pale as a result of decreased hemoglobin;
- osteoporosis;
- heart rhythm is disturbed: arrhythmia, tachycardia.
The disease in children usually progresses more rapidly than in adults. This is due to the anatomical and physiological characteristics of the young organism.
You need to carefully monitor your child and, at the slightest suspicion, go to the doctor.Complications
Patients with kidney failure can experience serious complications if not treated correctly.
Pay attention to changes in urinary output. Both acute and chronic forms of renal failure are often accompanied by an increase or decrease in diuresis. In particular, chronic renal failure is accompanied by urinary incontinence and/or recurrent urinary tract infections. Damage to the renal tubules leads to polyuria. Polyuria is excessive urine production that usually occurs in the early stages of kidney failure. Chronic renal failure can also cause a decrease in daily urine output, which usually occurs in more advanced forms of the disease. Other changes include the following:
- Proteinuria: In kidney failure, protein leaks into the urine. The presence of protein causes the urine to foam.
- Hematuria: Dark orange urine results from the presence of red blood cells in the urine.
Watch out for sudden feelings of tiredness. One of the first signs of chronic kidney failure is fatigue. This occurs due to anemia, when the body does not have enough oxygen-carrying red blood cells. The decrease in oxygen will make you feel tired and cold. Anemia is attributed to the fact that the kidneys produce a hormone called erythropoietin, which causes your Bone marrow produce red blood cells. But because the kidneys are damaged, they produce less of this hormone, therefore, less red blood cells are also produced.
Note swelling of body parts. Edema is an accumulation of fluid in the body, which can occur in both acute and chronic renal failure. When the kidneys stop working properly, fluid begins to accumulate in the cells, which leads to swelling. Swelling most often occurs in the hands, feet, legs and face.
Call your doctor if you experience dizziness or slow thinking. Dizziness, poor concentration, or lethargy may be caused by anemia. This is because there aren't enough blood cells getting to your brain.
Pay attention to pain in the upper back, legs, or side. Polycystic kidney disease causes fluid-filled cysts to form in the kidneys. Sometimes cysts can form in the liver. They cause severe pain. The fluid in cysts contains toxins that can cause harm. nerve endings V lower limbs and lead to neuropathy, dysfunction of one or more peripheral nerves. In turn, neuropathy causes pain in the lower back and legs.
Monitor for shortness of breath, bad breath, and/or a metallic taste in the mouth. When your kidneys start to fail, final products metabolism, most of which are acidic, will begin to accumulate in the body. The lungs will begin to compensate for this increased acidity by removing carbon dioxide through rapid breathing. This will make you feel like you can't catch your breath.
Please note if you suddenly start itching or experience dry skin. Chronic renal failure causes pruritis ( medical term skin itching). This itching is caused by the accumulation of phosphorus in the blood. All food products contain some phosphorus, but some foods, such as dairy, contain more phosphorus than others. Healthy kidneys are able to filter and remove phosphorus from the body. However, with chronic renal failure, phosphorus is retained in the body and phosphorus crystals begin to form on the surface of the skin, which cause itching.
This pathological condition can be characterized as serious illness organ genitourinary system, which leads to disturbances in acid-base, osmotic and water-salt homeostasis. The disease affects all processes that occur in the body, which ultimately leads to secondary damage.
What is kidney failure
There are two main paths of the disease, the result of which will be either complete loss of kidney function or ESRD. Kidney failure is a syndrome that causes problems with the functioning of the kidneys. The disease is main reason disorders of most types of metabolism in the human body, including nitrogen, water or electrolyte. The disease has two forms of development - chronic and acute, as well as three stages of severity:
- risk;
- damage;
- failure.
Causes of kidney failure
Based on reviews from doctors, the main causes of kidney failure in people affect only two areas - high blood pressure and diabetes. In some cases, the disease may occur due to heredity or be suddenly triggered by unknown factors. Such patients seek help from the clinic in very advanced cases, when it is extremely difficult to establish the source and cure the disease.
Stages of kidney failure
Chronic illness kidney disease is observed in five hundred out of a million patients undergoing treatment, however, this figure is steadily growing every year. As a result of the disease, there is a gradual death of tissue and the loss of all its functions by the organ. Medicine knows four stages of chronic renal failure that accompany the course of the disease:
- The first stage proceeds almost unnoticed; the patient may not even be aware of the development of the disease. For latent period characterized by increased physical fatigue. The disease can only be detected when biochemical research.
- At the compensated stage, there is an increase in the number of urinations against the background general weakness. The pathological process can be detected by the results of blood tests.
- The intermittent stage is characterized by a sharp deterioration in kidney function, which is accompanied by an increase in the concentration of creatinine and other products of nitrogen metabolism in the blood.
- According to etiology, end-stage renal failure causes irreversible changes in the functioning of all body systems. The patient feels constant emotional instability, lethargy or drowsiness, appearance deteriorates, and appetite disappears. Consequence last stage CRF is uremia, aphthous stomatitis or dystrophy of the heart muscle.
Acute renal failure
The reversible process of kidney tissue damage is known as acute renal failure. AKI can be determined by referring to symptoms of kidney failure in a person, which are expressed by complete or partial cessation of urination. The constant deterioration of the patient's condition at the terminal stage is accompanied by poor appetite, nausea, vomiting and other painful manifestations. The causes of the syndrome are the following factors:
- infectious diseases;
- renal condition;
- decompensated renal hemodynamic disorder;
- urinary tract obstruction;
- exogenous intoxications;
- acute diseases kidney
Chronic renal failure
Chronic renal failure gradually leads to a complete loss of the ability to function for this organ, causing shrinkage of the kidney, death of nephrons and complete replacement of its tissues. Being at the terminal stage of the disease, the patient’s body begins to refuse to excrete urine, which affects the electrolyte composition of the blood. Damage to the glomeruli can occur due to a number of reasons, the most common of which are:
- systemic lupus erythematosus;
- tumors;
- chronic glomerulonephritis;
- hydronephrosis;
- gout;
- urolithiasis disease;
- amyloidochronic pyelonephritis;
- diabetes;
- arterial hypertension;
- polycystic disease;
- hemorrhagic vasculitis;
- underdevelopment of the kidneys;
- scleroderma;
Kidney failure - symptoms
In order to figure out how to treat kidney failure, it is first worth studying the basic symptoms of chronic renal failure. At first, it is problematic to independently identify the disease, although timely medical intervention can reverse the development of dangerous pathological processes, eliminating the need for surgery. Mostly patients complain of symptoms of renal failure such as severe swelling, high blood pressure or pain syndrome.
First signs of kidney failure
The syndrome of kidney dysfunction has a gradual stage of development, so each stage is characterized by more pronounced manifestations of the disease. The first signs of kidney failure are considered to be weakness or fatigue without good reason, refusal to eat, and problems sleeping. In addition, you can check for the presence of the disease based on the frequency of urination at night.
Kidney failure - symptoms in women
Disturbances in the functioning of the kidneys can cause the most different manifestations depending on what stage pathological process there is a patient. Symptoms of kidney failure in women manifest themselves in a special, specific way. First alarm signal serves as emotional instability caused by a deficiency of the substance progesterone in the body. Against this background, a number of complications associated with the functioning of the genitourinary system are actively developing.
Kidney failure - symptoms in men
The syndrome affects the body in the early stages of its appearance, therefore, how to determine kidney failure and what to do can be found out by comparing some key facts. Symptoms of kidney failure in men are practically no different from the reactions of other groups of patients. On initial stages characteristic: decreased urination, diarrhea, loss of appetite, itchy skin, clearly visible signs of a nervous system disorder.
Kidney failure in children - symptoms
Kidney problems rarely affect young children, but if action is not taken in time, inaction can cause death. Symptoms of renal failure in children are no different from the course of the disease in adult patients. In addition to general malaise, the child feels nausea, his temperature rises, and in some cases swelling is detected. Such children often go to the toilet, but the amount of urine excreted is not normal. Analyzes allow us to diagnose the following picture:
- stones in the kidneys;
- cough;
- increased amount of protein in the urine;
- decreased muscle tone;
- tremor;
- skin acquire a yellow tint.
Kidney failure - diagnosis
The main sign of the presence of severe pathology in a patient is not only a decrease in the frequency of urination, but also the presence increased amount potassium or nitrogenous compounds in the blood. Diagnosis of renal failure is carried out in several stages, the condition of the kidneys is assessed according to the diagnosis based on the results of the Zimnitsky test. The main indicators of treatment effectiveness are:
- biochemical blood monitoring;
- Biopsy;
- Doppler ultrasound of blood vessels.
Kidney failure - treatment
During therapy, the main cause of pathogenesis is eliminated using modern medications. The recovery process includes replenishing the missing blood volume and normalizing blood pressure in case of a shock reaction in the patient. Treatment of renal failure during the period of nephrotoxin poisoning consists of washing the intestines and stomach from toxins; for these purposes the following is often used:
- plasmapheresis;
- nephroprotective treatment;
- hemodialysis;
- hemoperfusion;
- peritoneal dialysis;
- hemosorption.
Treatment of kidney failure - drugs
Treatment of such a serious disease must be supported by appropriate medical intervention, for example, insulin drugs. Most of the existing diuretics, when taken uncontrolled, can be harmful to human health, so the use of therapeutic substances is possible only under the strict supervision of a specialist. The most effective drugs for the treatment of kidney failure can be divided into a separate category of drugs:
- Trimetazidine;
- Lisinopril;
- Desferal;
- Sulodexide;
- Eufillin;
- Hypothiazide;
- Digoxide;
- Ramipril;
- Chime;
- Glurenorm;
- Enalapril;
- Metoprolol;
- Deferoxamine;
- Propranolol;
- Dopamine.
Kidney failure - treatment with folk remedies
Some people follow natural therapies, so treating kidney failure folk remedies allows the use of only the gifts of nature. With the help of medicinal plants, fruits or vegetables, special decoctions are prepared to relieve a person of this ailment. The most effective folk therapy methods are the use of burdock, pomegranate juice and corn silk. There are other useful ingredients to treat:
- seaweed;
- echinacea tincture;
- Dill seeds;
- horsetail.
Kidney failure during pregnancy
While carrying a child, the pregnant mother's body is subjected to an additional degree of stress, which is why all its systems are forced to work in increased mode. Sometimes the main cause of kidney failure during pregnancy is a malfunction of certain organs. These diseases threaten the health of the woman and her unborn child, so childbirth in such circumstances is impossible. The only exceptions are those cases when the disease was promptly eliminated in the early stages of diagnosis.
Prevention of kidney failure
Timely treatment diseases such as chronic pyelonephritis and glomerulonephritis will help prevent further complications, and regular adherence to the doctor’s recommendations will ensure the preservation of the functionality of the genitourinary system. Prevention of kidney failure is used for any category of patients, no matter what stage of the disease they are at. Simple rules, including following a diet, adjusting the water-salt balance and using medications will help prevent the development of the disease.
Video: kidney failure symptoms and treatment
