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Acute renal failure - Causes and Treatment
Acute renal failure, causes, stages, treatment and prognosis of the disease of acute renal failure.
Acute renal failure is a sudden stop or sudden decrease in the function of both kidneys or a solitary kidney. In this case violated all the functions of the kidneys:
Filtration
excretory
secretory.
The causes of renal failure is divided into three groups:
Causes of the entire body: illness and injury, leading to prolonged bleeding, resulting in dramatically reduced the pressure in the arteries of the kidneys and stop their work. To acute renal failure can result in severe injury, burns a large area of the body, electric shock, sepsis, allergic shock. Lack of blood supply to the kidney leads at first simply to a reduction of renal tissue cells, and then to death. The same result can cause a large loss of water when uncontrollable vomiting, uncontrolled use of diuretic drugs in diseases of the intestine is accompanied by prolonged diarrhea. If water shortages are not filled on time, in the kidneys, irreversible necrotic changes
Toxic effects on the kidneys of various substances - salts of mercury, cadmium, copper, acetic acid, poisonous mushrooms, fertilizer. To kidney damage can result uncontrolled use of some drugs - drugs from the group of sulfonamides, some antibiotics, anticancer drugs. Toxic substances affect cells of the renal tissue and the cells die. Renal function is terminated.
Infrarenal reasons. This causes the part of lower urinary tract. To acute renal failure can cause an acute blockage of the urinary tract of both or only one kidney stone, blood clot or compression of the urinary tract trauma or malignancy, with compression of the ureter during surgery on the abdominal cavity. The accumulation of urine in pyelocaliceal renal system causes an increase in pressure in it. With long-term existence of high-pressure edema, and later necrosis (death) of renal tissue. Usually, this occurs more slowly renal failure and possibly reverse the development of its recovery with timely flow of urine.
In acute renal failure the kidneys lose their ability to maintain a balance of electrolyte composition of the blood, increases the amount of potassium, calcium, chloride, accumulate in the blood products of protein metabolism - urea, creatinine. Due to violations of the secretory function of the kidneys occurs anemia (decrease in red blood cells), decreased platelet count, coagulation responsible for the ability of the blood. One of the earliest manifestations of acute renal failure is usually oliguric (decrease in urine) and anuria (no urine). The patient's condition worsens, it is accompanied by nausea, vomiting, diarrhea, lack of appetite, edema of limbs, increases in the volume of the liver. The patient may be inhibited, or vice versa comes excitement.
During acute renal failure is divided into four stages:
Elementary. At this stage the patient usually depends on the underlying reasons that caused kidney failure.
Oligoanuricheskaya. At this stage there is no urine or urine does not exceed 500 ml per day. This is the most dangerous stage, and if it lasts a long time the patient may fall into a coma. At this stage, the largest number of dying patients.
Diuretic phase. At this stage the amount of urine gradually increases and reaches a volume of 5 liters per day. In the blood of recovered water and electrolyte composition. The stage lasts about two weeks.
The stage of recovery. At this stage of renal function is gradually restored. To do this sometimes takes up to one year.
Treatment of acute renal failure. In the initial stages of renal failure should be treated to a disease or pathological effects, which has led to kidney failure. When a large hemorrhage are trying to compensate the loss of blood by intravenous administration of blood products. Toxic substances as soon as possible to withdraw from the body. To do this, carry out gastric lavage, apply an antidote (often unitiol that binds many toxins). Used plasmapheresis - cleaning liquid part of blood using a special apparatus. If blockage of the urinary tract, or restore them to conduct cross-puncture the kidney pelvis to remove urine. For proper treatment of acute renal failure is used osmotic diuretics (mannitol, sorbitol) in the very beginning of its occurrence. Be sure to control the amount of electrolytes and blood urea, water balance. Intravenous fluid. They are used anabolic hormones, and vitamin E. There shall be a diet. If conservative treatment does not give a positive result, hemodialysis is used.
The prognosis of acute renal failure depend largely on the underlying disease. For complete recovery of the kidneys after acute renal failure patient takes six months to two years.
