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Saturday, 08.08.2020, 06:44
Main » Urology » Chronic renal failure - Diagnosis, Causes, Treatment 
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Chronic renal failure - Diagnosis, Causes, Treatment


Chronic renal failure - Diagnosis, Causes, Treatment

Chronic renal failure - a gradual decline in renal function prior to its extinction, caused by the progressive loss of renal tissue due to chronic kidney disease. Chronic renal failure occurs in one out of 200-500 million people. Currently, the number of patients with chronic renal failure increases annually by 10-12%.


The causes of chronic renal failure may be a variety of diseases that lead to the defeat of the renal glomeruli. They are:
  • kidney disease - chronic glomerulonephritis, chronic pyelonephritis
  • metabolic disorders - diabetes, gout, amyloidosis
  • congenital kidney disease - cystic disease, renal hypoplasia, a congenital narrowing of the renal arteries
  • rheumatic diseases - systemic lupus erythematosus, scleroderma, vasculitis hemorrhagic.
  • vascular disease - hypertension, diseases that lead to a breach of renal blood flow
  • diseases that lead to a breach of the outflow of urine from the kidneys - kidney stones, hydronephrosis, tumors, leading to a gradual compression of the urinary tract. The most common causes of chronic renal failure are chronic glomerulonephritis, chronic pyelonephritis, diabetes and congenital anomalies of the kidneys.




At the heart of the development of chronic renal failure is always a gradual loss of primary production units kidney - nephron. The remaining nephrons of the kidneys have to work with the increased load. Nephrons, working with high load, in turn, also are more prone to change, and death. Despite the fact that the compensatory potential of high renal (even the remaining 10% of nephrons are able to maintain water and electrolyte balance in the body), in the early stages of chronic kidney failure lead to abnormalities in electrolyte composition of blood acidosis (acidification), violated the exchange of the protein in the body, delayed metabolites: urea, creatinine, uric acid. To date, identified more than 200 substances, which are sharing in the body is disturbed in renal failure.

There are four stages of chronic renal failure

Latent stage. At this stage the patient may not complain or appear during physical exertion fatigue, weakness, appearing in the evening, dry mouth. For biochemical analysis of blood reveals a small violation of the electrolyte composition of blood and sometimes protein in the urine.

Compensated stage. At this stage, patients' complaints are the same, but they occur more frequently. Is accompanied by an increase in urine output to 2.5 liters per day. Detected changes in the biochemical indices of blood and urine.
Intermittent phase. The work of the kidneys is reduced even further. There is a persistent increase in blood products of nitrogen metabolism (exchange protein) - raising the level of urea, creatinine. The patient has there weakness, fatigue, thirst, dry mouth, appetite decreased dramatically. The skin takes on a yellowish tint, it becomes dry. The patient may be much heavier than usual flow respiratory diseases, tonsillitis, pharyngitis. In this stage can be expressed in periods of improvement and deterioration in the patient's condition.

The terminal (final) stage. The filtration ability of the kidneys decreases to a minimum. The patient may feel satisfactorily for several years, but at this stage in the blood is constantly increased the amount of urea, creatinine, uric acid, disturbed electrolyte composition of blood. All this causes uremic toxicity or uremia (uremia - the urine in the blood). Number of urine per day is reduced to its complete absence. Affected other organs. There is a degeneration of the heart muscle, pericarditis, circulatory failure, pulmonary edema. Disorders of the nervous system are manifested symptoms of encephalopathy (sleep disturbance, memory, mood, the emergence of depressive states). Disrupted hormone production, changes occur in the coagulation of blood, impaired immunity. All these changes are irreversible. Nitrogenous waste products are excreted in sweat, and the patient's urine smell ever.

The diagnosis of chronic renal failure if the disease duration of more than 5 years, in blood and urine, there are characteristic changes. Be sure to try to find out the cause that led to the emergence of chronic renal failure.

Treatment of chronic renal failure. The first step is treatment of the underlying disease, which led to kidney failure.

Conservative treatment of chronic renal failure is aimed at slowing its progression. Assigned to work and rest, diet, medication. The patient should avoid high physical loads. Timely rest. Need to stick to a diet with reduced consumption of protein. Out of drugs used anabolic steroids (retabolil, nerabol) lespenefril.

In end-stage renal disease, conservative methods do not give a positive result, and for the removal of the patient's blood accumulated products of metabolism using hemodialysis. Blood is taken from one of the superficial vessels of the upper or lower limbs, passed through a special system in which the blood through an artificial membrane in contact with the dialysate. Due to the difference of concentrations in this solution and blood, a substance from the patient's blood pass into the solution. The purified blood is returned to another vessel on a limb patients. In the week is held 3 sessions of dialysis. One session lasting 4-5 hours. The use of dialysis increased the duration of life of patients with chronic renal insufficiency up to 25 years.

But the radical method of treatment of chronic renal failure is still a kidney transplant


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