What is kidney failure symptoms in adults. Blood clotting disorder

Distinguish between acute and chronic renal failure.
Acute renal failure (ARF)- a sudden violation of kidney function with a delay in the 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. The kidneys regulate the balance chemical substances and body fluids and filter waste from the blood into the urine. Acute kidney failure can occur for a variety of reasons, including kidney disease, partial or complete blockage urinary tract and a decrease in blood volume, for example, after severe blood loss. Symptoms may develop over several days: the amount of urine excreted may decrease dramatically, and the fluid that must be excreted accumulates entirely in the tissues, causing weight gain and swelling, especially in the ankles.

Acute kidney failure is a life-threatening condition 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 kidney failure due to kidney disease can sometimes lead to chronic kidney disease, in which case the outlook for the disease depends on the ability to cure the underlying disease.

Currently, there are several etiological groups of acute renal failure.

Prerenal acute renal failure (ischemic)

- shock kidney (trauma, fluid loss, massive tissue breakdown, hemolysis, bacteremic shock, cardiogenic shock). - Loss of extracellular volume (gastroenteric loss, urinary loss, burns). - Loss of intravascular volume or its redistribution (sepsis, bleeding, hypoalbuminemia). - Decreased cardiac output (heart failure, cardiac tamponade, heart surgery). - Other causes of reduced GFR (hypercalcemia, hepatorenal syndrome).

Renal OPN.

- Exogenous intoxications (damage to the kidneys by poisons used in industry and everyday life, bites of poisonous snakes and insects, intoxication with drugs and radiopaque substances). - Acute infectious-toxic kidney with indirect and direct action on the kidneys of an infectious factor - Damage to the renal vessels (hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura, scleroderma, systemic necrotizing vasculitis, thrombosis of arteries or veins, atherosclerotic embolism in severe atherosclerosis of the main vessels - primarily aorta and renal arteries). - Open and closed kidney injuries. - Postischemic 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 a stone, pus, thrombus; urolithiasis disease, blockade of tubules by 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). - Urination retention, not caused by an organic obstruction (impaired urination in diabetic neuropathy or as a result of the use of M-anticholinergics and ganglionic blockers).

Symptoms

Passing 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 body. . Fatigue. . Abdominal pain. . Urine with blood or dark color. . End-stage symptoms in the absence successful treatment: shortness of breath due to accumulation of fluid in the lungs; unexplained bruising or bleeding; drowsiness; confusion; muscle spasms or seizures; loss of consciousness.

There are four periods in the development of acute renal failure: the period of initial action etiological factor, oligoanuric period, diuresis recovery period and convalescence.

In the first period, the symptoms of the condition leading to acute renal failure predominate. For example, observe fever, chills, collapse, anemia, hemolytic jaundice with anaerobic sepsis associated with community-acquired abortion, or a clinical picture general action one or another poison (acetic essence, carbon tetrachloride, salts of heavy metals, etc.).

The second period - the period of a sharp decrease or cessation of diuresis - usually develops soon after the action of the causative factor. Azotemia increases, nausea, vomiting appear, coma, due to the retention of sodium and water, extracellular hyperhydration develops, manifested by an increase in body weight, abdominal edema, pulmonary edema, and brain.

After 2-3 weeks, oligoanuria is replaced by a period of recovery of diuresis. The amount of urine usually increases gradually, after 3-5 days diuresis exceeds 2 l / day. First, the fluid accumulated in the body during the period of oligoanuria is removed, and then dangerous dehydration occurs due to polyuria. 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) recovery period begins.

Thus, from a clinical standpoint, the most difficult and life-threatening patient with acute renal failure is the period of oligoanuria, when the picture of the disease 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 of severe complications may be associated with inadequate treatment, primarily with uncontrolled administration of saline solutions, when sodium accumulation first causes extracellular hydration, and then intracellular overhydration, leading to coma. Severe condition often aggravated by the uncontrolled use of a hypotonic or hypertonic glucose solution, which reduces the osmotic pressure of the plasma and enhances cellular overhydration due to the rapid transition of glucose, followed by water into the cell.

During the recovery period of diuresis due to severe polyuria, there is also a risk of severe complications, primarily due to developing electrolyte disorders (hypokalemia, etc.).

The clinical picture of acute renal failure may be dominated by signs of disorders of the heart and hemodynamics, advanced uremic intoxication with severe symptoms of gastroenterocolitis, mental changes, anemia. Often, the severity of the condition is aggravated by pericarditis, respiratory failure, nephrogenic (hyperhydration) and cardiac pulmonary edema, gastrointestinal bleeding, and especially infectious complications.

To assess the severity of the condition of a patient with acute renal failure, indicators of nitrogen metabolism, primarily creatinine, the level of which in the blood does not depend on the patient's diet and therefore more accurately reflects the degree of impaired renal function, are of primary importance. Creatinine retention usually outpaces the increase in urea, 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 clinical manifestations OPN, in particular, signs of damage to the nervous system and muscles (primarily myocardium), are associated with impaired potassium metabolism. Often occurring and quite understandable hyperkalemia leads to an increase in myocardial excitability with the appearance of a high, with a narrow base and a pointed top of the T wave on the ECG, slowing 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

Diagnostics

Clarification of the etiological factors of acute renal failure allows more targeted therapeutic interventions. So, prerenal acute renal failure develops mainly with shock states characterized by severe microcirculation disorders due to hypovolemia, low central venous pressure and other hemodynamic changes; the elimination of the latter and it is necessary to direct the main therapeutic measures. Close in mechanism to these conditions are cases of acute renal failure associated with a large loss of fluid and NaCl in severe extensive lesions of the gastrointestinal tract (infections, anatomical disorders) with indomitable 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 radiopaque substances, and can also be caused by renal diseases proper (AGN 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 fight against these diseases of the kidneys. Finally, therapeutic tactics in case of postrenal acute renal failure, it mainly boils down to the elimination of an acute obstructed outflow of urine due to urolithiasis, bladder tumors, etc.

It should be borne in mind that the ratios of various causes of acute renal failure may change due to certain features of their impact on the kidneys. Currently, the main group of cases of acute renal failure is still made up of acute shock and toxic kidney damage, 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 action of nephrotoxic factors (poisoning with vinegar essence, ethylene glycol) increases acute renal failure associated with an increase in surgical interventions, especially in older people age groups, as well as using new medicines. In endemic foci, the cause of AKI may be viral. hemorrhagic fever with kidney damage in the form of severe acute tubulointerstitial nephritis.

Although a large number of works have been devoted to the study of the mechanisms of development of acute renal failure, nevertheless, the pathogenesis of this condition cannot be considered definitively elucidated.

However, it has been proven that various etiological variants of AKI are characterized by a number of common mechanisms:

Violation of the renal (especially cortical) blood flow and a drop in GFR; . total diffusion of the glomerular filtrate through the wall of the damaged tubules; . compression of the tubules by edematous interstitium; . a number of humoral effects (activation of the renin-angiotensin system, histamine, serotonin, prostaglandins, other biologically active substances with their ability to cause hemodynamic disturbances and damage to the tubules); . shunting of blood through the juxtamedullary system; . spasm, thrombosis of arterioles.

The resulting morphological changes relate mainly to 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 disorders are usually minor. It should be noted that even with the deepest 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.

With the generality developing processes the predominance of one or another link of pathogenesis determines the features of the development of acute renal failure in each of its named variants. So, in shock acute renal failure, ischemic damage to the renal tissue plays the main role, 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, and thrombotic microangiopathy predominates in hemolytic-uremic syndrome.

In some cases, acute renal failure develops as a consequence of the so-called acute hepatorenal syndrome and is caused by severe liver diseases 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 (with fulminant hepatitis or advanced cirrhosis of the liver), 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 the sediment, but it is much more difficult to differentiate it from prerenal acute renal failure. In doubtful cases, the reaction of the kidneys to the replenishment of BCC helps - if renal failure does not respond to an increase in BCC, it almost always progresses and leads to lethal outcome. Developing in the terminal stage arterial hypotension can cause tubulonecrosis, which further complicates the clinical picture.

Treatment

Prevention

Treatment of a disease that may be the cause of acute kidney 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 by the products of its own vital activity.

Chronic renal failure occurs when both kidneys gradually stop functioning. The kidneys have numerous tiny structures (glomeruli) that filter waste from the blood and store large substances such as proteins in the blood. Waste substances and excess water accumulate in the bladder and are then excreted in the form of urine. In chronic kidney failure, the kidneys are damaged gradually over many months or years. Since kidney tissue is destroyed by damage or inflammation, the remaining healthy tissue compensates for its work. The extra work overworks previously undamaged parts of the kidney, causing more damage until the entire kidney stops functioning (a condition known as end stage kidney failure).

The kidneys have a large margin of safety; more than 80-90 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 kidney-damaging drug). 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 cured 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 ways can prolong life and allow a person to lead a normal life.

Can lead to the development of CKD various diseases and disorders of the kidneys. These include chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney disease, kidney tuberculosis, amyloidosis, and hydronephrosis due to the presence of different kind obstruction to the outflow of urine.

In addition, CRF can occur not only due to kidney disease, but also for other reasons. Among them, diseases of the cardiovascular system can be noted - arterial hypertension, stenosis of the renal arteries; endocrine system - sugar and diabetes insipidus, hyperparathyroidism. The cause of CKD can be systemic diseases connective tissue - systemic lupus erythematosus, scleroderma, etc., rheumatoid arthritis, hemorrhagic vasculitis.

Causes

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 the working activity in the nephron. External manifestations of CRF, 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 vital activity of the body is preserved even with the death of 90% of the nephrons. Compensation mechanisms include an increase in the activity of the remaining nephrons and an adaptive restructuring of the work of all other organs and systems.

The ongoing process of nephron death causes a number of disorders, primarily of an exchange nature, on which the patient's condition depends. These include violations of water-salt metabolism, retention in the body of its waste products, organic acids, phenolic compounds and other substances.

Symptoms

A characteristic feature of chronic renal failure is an increase in the volume of urine excreted - polyuria, which occurs even in the early stages with predominant damage to the tubular nephron. At the same time, polyuria is permanent even with limited fluid intake.

Salt metabolism disorders in CRF primarily affect sodium, potassium, calcium, and phosphorus. The excretion of sodium in the urine can be either increased or decreased. Potassium is normally excreted mainly by the kidneys (95%), therefore, in chronic renal failure, potassium can accumulate in the body, despite the fact that the function of its excretion is taken over by the intestines. Calcium, on the contrary, is lost, so it is not enough in the blood during CRF.

In addition to water-salt imbalance in the mechanism of development of CRF importance belongs to the following factors:

Violation of the excretory function of the kidneys leads to a delay in the products of nitrogen metabolism (urea, uric acid, creatinine, amino acids, phosphates, sulfates, phenols), which are toxic to all organs and tissues and, first of all, to the nervous system;

Violation of the hematopoietic function of the kidneys causes the development of anemia;

There is an activation of the renin-angiotensin system and stabilization of arterial hypertension;

The acid-base balance is disturbed in the blood.

As a result, deep dystrophic disorders occur in all organs and tissues.

It should be noted that the most common cause of CRF is chronic pyelonephritis.

In the asymptomatic course of 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 the developed manifestations of renal failure occur after 10-15 years, and its early signs in the form of polyuria - already after 5-8 years from the onset of the disease. An important role belongs to timely and regular treatment inflammatory process and addressing the immediate cause, if possible.

CRF caused by chronic pyelonephritis is characterized by an undulating course with periodic deterioration and improvement in kidney function. Deterioration, as a rule, are associated with exacerbations of pyelonephritis. Improvements come after full treatment diseases with the restoration of the disturbed outflow of urine and the suppression of the activity of the 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, as a rule, 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, when special forms urolithiasis, for example, with staghorn kidney stones, the death of nephrons is accelerated. Provoke the development of CRF in urolithiasis, repeated stone formation, a large stone, its long stay in the kidney with hidden current diseases.

At any rate of development of CRF, a number of stages pass sequentially: latent, compensated, intermittent and terminal. The main laboratory indicator separating one stage from another is endogenous (intrinsic) creatinine clearance, which characterizes the glomerular filtration rate. Normal creatinine clearance is 80-120 ml per minute.

The latent stage of chronic renal failure is detected with a decrease in glomerular filtration (according to creatinine clearance) to 60-45 ml / min. During this period, the main clinical signs of chronic renal failure are polyuria and nocturia - excretion more urine at night, not during the day. Maybe lung development anemia. Patients usually do not present 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. Complaints of weakness, drowsiness, increased fatigue, apathy join. Daily urine output usually reaches 2-2.5 liters, increased excretion of sodium in the urine may begin, as well as changes in phosphorus-calcium metabolism with the development of the first signs of osteodystrophy. At the same time, the level of residual nitrogen in the blood corresponds to upper bounds norms.

The intermittent stage is characterized by an undulating course with alternating periods of deterioration and a clear improvement after full treatment. The glomerular filtration rate is 23-15 ml/min. The level of residual nitrogen in the blood is persistently elevated. Patients constantly complain of weakness, sleep disturbances, increased fatigue. Anemia is a typical symptom.

The terminal stage is characterized by intoxication of the body with its own nitrogenous waste products - uremia. The glomerular filtration rate is 15-10 ml/min. The typical signs are pruritus, bleeding (nasal, uterine, gastrointestinal, subcutaneous hemorrhages), "uremic gout" with joint pain, nausea, vomiting, loss of appetite, up to aversion to food, diarrhea. The skin is pale, yellowish, dry, with traces of scratching, bruises. The tongue is dry, brown in color, a specific sweetish "uremic" smell comes from the mouth. For the most part, these symptoms occur because other organs, such as the skin, the gastrointestinal tract, etc., are trying to take over the function of the kidneys to remove nitrogenous waste and cannot cope with it.

The whole body suffers. Disturbances in the balance of sodium and potassium, persistently high blood pressure and anemia lead to deep damage to the heart. With an increase in the amount of nitrogenous wastes in the blood, symptoms of damage to the central nervous system increase: convulsive muscle twitches, encephalopathy up to uremic coma. In the lungs in the terminal stage, uremic pneumonia may develop.

Violations of phosphorus-calcium metabolism cause leaching of calcium from bone tissue. Osteodystrophy develops, which is manifested by pain in the bones, muscles, spontaneous fractures, arthritis, compression of the vertebrae and skeletal deformity. Children stop growing.

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 chronic renal failure in the terminal stage are purulent complications, up to sepsis, caused by opportunistic bacteria, such as intestinal daddy.

Diagnostics

Treatment

AT initial stages CKD treatment coincides with the treatment of the underlying disease, the purpose of which is to achieve a stable remission or slow down the progression of the process. If there are obstructions in the path of urine outflow, it is optimal to eliminate them surgically. In the future, against the background of continuing treatment of the underlying disease, a large role is given to the so-called symptomatic drugs - antihypertensive (pressure-reducing) drugs of the ACE inhibitor groups (Capoten, Enam, Enap) and calcium antagonists (Cordaron), antibacterial, vitamin agents.

An important role is played by the restriction in the diet of protein foods - no more than 1 g of protein per kilogram of the patient's weight. In the future, the amount of protein in the diet is reduced to 30–40 g per day (or less), and with a glomerular filtration rate of 20 ml/min, the amount of protein should not exceed 20–24 g per day. Table salt is also limited - up 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 preparations and other drugs are used to treat anemia. With a decrease in diuresis, it is stimulated with diuretics - furosemide (lasix) in doses up to 1 g per day. In a hospital, in order to improve blood circulation in the kidneys, intravenous drip-concentrated glucose solutions, hemodez, reopoliglyukin with the introduction of aminofillin, chimes, trental, 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 the purpose of detoxification, gastric and intestinal lavage, 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 shown regular (2-3 times a week) hemodialysis - an "artificial kidney" apparatus. The appointment of regular hemodialysis is necessary when the level of creatinine in the blood is over 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 survival of the organ is possible, so the issue of donor kidney transplantation should be addressed in advance.

Prevention

CKD prognosis

The prognosis of chronic renal failure has recently lost its fatality due to the use of hemodialysis and kidney transplantation, but the life expectancy of patients remains significantly lower than the average for the population.

Disorders of homeostasis are a direct consequence of a disease such as renal failure. This syndrome is associated with severe impairment of renal function. The occurrence of symptoms of kidney failure in women is very closely related to the violation of water-electrolyte or acid-base balance in the human body.

Kinds

Interestingly, the disease depends on the symptoms and form of the disease, it can be acute renal failure or chronic. The first option is associated with a sudden deterioration in kidney function. Disorders of the water, electrolyte, osmotic or acid-base balance are closely associated with such a negative process as a sharp slowdown or cessation of the excretion of nitrogen metabolism products from human body women. As a result of kidney failure, the symptoms of which are obvious, it is likely that such an unpleasant phenomenon as a violation normal composition blood.

If a woman has chronic renal failure, then this is due to a decrease in the number of functioning nephrons. Moreover, this form of the disease is characterized by a gradual progressive state with a slow increase in symptoms of kidney failure.

Due to symptoms gradual death kidney tissues, deficiency of renal functions becomes the cause of intoxication of the body in a woman, because her own waste products cannot be fully excreted from the body.

According to the international classification of chronic renal failure in women, the code for ICD 10 is number N18.

Chronic renal failure symptoms in women, creatinine stage counts 4. They are based on the level of its content in the blood. At the first stage, its level rises to 442.0 µmol per liter. On the second - up to 884.0 µmol per liter. On the third - up to 1326.0 µmol per liter, and on the fourth, everything that is above this indicator.

Causes

The occurrence of symptoms of kidney failure in women is closely associated with diseases leading to sharp deterioration renal blood flow. Such conditions can occur due to shock of various origins, severe infectious diseases, massive bleeding, acute heart failure, intoxication with nephrotoxic poisons, vascular lesions of the kidneys, acute diseases kidneys, urinary tract obstruction.

The chronic form may be associated with other chronic diseases and their symptoms. We are talking about diabetes, hypertension, scleroderma, systemic lupus erythematosus, chronic intoxication, pyelonephritis, glomerulonephritis, urolithiasis in women. Such conditions may occur if certain drugs have been used as adequate treatments.

Renal failure in women of this kind is real opportunity recover quickly and never remember this problem and symptoms again. It is much worse if the fact of the presence of a chronic form is confirmed. The disease can proceed for several years, which catastrophically affects the state of the human body. In addition, a steady increase in signs is unlikely to be avoided. Chronic renal failure is also complicated by the fact that the possibility of a complete restoration of the functions of damaged organs is practically absent.

The acute form and symptoms are observed in the first stage in women, so it is much easier to cure it. Moreover, the symptoms of kidney failure are quite obvious. Acute violation kidney function may manifest as fever, chills, headache, muscle pain. Often there is confusion or loss of consciousness. Paleness, sweating, thready pulse and decreased blood pressure- are also unpleasant signs of this disease. The disease can also be recognized by the presence of blood in the urine, pain in the lower back.

Due to untimely access to a doctor, the second stage of the disease often occurs. The disease is characterized by symptoms such as a sharp decrease or complete cessation of urine output, azothermia, impaired consciousness, weight gain, swelling of the subcutaneous tissue, swelling of vital organs, fluid accumulation in abdominal cavity. Not an exception is the onset of a general serious condition.

A favorable outcome in the treatment of renal failure is associated with a period of recovery of diuresis. At first, urine output gradually increases, reaching the norm, and then it becomes even more. This indicates the beginning of the process of removing fluid from the body, which has accumulated during the development of the disease.

In the case of improper control of renal failure, there is a possibility of the onset of the terminal stage. It is characterized by shortness of breath, cough, pink frothy sputum, subcutaneous hemorrhages, hematomas, internal bleeding. At the level of the nervous system we are talking confusion, drowsiness, coma, spasms or muscle cramps. It is likely that the cardiovascular system will be disturbed. People with health problems of this kind should definitely be checked regularly by a doctor in order to prevent the onset of the disease.

Symptoms of kidney failure

The main difference between acute and chronic disease in women is the time of onset of symptoms of kidney failure. In the first case, we are talking about rapid development, but the plus of this moment is that a complete recovery of kidney function in women is possible if adequate methods of treating kidney failure are used. Renal failure in women of this kind is a real opportunity to recover quickly and never again remember this problem. It is much worse if the fact of having a permanent form is confirmed.

The disease can proceed for several years, which has a catastrophic effect on the state of the woman's body. In addition, a steady increase in signs is unlikely to be avoided. Chronic renal failure is also complicated by the fact that the possibility of a complete restoration of the functions of damaged organs is practically absent.

In the early stages of the development of the disease, its presence can be determined by signs and symptoms. Further, we are talking about more significant changes in the structure of kidney tissues. An immediate sign of the onset of this process in women is an increase in the amount of urine that is excreted at night. Moreover, swelling may appear on the face, especially in the morning. This is accompanied by weakness and malaise.

Illness on last stage closely related to symptoms in women that are characteristic of uremia. Moreover, it is likely a violation of water-electrolyte metabolism. A fatal outcome can only be avoided if hemodialysis is applied in time.

If a woman has symptoms of kidney failure, then you need to immediately seek help from a doctor, because at the initial stage it is much easier to cope with the disease.

Kidney failure symptoms and signs in women

The kidneys are the most important organ excretory system. His spontaneous refusal leads to dire consequences. If you react in time and take action, you can manage to prevent the inevitable. It is very important to know the main symptoms of kidney failure in women in order to urgently follow the clinic.

Kidney failure symptoms and signs in men

Symptoms of the disease in men are completely identical to women. As a result of the condition worsening, people experience shortness of breath due to the fact that fluid accumulates in the lungs, bruises may form on the body. The general condition can be described as drowsy. Spasms and cramps affect the muscles. Loss of consciousness is critical.

Treatment of kidney failure

The first step in treating an acute form is to eliminate the cause. Moreover, it is necessary to restore homeostasis and impaired kidney function as soon as possible. More specific drugs used to treat kidney failure depend on the characteristics of the course of the disease and the condition of the patient. We can talk about antibacterial agents, detoxification therapy, fluid replacement, hormonal preparations. Detoxification of the body and the removal of nitrogenous slags is carried out using hemodialysis, plasmapheresis, hemosorption. To restore diuresis the best option is an correct selection diuretic drugs. The introduction of sodium, potassium salts, calcium is also practiced, which helps to restore the water-electrolytic balance.

In the treatment of an advanced stage, the main principle is the impact on the cause of the disease. Moreover, it is necessary to pay attention to detoxification therapy and maintaining the normal functioning of the kidneys. An important aspect is a special diet.

The initial stage of treatment of renal failure is associated with the need to achieve a slowdown or stable remission of the underlying disease. In the future, it is possible to appoint symptomatic therapy together with permanent measures. For example, swelling can be reduced with diuretics. If there is a threat of anemia, then you can not do without vitamins and iron supplements.

The last stages are associated with the need for hemodialysis, which is also called artificial blood filtration. This procedure is prescribed with a frequency of 2-3 times a week. A good but not always affordable alternative to this procedure is organ transplantation.

More about dialysis on video:

Nutrition and diet

Proper nutrition is one of the factors that can affect a speedy recovery. The main task is to reduce the load on the kidneys and slow down the process of increasing the volume of affected kidney tissues.

Diet must be very nutritious. The main principles include limiting the intake of food that contains protein. Moreover, it is necessary to provide a high calorie content and the use of more vegetables and fruits. Launched Form is inextricably linked with fruit and vegetable fasting days, which are recommended to be used several times a week.

High-calorie food can be provided by vegetable fats and carbohydrates. In order to determine the amount of fluid that needs to be consumed per day, a special formula is used. First you need to measure the amount of urine that is excreted per day, and then add 500-800 ml to this number. With severe edema and hypertension, it is necessary to include in the diet 3-4 g table salt. In the event that a sodium preparation is used in the treatment of renal failure, then the dosage of salt must be significantly reduced. However, limiting the amount of salt consumed for too long can lead to negative consequences. If a positive result is achieved in the process of treatment in women, then it is necessary to return the previous norm. As for protein, its intake should not exceed 20-30 g. Important point- introduction of essential amino acids. To consume them enough, you need to drink two chicken eggs daily.

Treatment of renal failure folk remedies

In the early stages, the treatment of kidney failure is very effective. folk remedies. Experts recommend using infusions and decoctions from plants that have a diuretic effect. We are talking about birch buds, lingonberry leaves, horsetail, string, black currant leaves, chamomile, kidney tea. It is acceptable to use mint, corn stigmas, St. John's wort and other plants or collections from them. However, in this case, do not forget about the need for prior consultation with a doctor. Please note, however, that the use of some traditional medicine can be extremely dangerous for the human body. Especially when it comes to such a serious illness. ethnoscience together with its methods, it is more of an auxiliary treatment than a main one.The responsibility for how to treat the disease lies only with you, because it is you who need working kidneys for life.

Kidney failure refers to a number of pathologies that pose a significant threat to human life. The disease leads to a violation of the water-salt and acid-base balance, which entails deviations from the norm in the work of all organs and tissues. As a result of pathological processes in the renal tissue, the kidneys lose their ability to fully excrete the products of protein metabolism, which leads to the accumulation of toxic substances in the blood and intoxication of the body.

By the nature of the course, the disease may have or. Causes, treatments and symptoms of kidney failure for each of them have certain differences.

Causes of the disease

The causes of kidney failure are varied. For acute and chronic forms of the disease, they differ significantly. Symptoms of acute renal failure (ARF) occur due to injuries or significant blood loss, complications after surgical operations, acute pathologies of the kidneys, poisoning with heavy metals, poisons or drugs and other factors. In women, the development of the disease can be triggered by childbirth or by infection and spread outside the pelvic organs as a result of an abortion. With acute renal failure functional activity kidneys is disturbed very quickly, there is a decrease in the glomerular filtration rate and a slowdown in the process of reabsorption in the tubules.

Chronic renal failure (CRF) develops over a long period of time with a gradual increase in the severity of symptoms. Its main causes are chronic diseases of the kidneys, blood vessels or metabolism, congenital anomalies development or structure of the kidneys. At the same time, there is a violation of the function of the organ for the removal of water and toxic compounds, which leads to intoxication and, in general, causes a disruption in the functioning of the body.

Tip: If you have chronic kidney disease or other factors that can provoke kidney failure, you should be especially careful about your health. Regular visits to the nephrologist, timely diagnosis and implementation of all doctor's recommendations have great importance to prevent the development of this serious disease.

Characteristic symptoms of the disease

Signs of renal failure in the case of an acute form appear abruptly and have a pronounced character. In the chronic variant of the disease in the early stages, the symptoms may not be noticeable, but with gradual progression pathological changes in the tissues of the kidney, their manifestations become more intense.

Symptoms of acute renal failure

Clinical signs of acute renal failure develop over a period of a couple of hours to several days, sometimes weeks. These include:

• a sharp decrease or absence of diuresis;
• weight gain due to excess fluid in the body;
• the presence of edema, mainly in the ankles and face;
• loss of appetite, vomiting, nausea;
• pallor and itching of the skin;
• feeling tired, headaches;
• excretion of urine with blood.

In the absence of timely or inadequate treatment, shortness of breath, coughing, confusion and even loss of consciousness, muscle spasms, arrhythmias, bruising and subcutaneous hemorrhages appear. This condition is fraught with death.

Symptoms of chronic renal failure

The period of development of CRF until the onset of characteristic symptoms, when significant irreversible changes in the kidneys have already occurred, can range from several to decades. Patients with this diagnosis have:

• violations of diuresis in the form of oliguria or polyuria;
• violation of the ratio of night and day diuresis;
• the presence of edema, mainly on the face, after a night's sleep;
• increased fatigue, weakness.

The last stages of CRF are characterized by the appearance of massive edema, shortness of breath, cough, high blood pressure, blurred vision, anemia, nausea, vomiting and other severe symptoms.

Important: If you find symptoms that indicate a violation of the kidneys, you should contact a specialist as soon as possible. The course of the disease has a more favorable prognosis with timely therapy.

Treatment of the disease

In case of renal failure, treatment should be comprehensive and aimed primarily at eliminating or controlling the cause that provoked its development. The acute form of renal failure, unlike chronic, responds well to treatment. Properly selected and timely therapy makes it possible to almost completely restore kidney function. To eliminate the cause and treat acute renal failure, the following methods are used:

• taking antibacterial drugs;
• detoxification of the body with the help of hemodialysis, plasmaphoresis, enterosorbents, etc.;
• fluid replenishment during dehydration;
• restoration of normal diuresis;
• symptomatic treatment.

Therapy for CKD includes:

• control of the underlying disease (hypertension, diabetes mellitus, etc.);
• maintaining kidney function;
• elimination of symptoms;
• body detoxification;
• adherence to a special diet.

At the last stage of CRF, patients are shown regular hemodialysis or donor kidney transplantation. Such treatments are the only way to prevent or significantly delay death.

Features of nutrition in the presence of renal failure

A special diet for kidney failure helps reduce the burden on the kidneys and stop the progression of the disease. Its main principle is to limit the amount of protein, salt and liquid consumed, which leads to a decrease in the concentration of toxic substances in the blood and prevents the accumulation of water and salts in the body. The degree of rigidity of the diet is determined by the attending physician, taking into account the patient's condition. The basic rules of nutrition for kidney failure are as follows:

• limiting the amount of protein (from 20 g to 70 g per day, depending on the severity of the disease);
• high energy value of food (fats plant origin, carbohydrates);
• high content in the diet of vegetables and fruits;
• control of the amount of fluid consumed in the amount, calculated from the volume of urine excreted per day;
• restriction of salt intake (from 1 g to 6 g, depending on the severity of the disease);
• fasting days at least once a week, consisting in the use of only vegetables and fruits;
• steam method of cooking (or cooking);
• fractional diet.

In addition, foods that cause kidney irritation are completely excluded from the diet. These include coffee, chocolate, strong black tea, cocoa, mushrooms, spicy and salty foods, fatty meat or fish and broths based on them, smoked meats, and alcohol.

diet is very important element in the treatment of renal failure

Folk methods of treatment

With renal failure, treatment with folk remedies in the early stages gives a good effect. The use of infusions and decoctions medicinal plants, which have a diuretic effect, helps to reduce swelling and remove toxins from the body. For this purpose, birch buds, rose hips, chamomile and calendula flowers, burdock root, dill and flax seeds, lingonberry leaves, horsetail grass, etc. are used. Various collections can be made from these plants and kidney teas can be prepared on their basis.

In renal failure, a good effect is also given by the use of pomegranate juice and a decoction of pomegranate peel, which has a tonic effect and enhances immunity. The presence of seaweed in the diet helps to improve kidney function and promote the excretion of metabolic products.

Tip: Use in kidney failure folk methods treatment must be agreed with the attending physician.

Renal failure (acute and chronic) is a symptom complex leading to rapid or gradual death of nephrons and a decrease in the functionality of the renal parenchyma.

The disease is life threatening because it etiological treatment does not exist.

Kinds

Types of kidney failure:

1. chronic;
2. Acute.

Chronic kidney failure develops due to the gradual death of nephrons.

Its prevalence in human population– 300-600 cases per 1 million population.

Acute kidney failure is characterized by a rapid drop in glomerular filtration, a stable increase in urea and creatinine, hyperkalemia, and metabolic acidosis.

If kidney failure is prevented in time, it is possible to fully preserve the functionality of the kidneys, but in most patients the disease passes into a chronic stage, in which periods of remissions and exacerbations alternate over several years.

Depending on the pathogenesis, there are the following types kidney failure:

1. prerenal;
2. Renal;
3. Postrenal.

Prerenal renal failure occurs due to changes in the state of the efferent and afferent arterioles of the renal nephron, which is accompanied by a violation of the intensity of blood flow in the nephrons.

The filtration rate is not disturbed until the intrarenal pressure drops below 70 mmHg. Exist medications, which lead to narrowing of arterioles (non-steroidal anti-inflammatory drugs, ACE inhibitors). They are prescribed to prevent a drop in intrarenal pressure.

Renal etiology of the disease occurs in the presence of inflammatory changes in the interstitium, death of nephrons and viral infections (papillomavirus, HIV).

Renal causes of insufficiency occur even with elevated blood pressure. In intensive care patients, sepsis (bacterial infection of the blood) becomes the cause of insufficiency.

Postoperative etiological factors:

• tubular necrosis;
• Stones in the urinary tract;
• Tumors of the kidneys;
• Anomalies of the ureteropelvic segment.

Postrenal causes in most patients provoke chronic renal failure. Only urolithiasis causes an acute block of urination, in which there is a strong expansion of the pelvis and ureter above the narrowing.

Causes

The etiological factors of the disease differ in children, adults and the elderly. If the cause of the pathology in a child is exclusively congenital anomalies of the structure urinary system, then in adults the etiology is more diverse:

• Pyelonephritis (chronic and acute);
• Hypertonic disease;
• Diabetes;
• obstructive oncological diseases;
• Atherosclerosis;
• The impact of drugs.

In Europe, 20% of kidney failure is due to diabetic nephropathy. In Africa, the disease is caused by schistosome nephropathy, malaria and HIV infection.

All causes of kidney failure can be divided into 3 groups:

1. Decreased blood flow in the kidneys (40-70%);
2. Damage to the renal parenchyma (10-45%);
3. Narrowing of the urinary tract (8-10%).

The following conditions lead to a decrease in blood flow in the nephrons - collapse and shock. The death of nephrons of the renal parenchyma occurs against the background of taking toxic poisons, taking drugs (tetracyclines), with insect and snake bites. Infectious diseases can also lead to inflammation of the renal parenchyma (acute and chronic pyelonephritis).

Glomerular filtration disorder of the kidneys

The narrowing of the urinary tract provokes urolithiasis and congenital narrowing of the ureter. A similar situation occurs with traumatic kidney injury.

The causes of chronic renal failure are somewhat different:

• Metabolic diseases (amyloidosis, gout, diabetes);
• Congenital kidney diseases (anomalies of the arteries, polycystic);
• Rheumatic diseases (systemic lupus erythematosus, vasculitis, scleroderma);
• Vascular diseases (hypertension, atherosclerosis);
• Diseases with impaired outflow of urine (tumor, hydronephrosis, gout).

Did you know that pyelonephritis and polycystosis can cause development? Read about the causes of chronic renal failure in children and adults, as well as how the disease manifests itself in the early stages.

Read about how chronic renal failure manifests itself in children. Symptoms in children and consequences of kidney failure.

And here you can learn about how seemingly harmless salt diathesis, if left untreated, can lead to KSD and kidney failure.

Symptoms of kidney failure

Stages of the course of acute renal failure:

1. Initial- symptoms occur immediately after exposure to the etiological factor and continue until severe damage to the renal tissue. Clinical signs of the initial stage of the pathology can be considered nausea, pallor and soreness in the abdomen;
2. Oligoanuric- combined with partial or complete anuria (lack of urine output). Symptoms of the pathology are combined with the accumulation of creatinine and urea in the blood, as well as the end products of protein metabolism - nitrogenous compounds. Against the background of blood intoxication, edema of the extremities, damage to the brain and heart appear, which is manifested by dementia and increased heart rate;
3. Restorative the stage during early diuresis is manifested by symptoms of oligoanuria, which gradually decrease. The next stage is polyuria, which is accompanied by an increase in the volume of urination. The duration of symptoms is about 2 weeks. The final stage of the pathology is the restoration of renal activity, but the degree of regeneration depends on the number of nephrons that have retained functionality. This stage can last up to a year.

Stages of acute renal failure

Stages of chronic renal failure:

1. Latent – external symptoms kidney damage is not observed. The person does not complain, and fatigue during exercise and dry mouth are the only signs of the disease;
2. Compensated- accompanied by an increase in the daily volume of urine above 2.5 liters. There is an increase in creatinine and urea in the blood;
3. Intermittent- a decrease in the functionality of the kidneys leads to an increase in nitrogen metabolism. At the same time, there is an increase in the level of creatinine and urea. Against the background of these symptoms, fatigue, vomiting and nausea, dry mouth, loss of appetite are observed. If the skin turns yellow, anemia is likely to occur. At the same time, muscle cramps occur, a tremor of the fingers can be traced, swelling of the extremities appears;
4. Terminal- there are symptoms of damage not only to the renal tissue, but also to all internal organs: insomnia, swelling of the face, brittle hair, muscle tissue dystrophy, hoarseness of voice, ammonia breath, diarrhea, increased uric acid, creatinine and electrolyte composition of the blood.

With kidney failure, damage to internal organs occurs gradually. To lethal outcome leads not only to the severity, but also to the multiplicity of the lesion.

Even at the initial stage of the pathology, damage to the nervous system is detected in the form of encephalopathy (depression, decreased memory and intelligence).

External signs of the disease

Before you send the patient to a laboratory study, you can determine the external signs of kidney failure.

Early symptoms of kidney damage:

• Frequent fatigue;
• Pain in the epigastrium;
• Nighttime urination;
• Tonic muscle contractions;
• Itching on the skin;
• Headache;
• Decreased vision;
• Fundus changes.

During an external examination of the patient, attention should be paid to the pallor of the skin, the appearance of a small petechial rash on the skin. With a decrease muscle mass the amount of nitrogenous compounds in the blood increases due to the breakdown of muscle protein.

Secondary syndromes of renal failure:

1. Cerebral - brain damage leads to the following symptoms: headache, hearing loss, insomnia and emotional lability;
2. Dyspeptic - anorexia with the appearance of an unpleasant odor in the mouth, a feeling of heaviness, nausea and malnutrition. Pathological process in the gastrointestinal tract leads to the occurrence of erosive and ulcerative defects;
3. Hemorrhagic - minor bleeding and large hemorrhages in different parts of the body;
4. Anemic - leads to a decrease in the number of red blood cells and hemoglobin. External signs anemia - yellowness of the skin, dry mouth and itching of the skin;
5. Serous - the presence of effusion and fibrous plaque on the visceral membranes of the lungs and internal organs. Specific signs of pathology - friction noise of the pleura and pericardium;
6. Osteo-articular - is formed due to impaired absorption of calcium in the intestine. Symptoms of this form are joint pain, limitation of movement and pathological fractures;
7. Cardiovascular - develops against the background of increased blood pressure, left ventricular failure and an increase in toxins in the blood. Damage to the heart muscle is characterized by an increase in its thickness and a general expansion of the myocardium (dilation);
8. Urinary - combined with low glomerular filtration, inflammation of the kidneys and the presence of protein in the urine.

In chronic renal failure, urinary and hemorrhagic syndrome. Subsequent manifestations of pathology depend on the time of its detection and treatment tactics.

Complications

Complications of renal failure:

1. vascular thrombosis;
2. Edema of the lungs and lower extremities;
3. Increasing pressure;
4. Damage to the heart muscle;
5. Thickening of the vessel wall;
6. myocardial ischemia;
7. Hemorrhage in the brain;
8. Microhematuria (streaks of blood in the urine);
9. Progressive glomerulonephritis;
10. Pyelonephritis.

Diagnostics

Diagnosis of renal failure is based on the use of the following methods:

• Complete blood count (leukocytosis, eosinophilia and thrombocytopenia);
• Zimnitsky's test (hypoisosthenuria);
• Biochemical blood test (increase in gamma globulins, creatinine and urea);
• Reberg's test (increased tubular reabsorption and glomerular filtration);
• Echocardiography (prolongation of the P-Q interval, expansion of P);
• Ultrasound (increase in the size of the kidneys).

Causes difficulties early diagnosis renal failure, when specific changes are not traced in the analyzes, it is difficult to establish a diagnosis.

Conservative treatment

Conservative treatment for renal failure involves the following principles:

• Etiological and symptomatic drugs;
• Diet therapy;
• Intravenous infusions.

If there is an increased level of nitrogenous compounds in the blood, it should be excluded from the diet protein products. In the initial stages, the protein norm is limited to 0.8 grams per day. With the progression of the pathology, the norm is reduced to a daily dose of 0.5 grams. At severe course diseases, the dosage of the protein substrate in the menu should be even less.

If an increase in blood pressure occurs against the background of insufficiency, the appointment of diuretics (hypochlorothiazide, furosemide), ACE inhibitors, calcium blockers and other antihypertensive agents is required.

These drugs are contraindicated in renal failure.

When conservative means fail to eliminate blood toxicity, hemodialysis and peritoneal dialysis are recommended. By connecting an apparatus called an "artificial kidney", it is possible to temporarily filter out toxic compounds from the blood.

Treatment with folk remedies

Treatment of renal failure is carried out by the following folk remedies:

• Cowberry juice;
• Decoction of bearberry;
• Burdock root;
• Dill and fennel;
• Horsetail;
• Flax seed;
• Rosehip decoction;
• Strawberry leaves.

Here is one of the popular folk recipes for the treatment of kidney failure with burdock root:

1. Grind burdock root to a powder;
2. Pour a spoonful of the mixture with a glass of boiling water;
3. Drink during the day.

The use of this recipe and other analogues that are diluted with water requires taking into account the amount of daily urine. You can not consume fluids more than the volume of daily urination.

diet for kidney failure

Features of nutrition in renal failure:

1. Restriction of protein foods;
2. Inclusion in the menu of vegetable and butter (50-100 grams per day);
3. Dairy products are excluded;
4. High-calorie meals are taken in portions (6 times a day);
5. salt restriction;
6. Fluid intake equal to daily losses.

Forecast

If the treatment of the disease is started in the early stages, it is possible to return the patient to normal life. Reversible acute kidney failure. In the chronic variant, there is a danger of losing the full functionality of the kidney with the need for a subsequent organ transplant.

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Kidney failure: how to treat, what diet and nutrition

Kidney failure is pathological condition kidneys, in which they do not fully perform their work in the required volume as a result of any disease. This process leads to a change in the constancy of the body's self-regulation, and as a result, the work of its tissues and organs is disrupted.
Kidney failure can occur in acute (ARF) and chronic (CRF) forms.

The causes of kidney failure vary depending on the form of the disease. There are several reasons that cause ROP:

• Prerenal, that is, the disease is caused by heart failure, collapse, shock, severe arrhythmias, a significant reduction in circulating blood volume (possibly in case of blood loss).
• Renal, in which the death of the renal tubules is caused by the action heavy metals, poisons, alcohol, drugs or due to insufficient blood supply to the kidney; sometimes the cause is acute glomerulonephritis or tubulointerstitial nephritis.
• Postrenal, that is, as a result of acute bilateral blockage of the ureters in urolithiasis.

The causes of CRF are chronic glomerulonephritis and pyelonephritis, systemic diseases, urolithiasis, neoplasms in the urinary system, diseases with impaired metabolism, vascular changes (high blood pressure, atherosclerosis) and genetic diseases.

Symptoms of the disease

Signs of renal failure depend on the severity of changes in renal function, on the duration of the disease and on general condition organism.

There are four degrees of acute renal failure:

1. Signs of renal failure of the initial phase: a decrease in the amount of urine, a decrease in blood pressure, an increase in heart rate.
2. The second phase (oliguric) is to reduce the amount of urine or to stop its production. The patient's condition becomes severe, as almost all body systems are affected and there is a complete metabolic disorder that threatens life.
3. The third phase (recovery or polyuric) is characterized by an increase in the amount of urine up to normal level, but it almost does not remove any substances from the body, except for salts and water, therefore, in this phase, the danger to the patient's life remains.
4. Renal failure of the 4th degree consists in the normalization of urine output, kidney function returns to normal after 1.5-3.5 months.

Signs of kidney failure in people who have a chronic form are a significant decrease in the amount of working tissues of the kidneys, which leads to azotemia (an increase in the level of nitrogenous substances in the blood). Since the kidneys cease to cope with their work, these substances are excreted in other ways, mainly through the mucous membranes of the gastrointestinal tract and lungs, which are not designed to perform such functions.

The syndrome of renal insufficiency quickly leads to the development of uremia, when self-poisoning of the body occurs. There is a rejection of meat food, bouts of nausea and vomiting, a regular feeling of thirst, a feeling of cramps in the muscles and pain in the bones. An icteric shade appears on the face, and when breathing, the smell of ammonia is felt. The amount of urine excreted and its density are greatly reduced. Kidney failure in children proceeds according to the same principles as in adults.

Complications of the disease

The end stage of renal failure is due to the complete loss of kidney function, due to which toxic products accumulate in the patient's body. Terminal renal failure provokes complications such as gastroenterocolitis, myocardial dystrophy, hepatic-renal syndrome, pericarditis.

Hepato-renal insufficiency means progressive oliguric renal failure in the presence of liver disease. With hepatic-renal syndrome, vasoconstriction occurs in the cortical region of the kidneys. This syndrome in cirrhosis is considered as the last stage of the development of the disease, which leads to the retention of water and sodium ions.

Diagnostic methods

Diagnosis of kidney failure includes determining the amount of creatinine, potassium and urea in the blood, as well as constant monitoring of the amount of urine excreted. They can use ultrasound, radiography and radionuclide methods.

To diagnose chronic renal failure, a set of advanced biochemical blood and urine tests, filtration rate analysis, and urography are used.

Medical treatment

Renal failure is treated with intensive care unit or wards intensive care hospital. At the slightest complications, you should immediately seek medical help. Today it is possible to cure patients with acute renal failure using the apparatus artificial kidney while restoring renal function.

If treatment is started on time and carried out in in full, the prognosis is usually good.
During therapy, disturbed metabolic processes are treated, diseases that aggravate chronic renal failure are identified and treated. At a later stage, permanent hemodialysis and kidney transplantation are required.

Medicines for renal failure are used to lower metabolic processes: anabolic hormones - testosterone propionate solution, methylandrostenediol. To improve renal microcirculation, you need long time use trental, chimes, troxevasin and complamin. To stimulate urine output, a glucose solution is prescribed with the introduction of insulin or diuretics from the furosemide group. If there is a high concentration of nitrogen in the blood, then washing is applied. gastrointestinal tract sodium bicarbonate solution, which removes nitrogenous slags. This procedure is carried out on an empty stomach, before meals, once a day.

Antibiotics for renal failure are used in reduced doses, since the rate of their excretion is significantly reduced. The degree of chronic renal failure is taken into account and the dose of antibiotics is reduced to 2 or 4 times.

Treatment of the disease with folk methods

How to treat kidney failure without the use of antibiotics and other medicines is described in the recipes listed below.

1. Take lingonberry leaves, chamomile, motherwort grass, string flowers, dandelion and violets in half a teaspoon. This collection is poured with a glass of boiled water, insisted for about 1 hour and taken in a third of a glass 5 times a day.
2. The second recipe: mix mint, St. John's wort, lemon balm, calendula 1 tbsp. l. In a saucepan, pour the herbal mixture with 2 cups of boiled water and bring to a boil. Pour the prepared infusion into a thermos and leave overnight. Take 100 ml per day.
3. Treatment of folk remedies for renal failure includes the use of watermelon rinds with a diuretic effect. Take 5 tbsp. l. chopped watermelon rinds per liter of water. It is necessary to fill the crusts with water, leave for an hour and take several times throughout the day.
4. Pomegranate peel and rose hips also have a slight diuretic effect. Take them in equal parts and fill with two glasses of boiled water. Insist for half an hour in warmth and take up to 2 glasses a day.

Principles of diet therapy in renal failure

Diet in kidney failure plays an important role - it is necessary to adhere to a diet low in protein and salt, to exclude drugs that have a toxic and damaging effect on the kidneys. Nutrition in kidney failure depends on several general principles:

• It is necessary to limit the intake of proteins to 65 g per day, depending on the phase of kidney disease.
• The energy value of food increases due to the increased consumption of fats and carbohydrates.
• Diet for kidney failure is reduced to the use of a variety of fruits and vegetables. In this case, it is necessary to take into account the content of proteins, vitamins and salts in them.
• Appropriate culinary processing of products is carried out to improve appetite.
• The intake of sodium chloride and water into the body is regulated, the amount of which affects the presence of puffiness and blood pressure indicators.

Sample diet menu for kidney failure:

First breakfast: boiled potatoes - 220g, one egg, sweet tea, honey (jam) - 45g.

Lunch: sweet tea, sour cream - 200g.

Dinner: rice soup - 300g (butter - 5-10g, sour cream - 10g, potatoes - 90g, carrots - 20g, rice - 20g, onions - 5g and tomato juice - 10g). The second is vegetable stew - 200g (from carrots, beets and rutabaga) and a glass of apple jelly.

Dinner: rice milk porridge - 200g, sweet tea, jam (honey) - 40g.

Prognosis for the disease

With timely and adequate treatment, the prognosis for acute renal failure is quite favorable.

In the chronic variant of the disease, the prognosis depends on the stage of the process and the degree of impaired renal function. In the case of compensation for the work of the kidneys, the prognosis for the patient's life is favorable. But in the terminal stage, the only life-sustaining options are permanent hemodialysis or a donor kidney transplant.