Acute tubular necrosis. What is kidney necrosis treatment

Causes of necrosis

Necrosis is the irreversible cessation of the vital activity of cells, tissues or organs in a living organism, caused by the influence of pathogenic microbes. The cause of necrosis can be tissue destruction by a mechanical, thermal, chemical, infectious or toxic agent. This phenomenon occurs due to allergic reaction, disturbances of innervation and blood circulation. The severity of necrosis depends on general condition body and unfavorable local factors.

The development of necrosis is facilitated by the presence pathogenic microorganisms, fungi, viruses. Also negative impact has cooling in the area where there is poor circulation; under such conditions, vascular spasm intensifies and blood circulation is further disrupted. Excessive overheating affects the increase in metabolism and with a lack of blood circulation, necrotic processes appear.

Symptoms of necrosis

Numbness and lack of sensitivity are the very first symptoms that should be a reason to visit a doctor. There is pallor skin as a result of improper blood circulation, the skin color gradually becomes bluish, then black or dark green. If necrosis occurs in lower limbs, then at first it manifests itself as rapid fatigue when walking, a feeling of cold, the appearance of lameness, after which non-healing lesions form trophic ulcers, necrotic over time.

Deterioration of the general condition of the body occurs from dysfunctions of the central nervous system, blood circulation, respiratory system, kidneys, liver. In this case, there is a decrease in immunity due to the appearance of concomitant blood diseases and. Metabolic disorder, exhaustion, hypovitaminosis and overwork occur.

Types of necrosis

Depending on what changes occur in the tissues, two forms of necrosis are distinguished.

Kidney necrosis is extremely dangerous condition, in which the development of acute syndrome is possible renal failure.

In the absence of emergency medical care in a hospital setting, organ loss and even death cannot be ruled out.

The kidneys are located on both sides of the spine at the level lumbar region. It borders on the liver from above, so it is anatomically located slightly below the left.

Human kidneys

On the outside they are covered with adipose tissue, under which there is a dense, poorly extensible fibrous capsule. It is connected to the parenchyma, in which two layers are distinguished - the outer cortex and the inner medulla.

The parenchyma contains about a million functional kidney cells - nephrons; they consist of a glomerulus and a system of tubules. Their main function is to filter blood plasma to form urine.

The medulla of the parenchyma forms so-called pyramids. In each kidney there are from 8 to 12. Urine passes through the nephron tubules into the collecting ducts, which exit to the top of each pyramid - the papilla.

The papillary openings open into the cavity of the renal calyces. In turn, they are combined into a pelvis. From the pelvis, urine enters the bladder through the ureters and urethra excreted from the body.

Kidney functions

The main function is to filter the blood from toxic end products of metabolism and remove them in the urine.

Kidney functions

In addition to this, the kidneys also:

• excreted in urine medicines and toxins entering the body;
• maintain acid-base balance;
• regulate the content of electrolytes in the blood (sodium, potassium, chlorine, calcium);
• participate in maintaining normal level blood pressure;
• secrete some biologically active substances (renin, erythropoietin, prostaglandins).

Therefore, disruption of their work affects the general condition of the entire body. One of the most dangerous is necrosis.

This is the irreversible death of cells and organ tissues. Depending on the location of its localization, necrotic papillitis, acute tubular (tubular) and cortical necrosis are distinguished.

Necrotizing papillitis

This is called necrosis of the renal papillae. This condition occurs as a complication of acute pyelonephritis.

Kidney inflammation

Pyelonephritis is caused by bacteria in the calyces and pelvis.

Pathogenic microorganisms can enter the circulatory system of the medulla of the kidney and clog the vessels. In this case, necrosis develops as a result of impaired blood supply.

In addition, the infiltrate formed during inflammation can block the ureter. In this case, the outflow of urine is sharply disrupted, and it begins to accumulate in the calyces and pelvis.

As a result, they increase in volume and begin to put pressure on the parenchyma, causing necrosis.

With papillitis, blood appears in the urine. Renal colic may begin. Specific sign is the presence of a dead papilla in the urine. An x-ray is taken to confirm the diagnosis.

To stop necrosis, first eliminate its cause. For example, if the ureter is blocked, antispasmodics are prescribed or catheterization is performed.

Also used are drugs that restore and enhance blood circulation, antibiotics wide range actions, immunostimulants and immunomodulators.

Kidney pathologies

If drug therapy is ineffective, and necrosis continues to develop, then an operation (nephrectomy) is performed.

Necrotic lesion of the cortex

Acute cortical necrosis develops with prolonged absence of blood circulation in the cortical layer of the parenchyma.

It can occur in newborns with prolonged asphyxia, congenital defects hearts, premature birth with placental abruption, impaired blood supply to the uterus in a pregnant woman, severe bacterial sepsis.

The diagnosis of cortical necrosis is made based on the results ultrasound examination. A favorable treatment outcome depends on the degree of kidney damage.

Doctors restore blood supply, if possible, of course, perform hemodialysis, and prescribe antibacterial drugs.

After cortical necrosis, the risk of developing chronic renal failure is high.

Necrotic process in tubules

Tubular or tubular necrosis is damage to the cells of the nephron tubules.

Injuries and blood loss

Necrosis begins for several reasons:

• circulatory disorders in the kidney;
• compression of the tubular system;
• toxic effects.

Circulatory problems may occur when heavy bleeding after injury or during surgery, with blood vessels (for example, scleroderma, thrombosis).

Necrosis of the nephron tubules can begin due to their mechanical compression due to severe trauma, increased pressure inside the kidney itself due to blockage of the ureter and disruption of the outflow of urine.

This picture is typical for acute bacterial kidney infections.

The following have a pronounced nephrotoxic effect:

• heavy metals (bismuth, mercury, arsenic, lead, gold);
• pesticides;
• fungicides;
• organic solvents (for example, ethylene glycol);
• the venom of some snakes.

Medicines

It is also worth noting that many antibiotics antivirals, chemotherapy and radiocontrast drugs also have Negative influence on the kidneys, so patients with nephrological diseases should be prescribed them with extreme caution and careful dosage calculation.

With tubular necrosis, acute renal failure develops. All Clinical signs This process is caused by poisoning of the body with metabolic products.

These are nausea, vomiting, loss of appetite, drowsiness, lethargy, abdominal pain, enlarged liver.

The diagnosis is made on the basis of general and biochemical urine analysis, ultrasound, X-ray, and computed tomography results.

When treating tubular necrosis, first of all, they fight its cause.

This is the restoration of renal blood flow, or the removal of toxins using plasmapheresis or hemofiltration, and the immediate cessation of taking medications with nephrotoxic effects.

At infectious lesion antibacterial therapy is carried out.

Then the patient is prescribed a diet and restoratives.

Kidney necrosis is a disease accompanied by a violation of the separation of cytoplasmic proteins. As a result, a characteristic process of cell destruction occurs. This disease is often observed when the blood supply is disrupted, as well as due to exposure to pathogens - bacteria or viruses.

What types of kidney necrosis are there, symptoms, causes? of this disease what are they? Let's talk about it today:

Classification of necrosis

Distinguish the following types of this pathology:

Prerenal failure: this type of necrosis is characterized by pronounced violation organ functionality, due to general violation hemodynamics. This type often turns into renal failure, since impaired renal blood flow is the main cause of ischemia.

Renal failure: In this type, the functionality of the kidney is impaired due to damage to the organ tissue. Typically, renal failure occurs after warm ischemia or cold ischemia.

Postrenal failure: With this type, kidney function is usually not affected. Difficulty or lack of urine output occurs due to damage urinary tract. This type can become renal when the renal pelvis, overfilled with urine, compresses the kidney tissue, which contributes to the occurrence of ischemia.

Why does kidney necrosis occur? Causes of the condition

In children and infants, this disease can occur due to the penetration of bacteria into the blood, as well as due to dehydration (dehydration), or due to hemolytic-uremic syndrome (acute diarrhea). The cause of kidney necrosis in adults is often bacterial sepsis.

In pregnant women, pathology may develop due to sudden separation of the placenta, or due to its incorrect location. Besides this pathology diagnosed with severe uterine bleeding, when the artery is filled with amniotic fluid, etc.

Other reasons include: rejection of a transplanted kidney that has not taken root, kidney injuries, inflammatory diseases pancreas. The pathological process can be provoked by the bite of a poisonous snake, as well as arsenic poisoning.

Necrotizing papillitis or necrosis renal tubules often develops due to organic or functional disorders, which are characterized by destructive processes and changes in the medulla of the kidney.

Necrosis can be provoked by diseases such as diabetes mellitus, prolonged vascular spasm, as well as thrombosis, atherosclerosis, anemia, urinary infection etc. There is a high risk of developing acute tubular necrosis in patients who have suffered severe renal injuries, as well as in those who have suffered surgery dissecting aortic aneurysm.

How does kidney necrosis manifest? Symptoms of the disease

The main sign of developing necrosis is a deterioration in the general condition that occurs against the background of the underlying disease. Patients complain of severe lumbar pain and severe hyperthermia. High oliguria and other manifestations of acute renal failure are observed. In this case, signs of serious leukocyturia, bacteriuria, and hematuria appear. Sometimes pieces of renal papillae are found in the urine.

At timely application to the doctor, when timely treatment, the patient makes a full recovery. Otherwise, the disease may progress to a relapsing course with severe attacks renal colic. Severe course without the necessary, timely treatment, it can be fatal.

How is kidney necrosis corrected? state

The main thing in the treatment of this disease is diagnosis and elimination of the underlying pathology that caused necrosis. Therapeutic measures are carried out aimed at improving and restoring blood microcirculation, eliminating bacteriuria, dehydration and arterial hypertension.

In the presence of complications, which often arise due to ureteral resistance with massive hematuria, the patient is subject to emergency hospitalization.

In order to restore and normalize the passage of urine, the patient is shown catheterization of the renal pelvis with the application of a nephrostomy. Medication consists of taking antibiotics. In case of acute renal failure, the patient undergoes hemodialysis. Patients with polyuria are advised to drink more and not limit salt intake.

Kidney necrosis, signs, therapy, the causes of which we discussed with you today - a pathology with very serious negative consequences. To prevent or reduce the risk of developing necrosis, diseases that may cause its occurrence should be promptly treated. Be healthy!

A condition in which chaotic death of the cellular elements of the paired urinary organ is observed is called kidney necrosis. This severe structural and functional pathology is characterized by the rate of progression and development irreversible changes leading to renal failure.

As necrosis develops, it decreases functional activity paired organ and develops clinical picture general intoxication of the body, which is caused by the accumulation of toxins and metabolic products in the systemic bloodstream. If necrotic changes in the kidneys are not detected in a timely manner, the person’s condition will rapidly deteriorate and lead to death.

If we talk in detail about what kidney necrosis is, then this condition can be characterized as structural damage to the proteins of the cytoplasm of the cells of a paired organ, as a result of which the death of individual sections of the kidney tissue is observed.

This condition occurs with equal frequency in both adult patients and newborns. Potential factors for the development of necrotic changes include:

• Generalized spread of infection throughout the body (sepsis);
• Traumatic injury to the kidney area;
• Rejection of a previously transplanted kidney by the body;
• Placental abruption in a pregnant woman;
• Bites poisonous snakes and insects;
• Poisoning by toxic components and chemical compounds;
• Complications of existing vascular and heart diseases.

Classification

Depending on the location of necrotic changes and the processes occurring in the paired organ, the following types of renal necrosis are distinguished:

• Tubular (acute) necrosis. In this case, necrotic changes affect the epithelium of the renal tubules. The disease itself is divided into nephrotoxic and ischemic necrosis. Nephrotoxic necrosis is caused by exposure to paired organ toxic and chemical compounds. Ischemic necrosis, as a rule, occurs during shock conditions, sepsis, and also against the background traumatic injuries. Tubular necrosis is characterized by an intense inflammatory process, under the influence of which the tissue of the paired organ is damaged, its structure changes and failure is formed.
• Cortical necrosis or mercuric bud. This pathology occurs with partial or complete obstruction (blockage) blood vessels, feeding the paired organ. When there is insufficient blood supply, the functional state kidneys and its failure develops. In no less than 35% of cases of diagnosed cortical necrosis, the pathology arose against the background of septic damage to the body. In addition to sepsis, the disease can be triggered by intoxication with chemical compounds, burns, transplantation procedures and injuries. In newborns, cortical renal necrosis occurs if a pregnant woman is faced with the problem of placental abruption.
• Papillonecrosis. The papillary form of this disease is characterized by the involvement of the renal medulla and renal papillae in the necrotic process. At least 3% of people who have previously had pyelonephritis experience complications in the form of papillary necrosis. Female patients are 2 times more likely to experience this disease.

Symptoms

The clinical manifestations of renal necrosis directly depend on the form of the disease.

At acute form papillary necrosis, the patient is worried about acute pain, severe chills and fever. In addition, when emptying Bladder fragments of blood are visible in the urine. If the patient is not provided with timely assistance, then within 3-5 days he will develop acute failure renal activity. Chronic form papillary necrosis is manifested by moderate pain in the lumbar region, leukocytosis in the urine, as well as signs of sickle cell anemia.

When a mercuric bud forms, the following clinical symptoms come to the fore:

• Partial or complete absence the act of emptying the bladder;
• Pain in the area of ​​​​the projection of the kidneys;
• The appearance of blood fragments in urine, as a result of which it acquires the characteristic color of urine during renal necrosis: brown or red;
• Decrease in blood pressure;
• Increase in body temperature.

The tubular form of renal necrosis is characterized by the following clinical manifestations:

• Swelling in the face, neck and lower extremities;
• Drowsiness;
• Nausea and vomiting;
• Decreased volume of urine excreted;
• Severe damage to the central nervous system, which manifests itself in the form of confusion, even coma.

It is important to remember that failure to provide timely assistance to a person with signs of one or another type of renal necrosis will lead to death in a short period of time.

Diagnostics

To correctly formulate a diagnosis, the doctor collects the patient’s medical history and analyzes his complaints. Important has a list of used medicinal drugs, as well as the presence of diseases such as diabetes and heart failure.

It is also important to take into account information about possible contact with poisonous, toxic and other chemical compounds. Confirm clinical diagnosis The following laboratory and instrumental examination options will help:

Treatment

The primary task when diagnosing renal necrosis is to eliminate the cause that provoked this serious complication.

If the patient has been diagnosed with a papillary form of necrosis, then he is prescribed antispasmodic drugs and catheterization of the bladder is performed. In addition, they are appointed antibacterial agents broad spectrum of action, drugs that improve blood circulation, as well as immunostimulants. If ineffective conservative treatment, the issue of removing the damaged organ is being decided.

When necrotic changes develop in the area of ​​the cortex of the paired organ, measures are taken to restore normal blood supply to the kidney, the blood is cleansed of toxic elements using the hemodialysis procedure, and a course of antibacterial therapy is prescribed.

If necrosis has affected the kidney tubules, a set of measures is implemented to eliminate general intoxication of the body. Infusion therapy, a course of antibiotic treatment, antiemetics and antispasmodics are prescribed. In severe cases, patients undergo hemodialysis.

Complications and prognosis

A single variant of complications for each form of renal necrosis is functional impairment renal activity. This condition is characterized by severe intoxication of the whole body, heart failure and septic complications. Only timely diagnosis and proper treatment can save a person’s life.

With timely treatment, it is possible to preserve the paired organ and restore its functional state. Despite this, statistics indicate that 70% of patients with similar problem, there is a need for an organ transplant. For patients with diagnosed necrosis, hemodialysis is vital. In especially severe cases, if treatment is not timely, death is likely.

A disease characterized by the destruction of kidney tissue is called necrosis. A characteristic feature The appearance of dead cells in the organ is its swelling due to the decomposition of proteins. Kidney necrosis occurs as complications after diseases, poisoning of the body various substances, injury.

The kidneys perform great amount important functions in the body, so any damage to them affects its functioning. Envelops the kidney adipose tissue, under it there is a muscle capsule associated with common system kidneys - parenchyma. The outer layer of the kidney is the cortex, the inner medulla. The parenchyma is an interweaving of millions of tubules and glomeruli; its medulla forms pyramids (up to 12 pieces). At the top of the pyramid is a papilla that opens into the renal calyx. The collection of calyces form the pelvis. And from the pelvis through the ureteric canals, urine enters the bladder and is excreted.

Kidney destruction can be of several types, depending on the affected area:

1. Necrotizing papillitis (necrosis of the renal papillae).
2. Canalicular or tubular.
3. Necrosis of the renal cortex (cortical).
4. Cheesy.
5. Focal.

Let's take a closer look at each type.

Papillary

Necrosis of the renal papillae develops as a complication against the background of diabetes mellitus, pyelonephritis, etc. It is extremely rare that a primary disease is diagnosed.

The disease occurs for the following reasons:

1. Disorders of blood circulation in the vessels of the medulla.
2. Impaired blood flow to the renal papilla, as a result of compression on the vessels due to tissue edema.
3. Impaired urinary function, resulting in stagnation.
4. Infectious and purulent processes.
5. Toxic damage.

Papillary necrosis has two various shapes manifestations are acute and chronic necrosis of the renal papillae. Acute, manifested by pain in the form of colic, chills and blood in the urine. Within a week, acute renal failure may develop and the outflow of urine may stop. Chronic, the presence of bloody inclusions in urine is diagnosed, the pain is not severe, and is accompanied by diseases of the urinary system.

To treat this type of disease, the cause of its occurrence is first eliminated, for example, a catheter is placed on the ureter to remove the blockage. Then apply various drugs to relieve spasms, pain and maintain the patient’s immunity.

If conservative treatment is ineffective, surgical intervention is used to remove the organ.

The disease is diagnosed using x-rays. Papillae may be present in the urine.

Acute tubular (tubular)

With tubular necrosis, the epithelium of the renal tubules suffers. Depending on the nature of the occurrence, it happens:

1. Ischemic. Develops after stress, trauma, inflammatory process, shock. The vessels are compressed, resulting in impaired blood flow.
2. Nephrotoxic. Develops after poisoning with toxic substances and drugs. The venom of some snakes can cause this reaction.

This type of disease destroys renal tubules, which leads to a strong infectious and inflammatory process that penetrates all tissues of the organ and leads to acute renal failure.

Even “neglected” kidney stones can be quickly eliminated. Just remember to drink once a day.

Symptoms of destruction of the renal tubules will be: coma, swelling, problems with urination (to the point of complete absence), delirium, nausea.

Treatment for tubular necrosis is prescribed by removing the cause. Restore blood flow and filter blood from harmful toxic impurities.

Diagnosed using comprehensive research: general and biochemical tests blood and urine, ultrasound, x-ray, CT and MRI.

Necrosis of the renal cortex (cortical)

Cortical necrosis is characterized pathological change tissue of the outer part of the organ. Symptoms are similar to acute renal failure. Most often diagnosed in young children and pregnant women. The disease manifests itself after blockage of the arteries of the cortical layer, against the background of bacterial infections. In the cortex, glomerular loops are affected.

The cause of cortical necrosis is infectious process, which arose after an abortion in non-sterile conditions, with the development state of shock. In such conditions, blood begins to circulate only through the central arteries, but does not enter the renal cortex.

The symptoms of such processes are quite varied:

1. Discharge of blood along with urine.
2. Decreased or stopped urination.
3. Pain syndrome in the lower back, abdomen.
4. Symptoms of intoxication: vomiting, nausea, fever.

Most cases of cortical necrosis occur in pregnant women who have had placental abruption, uterine bleeding and etc.

The diagnosis is confirmed using ultrasound.

Caseous and focal necrosis

Caseous necrosis (cheesy) appears as a complication of tuberculosis, syphilis and leprosy. It got its place in the classification due to its curdled appearance. Notice the disease initial stages It is almost impossible, due to the asymptomatic course of the underlying diseases.

Focal necrosis is characterized by point (local) damage to the glomeruli of the kidney, while others function normally.

Treatment

Initially, in the treatment of renal necrosis, they try to remove the root cause of the appearance this process. In most cases, they carry out antibacterial therapy, antispasmodics and analgesics are prescribed.

Depending on the type of necrosis, the following measures are carried out:

1. In case of necrosis of the renal papillae, antispasmodics are prescribed first. To unblock the ureter, a catheter is installed. Antibiotics, blood thinners and immunostimulants are used.
2. At cortical necrosis restore blood flow in the brain tissue. The patient is prescribed procedures using the device " artificial kidney" Antibiotic therapy is used to eliminate foci of infection.
3. In case of tubular necrosis, the drugs used are adjusted, antibacterial drugs are prescribed, and procedures are carried out to cleanse the bloodstream and body of toxins.

In severely advanced cases, when medication and physiotherapy do not help, resort to surgical intervention. The kidney is removed entirely or only the area affected by necrosis is removed.

If a blood clot is detected in the kidney vessels, removal does not occur; specialists use a special balloon to remove the blockage, and drug treatment continues.

Forecast

If renal necrosis is diagnosed early, the prognosis is favorable. All dead areas and areas are removed and they are scarred over a period of time. The patient continues to live his usual life, with some adjustments.

If detected late, the majority of cases require kidney transplantation. And in very advanced cases there is a possibility fatal outcome. Therefore, it is so important to monitor your health, undergo regular medical check-ups, and if you suspect the presence of any disease, contact your doctor.

And a little about secrets.

Have you ever suffered from problems due to kidney pain? Judging by the fact that you are reading this article, victory was not on your side. And of course you know firsthand what it is:

• Discomfort and pain in the lower back
• Morning swelling of the face and eyelids does not add to your self-confidence.
• It’s kind of embarrassing, especially if you suffer from frequent urination.
• In addition, constant weakness and ailments have already become a firm part of your life.

Every person who suffers at least some chronic pathology should be aware of the first signs of kidney tissue death, which is called renal necrosis.

Kidney necrosis

Kidney necrosis is the process of death of kidney tissue cells. As a result of research, it was found that kidney necrosis is characterized by swelling of cells and protein structures in them, followed by destruction (lysis).

Necrotic changes in the kidneys can occur as a result of severe intoxication with any toxic substances, as a result of the development of autoimmune processes in the human body. Quite often, the cause of kidney cell destruction is a decrease in blood flow in the organ itself. With a decrease in the degree of blood supply, ischemia and hypoxia of the cellular system of the kidney develop, and then cell destruction.

Impaired blood flow to the kidney may occur due to thrombosis of the renal vessels or obstruction of the urinary tract by a stone or neoplasm.

In children, this pathology occurs against the background of a viral or bacterial disease as a complication of dehydration (with excessive vomiting or diarrhea).

Necrosis of convoluted tubule epithelial cells

Toxic substances affect the most sensitive areas of the kidneys - the epithelium of the tubular apparatus.

In the role toxic substances may act:

• Pesticides included in various toxic substances or detergents;
• Connections heavy metals, often mercury, lead and arsenic;
• Ethylene glycol is a representative of organic solvents.

The photo shows necrotic changes epithelial cells Convoluted tubules of the kidneys or acute tubular necrosis - microscopic specimen

A.- Nuclear-free cells; B. - Preserved nuclei in the cells of the loop of Henle; B. The vessels are filled with blood and dilated.

Also possible reason Acute tubular necrosis can result from an injury consisting of severe compression of the organ, resulting in disruption of blood flow to the kidney tubules.

Manifests this type necrosis of acute or gradual urinary retention, blood initially appears in the urine, and the frequency of urination per day decreases. Very often, patients feel discomfort and severe pain in the lumbar region. The patient may have a fever. Such symptoms occur due to the development of dangerous pathological condition with renal dysfunction - renal failure.

Acute tubular necrosis of the kidneys - macroscopic specimen

Cortical

Necrosis of the renal cortex (cortical) can be more often found in newborns or pregnant women.

Pathogenetically, cortical necrosis is caused by increased intravascular blood coagulation locally in the kidneys or totally (in the bloodstream of the whole body). Blood clots intensely due to a decrease in fibrinogen levels and an increase in the concentration of thromboplastin and thrombin. There is a blockage of the blood-bearing (afferent) renal arterioles, which leads to impaired blood supply and shrinkage of the kidney.

As a result of a criminal abortion carried out in inappropriate conditions, bacteria enter the bloodstream and release toxins. A sharp intake of such toxins into large quantities into the blood provokes the development of a state of shock (endotoxic shock).

Quite often, necrotic changes in the cortical layer result in the deposition of calcifications.

Symptoms for this type of pathology can be varied: there is urination with blood, the frequency of urination decreases until it is completely absent. There may be pain in the back (lower part), in the abdomen, vomiting and severe nausea, fever. If the process of intravascular coagulation is total, symptoms of damage to other organs appear. Hemorrhages appear on the skin.

Cortical necrosis of the kidney

Papillary

Main etiological factor the development of necrotic changes in the cells of the renal papillae is bacterial infection. Bacteria can enter the pelvis from outside urinary tract, and are also transferred to the kidney with the blood (hematogenous route). When urine pressure increases in the pelvis, bacteria spread to one or more papillae. As a result, cell lysis develops and blood flow to the kidney pyramids is disrupted.

Symptoms include severe fever, gross hematuria, pain, and severe signs of intoxication.

Papillary necrosis of the kidneys

Cheesy

Caseous type necrosis of renal tissue usually develops at the site of growth and development of tuberculous or syphilitic granulomas (growths). Often the cause of this pathology can be a disease such as leprosy. Caseous areas resemble a cheesy mass upon examination. Under a microscope, the homogeneous nature of the kidney tissue, destroyed cells and connective tissue fibers are noted.

Diagnosis of tuberculosis and syphilis according to initial clinical manifestations quite complicated. There may be periods of significant rise in body temperature, long time leukocytes and red blood cells are found in the urine in large quantities.

The diagnosis can be confirmed by performing laboratory and instrumental studies. The most informative method diagnosis is considered needle biopsy kidneys

Focal

Focal necrosis of renal tissue is usually caused by bacterial flora (syphilis, tuberculosis, leprosy and some other diseases). Symptoms are similar to those of the above forms of renal necrosis.

Treatment

The main principles of treating renal necrosis are to eliminate the root cause pathological process. To do this, it is necessary to carry out a complete clinical and laboratory examination.

Therapeutic measures depending on the etiology and pathogenetic mechanisms of the disease:

• Antibacterial therapy;
• Improvement of hemodynamics (anticoagulant therapy);
• Elimination of obstructive urinary tract syndrome (catheterization is possible renal pelvis and formation of nephrostomy).
• Elimination of signs of renal failure and removal of toxic substances (using hemodialysis);
• To remove pain syndrome antispasmodics or non-narcotic/narcotic analgesics are prescribed.

Surgical interventions are performed only in severe cases of the disease. If necrosis covers almost the entire area of ​​the kidney, then its complete removal (nephrectomy) is performed.

If the cause of necrosis is thrombosis of the vessel, then thrombectomy and angioplasty using a balloon are widely used.

Attention! In order to prevent necrosis of renal tissue, it is recommended to be attentive to your health, monitor the condition of your cardiovascular, endocrine, genitourinary systems. And if the slightest alarming symptoms appear, you should immediately consult a doctor!