Kidney failure in women. Kidney failure

Kidney failure is a progressive disease that gradually leads to tissue death. When the process becomes chronic, the functionality of all organs and systems is disrupted.

What are the symptoms of kidney failure?

Clinical picture

Kidney failure affects both men and women, occurring in their bodies in approximately the same way.

Starting from the acute phase, the process quickly becomes chronic, which is characterized by high concentrations of urea and creatinine in the blood. They are nitrogenous products of protein breakdown. Gradually, the kidneys fail, and the body tries to remove these substances through the delicate mucous membranes of the gastrointestinal tract and lungs, which are simply not adapted to such stress. The result is uremia, which poisons all cells.

With kidney failure, an aversion to meat develops, the patient constantly suffers from thirst, nausea and vomiting. Muscle cramps, aches and bone pain occur. The skin on the face becomes jaundiced, and the breath is accompanied by an ammonia odor.

The amount of urine produced is significantly reduced or urination stops completely. The patient takes diuretics, but they do not help much, and his swelling does not go away. A decrease in renal function is accompanied by a disruption in the production of biologically active substances in the filtering organ. At the same time, the metabolism of glucose, calcium and phosphorus becomes difficult, and the performance of the gonads deteriorates.

Acute form

Acute renal failure (ARF) in men and women usually develops asymptomatically and manifests itself suddenly. When a person learns about the disease, kidney damage is often irreversible. This results in urinary retention. In men, this condition in most cases becomes one of the manifestations of prostate adenoma. However, this symptom may also indicate the presence of kidney stones or a bladder tumor. In this case, men experience bursting pain in the lower abdomen, and the urge to go to the toilet becomes strong and frequent. If back pain and fever are added, pyelonephritis has most likely developed.

Acute renal failure is an indication for urgent hospitalization. The patient requires serious treatment. In this case, treatment methods are determined by the causes of renal dysfunction. The modern approach involves conservative treatment, which uses drugs to relieve symptoms.

Causes

The following causes of acute renal failure are identified:

1. Impaired renal hemodynamics.
2. Infectious diseases.
3. Pathologies of the urinary system.
4. Kidney injuries and surgeries.

The prerenal form of acute renal failure causes difficulty in blood circulation as a result of blood loss and congestion. Treatment involves drugs to normalize heart rate, droppers with saline solutions to restore plasma levels, and medications to improve blood microcirculation.

The renal form of acute renal failure occurs due to pathologies of small blood vessels or medications. Acute renal failure syndrome develops as a result of poisoning with household toxins and bites of poisonous snakes. Treatment is also conservative. For glomerulonephritis and immune disorders, cytotoxic drugs and glucocorticosteroids are prescribed, and for infections - antibiotics. Signs of intoxication are relieved by plasmapheresis.

The postrenal form of the disease occurs due to difficulty in the outflow of urine. This is common in older men with an enlarged prostate gland. Surgery is often required to remove the obstruction that is blocking the normal flow of urine. Otherwise, even diuretics will not be effective.

Characteristic signs

When acute renal failure develops, symptoms may not appear for a long time. The main symptom of acute renal failure syndrome is a decrease in urine output (oliguria), up to complete cessation of urination (anuria). The patient’s health is rapidly deteriorating, and the following signs are observed:

• nausea with vomiting;
• diarrhea;
• loss of appetite;
• swelling of the hands and feet;
• lethargy;
• excited state;
• enlarged liver.

Signs may vary depending on the stage of the disease. In total, there are 4 stages of the disease.

In case of acute renal failure of the first degree, poisoning occurs with nausea, which is accompanied by intestinal pain. The patient becomes pale, feels weak and unwell.

Acute renal failure stage II is characterized by oliguria or anuria. The patient's condition worsens significantly; urea and other products of protein metabolism begin to quickly accumulate in his blood. Self-intoxication starts in the body, the person suffers from edema, diarrhea, hypertension, tachycardia. He quickly loses strength, constantly wants to sleep, and becomes lethargic.

Acute kidney failure of the third degree is marked by the beginning of recovery. Urine formation increases and the concentration function of the kidneys is restored. The functionality of the paired organ is restored.

Stage IV of acute renal failure syndrome is the recovery phase. All indicators of renal activity are normalized. However, full recovery may take a year.

Chronic form

Chronic renal failure (CRF) is a steady deterioration in kidney function due to the death of tissue, which is replaced by connective tissue. The organ shrinks and completely loses its functionality. Chronic renal failure syndrome affects up to 500 people out of every million men and women, and the number of cases is growing every year.

Reasons for appearance

Chronic renal failure develops as a result of various pathologies with concomitant damage to the glomeruli, among them:

• chronic kidney diseases;
• metabolic disorders;
• congenital kidney anomalies;
• rheumatic diseases;
• vascular diseases;
• pathologies leading to difficulty in the outflow of urine.

Often, chronic renal failure syndrome appears against the background of chronic pyelonephritis and glomerulonephritis, diabetes mellitus and gout. The hereditary factor has a significant influence on the development of the disease.

Among the rheumatic diseases that provoke chronic renal failure syndrome are lupus erythematosus and scleroderma, and among vascular diseases - arterial hypertension. Often, chronic renal failure develops as a consequence of kidney stones, hydronephrosis and tumors, due to which the urinary tract is compressed.

Symptoms

Signs of renal failure when it becomes chronic become pronounced, so it is not difficult to identify the disease.

Chronic renal failure occurs in 4 stages:

1. Latent.
2. Compensated.
3. Intermittent.
4. Terminal.

Depending on the degree of the disease, symptoms are expressed stronger or weaker, which affects treatment. Initially, a person experiences weakness and dry mouth.

At stage II, these signs intensify. Chronic renal failure syndrome, when compensated, is accompanied by an increase in urine output to 2.5 liters per day, while tests show deviations in the chemical composition of biological fluids.

In the intermittent stage, chronic renal failure is characterized by even greater inhibition of organ function. A consistently elevated level of nitrogenous metabolic products of protein, urea and creatinine is detected in the blood. Chronic renal failure syndrome leads to severe fatigue and nausea with vomiting. The patient experiences constant thirst and dry mouth, and loses his appetite. The skin becomes flabby and dry, acquiring a jaundiced color. At the same time, muscle tone is lost, tremors (involuntary vibrations of any part of the body) develop, and joints and bones begin to hurt less often.

When chronic renal failure syndrome reaches this stage of development, there is a sharp decrease in the body's defenses. A person's condition may periodically improve, but then it gets worse again. The patient is treated with conservative methods, at this time he is still able to work. But if you do not follow the diet, physical and emotional stress, the symptoms worsen. Surgery may be required.

With the onset of the final stage, people's general condition worsens. Apathy is replaced by excitement, problems with night sleep arise, retardation of movements and inappropriate behavior appear. A person’s appearance changes: the face becomes puffy and gray-yellow in color, the hair becomes thinner, loses its shine, scratches remain on the skin because it is constantly itching, and dystrophy develops. The voice becomes hoarse, and the breath begins to smell of ammonia.

From the gastrointestinal tract, bloating, diarrhea, and vomiting are observed. The tongue is constantly coated, and aphthous stomatitis is observed.

Tests reveal persistently elevated concentrations of urea and creatinine in the patient’s blood, which provokes uremia. Moreover, the presence of hematuria in men may be a sign of hemophilia.

End stage chronic renal failure syndrome is also accompanied by encephalopathy with depression, memory impairment, and mood swings. Normal hormone synthesis is disrupted, resulting in impaired blood clotting and decreased immunity. The patient requires long-term treatment, and the sooner it is started, the more likely it is that surgery can be avoided.

Method of examination

Diagnosis of acute and chronic renal failure is necessary for the doctor to clarify the diagnosis and prescribe competent treatment. The following tests are expected:

1. General and bacteriological urine analysis.
2. Biochemical and general blood test.

Urine tests can confirm the reason for the decrease in renal function. Red blood cells indicate urolithiasis, tumors, injuries, and white blood cells indicate the presence of infection and immunity disorders.

If a decrease in renal function occurs due to infection, then a bacteriological analysis of urine will reveal the pathogen.

Both chronic and acute renal failure are characterized by a high level of leukocytes in the blood and a slight decrease in the content of platelets in it. A decrease in hemoglobin indicates anemia, and an acceleration of their sedimentation indicates the presence of inflammation.

A biochemical blood test allows you to trace changes in the body that caused a decrease in kidney function. In acute renal failure, high levels of magnesium and creatine and low pH are detected. When the process becomes chronic, increased levels of cholesterol, urea, potassium and phosphorus are found in the blood. At the same time, a decrease in calcium and protein concentrations is recorded.

Analyzes are carried out first, then hardware research methods are used:

1. Computed and magnetic resonance imaging.
2. X-ray.
3. Kidney biopsy.

Ultrasound, CT and MRI are used in acute renal failure to determine the cause of narrowing of the urinary tract, which has led to deterioration of renal function.

X-rays are used to detect pathologies of the respiratory system. A biopsy is used when other methods fail to identify the cause of deterioration in kidney function. Arrhythmias are detected using an ECG.

Symptoms of kidney failure do not appear immediately, so the disease cannot always be diagnosed at an early stage . However, conservative treatment is usually used, and surgery is required only in advanced cases.

Homeostasis disorders are a direct consequence of a disease such as renal failure. This syndrome is associated with severe renal dysfunction. The occurrence of symptoms of renal failure in women is very closely related to a 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 or chronic renal failure. The first option is associated with a sudden deterioration in kidney function. Disorders of water, electrolyte, osmotic or acid-base balance are closely related to such a negative process as a sharp slowdown or cessation of the excretion of nitrogen metabolism products from the human body of a woman. As a result of renal failure, the symptoms of which are obvious, it is quite possible that such an unpleasant phenomenon as a violation of the normal composition of the 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 condition with a slow increase in symptoms of renal failure.

Due to the symptoms of gradual death of renal tissue, a deficiency of renal function becomes the cause of intoxication in a woman’s body, because her own waste products cannot be fully eliminated from the body.

According to the international classification, chronic renal failure in women is coded according to ICD 10 and has the number N18.

Chronic renal failure symptoms present in women, the stages of creatinine number 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 figure.

Causes

The occurrence of symptoms of renal failure in women is closely related to diseases that lead to a sharp deterioration in 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, damage to the kidney vessels, acute kidney diseases, and urinary tract obstruction.

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

Kidney failure in women of this type is a real opportunity to recover quickly and never have to think about this problem and symptoms again. It is much worse if the presence of a chronic form is confirmed. The disease can last for several years, which has a catastrophic effect on the condition of the human body. In addition, a steady increase in symptoms is unlikely to be avoided. Chronic renal failure is complicated by the fact that the possibility of completely restoring the functions of damaged organs is practically absent.

The acute form and symptoms are observed at the first stage in women, so it is much easier to cure. Moreover, the symptoms of kidney failure are quite obvious. Acute renal dysfunction can manifest itself in the form of fever, chills, headache, and muscle pain. Confusion or loss of consciousness often occurs. Paleness, sweating, thready pulse and low blood pressure are also unpleasant signs of this disease. The disease can also be recognized by the presence of blood in the urine and pain in the lower back.

Due to late consultation with 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, and accumulation of fluid in the abdominal cavity. The onset of a general serious condition is no exception.

A favorable outcome in the treatment of renal failure is associated with the period of restoration of diuresis. At first, urine output gradually increases, reaching normal levels, and then becomes even greater. This indicates the beginning of the process of removing fluid from the body that has accumulated during the development of the disease.

In 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, foamy pink sputum, subcutaneous hemorrhages, hematomas, and internal bleeding. At the nervous system level, we are talking about confusion, drowsiness, coma, spasms or muscle cramps. Disturbances in the functioning of the cardiovascular system are quite likely. People who have such health problems should be regularly checked by a doctor in order to prevent the occurrence of the disease.

Symptoms of kidney failure

The main difference between acute and chronic forms of the disease in women is the timing of the onset of symptoms of renal failure. In the first case, we are talking about rapid development, but the advantage of this point is that complete restoration of kidney function in women is possible if adequate methods of treating renal failure are used. Kidney failure in women of this type is a real opportunity to recover quickly and never have to think about this problem again. It is much worse if the fact of the presence of a permanent form is confirmed.

The disease can last for several years, which has a catastrophic effect on the condition of the woman’s body. In addition, a steady increase in symptoms is unlikely to be avoided. Chronic renal failure is complicated by the fact that the possibility of completely restoring the functions of damaged organs is practically absent.

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

The disease in its final stage is closely associated with symptoms in women that are characteristic of uremia. Moreover, it is likely that water-electrolyte metabolism is impaired. Death can only be avoided if hemodialysis is applied in a timely manner.

If a woman develops symptoms of kidney failure, she should 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 of the 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 go to the clinic.

Kidney failure symptoms and signs in men

The symptoms of the disease in men are completely identical to those in women. As the condition worsens, people experience shortness of breath due to fluid accumulating in the lungs and bruising may form on the body. The general condition can be described as drowsy. Spasms and cramps affect the muscles. Losing consciousness is critical.

Treatment of kidney failure

The first stage of treatment for the acute form is to eliminate the cause. Moreover, it is necessary to restore homeostasis and impaired renal function as quickly as possible. More specific agents used to treat renal failure depend on the course of the disease and the patient's condition. We can talk about antibacterial agents, detoxification therapy, fluid replenishment, hormonal drugs. Detoxification of the body and removal of nitrogenous wastes is carried out using hemodialysis, plasmapheresis, and hemosorption. To restore diuresis, the best option is the correct selection of diuretics. The introduction of sodium, potassium and calcium salts is also practiced, which helps restore water-electrolytic balance.

When treating an advanced stage, the main principle is to address the cause of the disease. Moreover, it is necessary to pay attention to detoxification therapy and maintaining normal kidney function. 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 prescribe symptomatic therapy together with permanent measures. For example, swelling can be reduced by prescribing diuretics. If there is a threat of developing anemia, then you cannot 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 2-3 times a week. A good, but not always accessible, alternative to this procedure is organ transplantation.

More details about dialysis in the video:

Nutrition and diet

Proper nutrition is one of the factors that can influence 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 tissue.

Diet must be very nutritious. The basic principles include limiting the consumption of foods that contain protein. Moreover, it is necessary to ensure high caloric intake and consumption of more vegetables and fruits. The neglected form is inextricably linked with fruit and vegetable fasting days, which are recommended to be used several times a week.

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

Treatment of kidney failure with folk remedies

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

There are acute and chronic renal failure.
Acute renal failure (ARF)- sudden impairment 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 of chemicals and fluids in the body 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 of the urinary tract, and decreased blood volume, such as after severe blood loss. Symptoms can develop over several days: the amount of urine output may decrease sharply, and fluid that should be eliminated accumulates entirely in the tissues, causing weight gain and swelling, especially in the ankles.

Acute kidney failure is a life-threatening disease because excessive amounts of water, minerals (particularly potassium) and waste products that are normally excreted in urine accumulate in the body. The disease usually responds well to treatment; Kidney function can be fully restored in a few days or weeks if the cause is correctly identified and appropriate treatment is given. However, acute renal failure due to kidney disease can sometimes lead to chronic renal failure, in which case the prospect of developing the disease depends on the ability to treat the underlying disease.

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

Prerenal acute renal failure (ischemic)

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

Renal acute renal failure.

— Exogenous intoxication (kidney damage from poisons used in industry and everyday life, bites of poisonous snakes and insects, intoxication with drugs and radiocontrast substances). — Acute infectious-toxic kidney with an indirect and direct effect on the kidneys of the infectious factor — Renal vascular lesions (hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura, scleroderma, systemic necrotizing vasculitis, thrombosis of arteries or veins, atherosclerotic embolism in severe atherosclerosis of the great vessels — primarily aorta and renal arteries). — Open and closed kidney injuries. — Post-ischemic acute renal failure.

Postrenal acute renal failure.

- Extrarenal obstruction (occlusion of the urethra; tumors of the bladder, prostate, pelvic organs; blockage of the ureters with stones, pus, thrombus; urolithiasis, blockage of tubules with urates in the natural course of leukemia, as well as their treatment, myeloma and gouty nephropathies, treatment with sulfonamides; accidental ligation of the ureter during surgery). — Retention of urination not caused by an organic obstruction (impaired urination due to diabetic neuropathy or as a result of the use of M-anticholinergics and ganglion blockers).

Symptoms

Excreting only small amounts of urine. . Weight gain and swelling of the ankles and face due to fluid accumulation. . Loss of appetite. . Nausea and vomiting. . Itching all over the body. . Fatigue. . Abdominal pain. . Urine that is bloody or dark in color. . Symptoms of the final stage in the absence of successful treatment: shortness of breath due to fluid accumulation in the lungs; unexplained bruising or bleeding; drowsiness; confusion; muscle spasms or cramps; loss of consciousness.

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

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

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

After 2-3 weeks, oligoanuria is replaced by a period of restoration of diuresis. The amount of urine usually increases gradually; after 3-5 days, diuresis exceeds 2 l/day. First, the fluid that accumulated in the body during the period of oligoanuria is removed, and then, due to polyuria, dangerous dehydration occurs. Polyuria usually lasts 3-4 weeks, after which, as a rule, the level of nitrogenous wastes normalizes and a long (up to 6-12 months) period of recovery begins.

Thus, from a clinical point of view, the most severe and life-threatening period for a patient with acute renal failure is the period of oligoanuria, when the disease picture is characterized primarily by azotemia with a sharp accumulation of urea, creatinine, uric acid in the blood and electrolyte imbalance (primarily hyperkalemia, as well as hyponatremia , hypochloremia, hypermagnesemia, hypersulfate and phosphatemia), the development of extracellular hyperhydration. The oligoanuric period is always accompanied by metabolic acidosis. During this period, a number of severe complications can be associated with inadequate treatment, primarily with the uncontrolled administration of saline solutions, when the accumulation of sodium first causes extracellular hydration, and then intracellular hyperhydration, leading to coma. A serious condition is often aggravated by the uncontrolled use of a hypotonic or hypertonic glucose solution, which reduces the osmotic pressure of the plasma and increases cellular hyperhydration due to the rapid transition of glucose, and subsequently water, into the cell.

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

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

To assess the severity of a patient’s condition with acute renal failure, the main importance is indices of nitrogen metabolism, primarily creatinine, the level of which in the blood does not depend on the patient’s nutritional characteristics and therefore more accurately reflects the degree of renal dysfunction. The retention of creatinine usually precedes the increase in urea levels, although the dynamics of the level of the latter is also important for assessing the prognosis in acute renal failure (especially when the liver is involved in the process).

However, in many ways, the clinical manifestations of acute renal failure, in particular signs of damage to the nervous system and muscles (primarily the myocardium), are associated with disturbances in potassium metabolism. Frequently occurring and quite understandable hyperkalemia leads to an increase in myocardial excitability with the appearance of a high, narrow base and pointed apex T wave on the ECG, slowing down atrioventricular and intraventricular conduction up to cardiac arrest. In some cases, however, instead of hyperkalemia, hypokalemia may develop (with repeated vomiting, diarrhea, alkalosis), the latter is also dangerous for the myocardium.

Causes

Diagnostics

Clarification of the etiological factors of acute renal failure allows for more targeted therapeutic interventions. Thus, prerenal acute renal failure develops mainly in shock conditions, characterized by severe microcirculation disorders due to hypovolemia, low central venous pressure and other hemodynamic changes; It is necessary to direct the main therapeutic measures to eliminate the latter. Close in mechanism to these conditions are cases of acute renal failure associated with large loss of fluid and NaCl in severe extensive lesions of the gastrointestinal tract (infections, anatomical disorders) with uncontrollable vomiting, diarrhea, which also determines the range of therapeutic effects. Renal acute renal failure develops due to the action of various toxic factors, primarily a number of chemical, medicinal (sulfonamides, mercury compounds, antibiotics) and radiocontrast substances, and can also be caused by renal diseases themselves (angina and nephritis associated with systemic vasculitis). Prevention and treatment of acute renal failure in these cases should include measures that limit the possibility of exposure to these factors, as well as effective methods of combating these kidney diseases. Finally, therapeutic tactics for postrenal acute renal failure mainly boil down to the elimination of acute obstructed urine outflow due to urolithiasis, bladder tumors, etc.

It should be borne in mind that the ratios of various causes of acute renal failure may vary due to certain features of their effect on the kidneys. Currently, the main group of cases of acute renal failure is still made up of acute shock and toxic kidney injuries, but within each of these subgroups, along with post-traumatic acute renal failure, acute renal failure in obstetric and gynecological pathology (abortion, complications of pregnancy and childbirth), acute renal failure due to blood transfusion complications and the effect of nephrotoxic factors (poisoning with vinegar essence, ethylene glycol), acute renal failure is becoming more frequent, associated with an increase in surgical interventions, especially in older age groups, as well as with the use of new drugs. In endemic areas, the cause of acute renal failure may be viral hemorrhagic fever with kidney damage in the form of severe acute tubulointerstitial nephritis.

Although a large number of studies have been devoted to the study of the mechanisms of development of acute renal failure, the pathogenesis of this condition cannot be considered completely clarified.

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

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

The morphological changes that arise in this case concern mainly the tubular apparatus of the kidneys, primarily the proximal tubules, and are represented by dystrophy, often severe necrosis of the epithelium, accompanied by moderate changes in the interstitium of the kidneys. Glomerular abnormalities are usually minor. It should be noted that even with the most profound necrotic changes, regeneration of the renal epithelium occurs very quickly, which is facilitated by the use of hemodialysis, which prolongs the life of these patients.

Given the commonality of developing processes, the predominance of one or another link in pathogenesis determines the features of the development of acute renal failure in each of its named variants. Thus, in shock acute renal failure, the main role is played by ischemic damage to the renal tissue; in nephrotoxic acute renal failure, in addition to hemodynamic disorders, the direct effect of toxic substances on the tubular epithelium during their secretion or reabsorption is important; in hemolytic-uremic syndrome, thrombotic microangiopathy predominates.

In some cases, acute renal failure develops as a consequence of the so-called acute hepatorenal syndrome and is caused by 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 (fulminant hepatitis or advanced liver cirrhosis), but without any visible organic changes in the kidneys. Apparently, changes in blood flow in the renal cortex of neurogenic or humoral origin play a certain role in the pathogenesis of this condition. Harbingers of the onset of hepatorenal syndrome are gradually increasing oliguria and azotemia. Hepatorenal syndrome is usually distinguished from acute tubular necrosis by a low concentration of sodium in the urine and the absence of significant changes in sediment, but it is much more difficult to differentiate it from prerenal AKI. In doubtful cases, the reaction of the kidneys to the replenishment of the volume of blood volume helps - if renal failure does not respond to an increase in the volume of blood volume, it almost always progresses and leads to death. Arterial hypotension developing in the terminal stage can cause tubulonecrosis, which further complicates the clinical picture.

Treatment

Prevention

Treatment of an illness that may cause acute renal failure.

Chronic renal failure (CRF)- impaired renal function, caused by a significant decrease in the number of adequately functioning nephrons and leading to self-poisoning of the body with products of its own vital activity.

Chronic kidney failure occurs when both kidneys gradually stop functioning. The kidneys contain numerous tiny structures (glomeruli) that filter waste from the blood and store larger substances such as proteins. Unnecessary substances and excess water accumulate in the bladder and are then excreted as urine. In chronic renal failure, the kidneys are gradually damaged over many months or years. As kidney tissue is destroyed by injury or inflammation, the remaining healthy tissue compensates. The extra work puts previously undamaged parts of the kidneys under strain, causing more damage until the entire kidney fails to function (a condition known as end-stage renal failure).

The kidneys have a large margin of safety; more than 80 to 90 percent of the kidney may be damaged before symptoms appear (although symptoms may appear sooner if the weakened kidney is subjected to sudden stress, such as infection, dehydration, or use of a drug that damages the kidneys). As excessive amounts of fluid, minerals such as potassium, acids and waste accumulate in the body, chronic kidney failure becomes a life-threatening disease. However, if the underlying disease is treated and further kidney damage can be controlled, the onset of end-stage renal disease may be delayed. End-stage kidney failure is treated with dialysis or a kidney transplant; any of these methods can prolong life and allow a person to lead a normal life.

Various diseases and disorders of the kidneys can lead to the development of chronic renal failure. These include chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney disease, renal tuberculosis, amyloidosis, as well as hydronephrosis due to the presence of various kinds of obstacles to the outflow of urine.

In addition, chronic renal failure can occur not only due to kidney disease, but also for other reasons. Among them are diseases of the cardiovascular system - arterial hypertension, renal artery stenosis; endocrine system - diabetes mellitus and diabetes insipidus, hyperparathyroidism. The cause of chronic renal failure can be systemic connective tissue diseases - 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 working activity in the nephron. External manifestations of chronic renal failure, as well as laboratory signs of renal failure, begin to be detected with the loss of 65-75% of nephrons. However, the kidneys have amazing reserve capabilities, because the body’s vital activity is maintained even if 90% of the nephrons die. Compensation mechanisms include increased activity of surviving nephrons and adaptive restructuring of the work of all other organs and systems.

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

Symptoms

A characteristic symptom of chronic renal failure is an increase in the volume of urine excreted - polyuria, which occurs even in the early stages with primary damage to the tubular part of the nephron. In this case, polyuria is constant even with limited fluid intake.

Disorders of salt metabolism in chronic renal failure primarily affect sodium, potassium, calcium, and phosphorus. Sodium excretion in urine can be either increased or decreased. Potassium is normally excreted primarily by the kidneys (95%), therefore, with chronic renal failure, potassium can accumulate in the body, despite the fact that the intestines take over the function of removing it. Calcium, on the contrary, is lost, so there is not enough of it in the blood during chronic renal failure.

In addition to water-salt imbalance, the following factors are important in the mechanism of development of chronic renal failure:

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

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

The renin-angiotensin system is activated and arterial hypertension is stabilized;

The acid-base balance in the blood is disturbed.

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

It should be noted that the most common direct cause of chronic renal failure is chronic pyelonephritis.

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 full-blown manifestations of renal failure appear 10-15 years later, and its early signs in the form of polyuria occur 5-8 years after the onset of the disease. An important role belongs to the timely and regular treatment of the inflammatory process, as well as eliminating its immediate cause, if possible.

Chronic renal failure caused by chronic pyelonephritis is characterized by an undulating course with periodic deterioration and improvement of renal function. Deterioration, as a rule, is associated with exacerbations of pyelonephritis. Improvements occur after complete treatment of the disease with restoration of impaired urine outflow and suppression of 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, usually with late or inadequate treatment, as well as with concomitant arterial hypertension and pyelonephritis with frequent exacerbations. In such cases, chronic renal failure develops slowly, within 10-30 years from the onset of the disease. However, in special forms of urolithiasis, for example, coral kidney stones, the death of nephrons is accelerated. The development of chronic renal failure in urolithiasis is provoked by repeated stone formation, a large stone, and its long-term presence in the kidney with a latent course of the disease.

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

The latent stage of chronic renal failure is detected when glomerular filtration rate (based on creatinine clearance) decreases to 60-45 ml/min. During this period, the main clinical signs of chronic renal failure are polyuria and nocturia - the release of more urine at night rather than during the day. Mild anemia may develop. Patients usually do not present any other complaints or note increased fatigue, weakness, and sometimes dry mouth.

The compensated stage is characterized by a decrease in glomerular filtration to 40-30 ml/min. There are also complaints of weakness, drowsiness, increased fatigue, and apathy. Daily urine output usually reaches 2-2.5 liters; increased sodium excretion in the urine may begin, as well as changes in phosphorus-calcium metabolism with the development of the first signs of osteodystrophy. In this case, the level of residual nitrogen in the blood corresponds to the upper limits of normal.

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

The terminal stage is characterized by intoxication of the body with its own nitrogenous waste - uremia. The glomerular filtration rate is 15-10 ml/min. Typical symptoms are skin itching, bleeding (nasal, uterine, gastrointestinal, subcutaneous hemorrhages), “uremic gout” with joint pain, nausea, vomiting, loss of appetite, even aversion to food, diarrhea. The skin is pale, yellowish, dry, with traces of scratching and bruises. The tongue is dry, brown in color, and a specific sweetish “uremic” odor emanates from the mouth. For the most part, these symptoms arise because other organs, for example, the skin, gastrointestinal tract, etc., try to take over the function of the kidneys to eliminate nitrogenous waste and cannot cope with it.

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

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

There is a decrease in immunity, which significantly increases the body's susceptibility to bacterial infections. One of the most common causes of death in patients with end-stage chronic renal failure are purulent complications, including sepsis, caused by opportunistic bacteria, such as intestinal papillae.

Diagnostics

Treatment

In the initial stages, treatment of chronic renal failure coincides with the treatment of the underlying disease, the goal of which is to achieve stable remission or slow down the progression of the process. If there are obstacles to the outflow of urine, it is optimal to remove them surgically. In the future, while the treatment of the underlying disease is continued, a large role is given to the so-called symptomatic drugs - antihypertensive (pressure-lowering) drugs from the ACE inhibitor group (Capoten, Enam, Enap) and calcium antagonists (Cordarone), antibacterial, vitamin drugs.

An important role is played by dietary restrictions on protein foods - no more than 1 g of protein per kilogram of the patient’s weight. Subsequently, the amount of protein in the diet is reduced to 30-40 g per day (or less), and with a glomerular filtration level of 20 ml/min, the amount of protein should not exceed 20-24 g per day. Table salt is also limited to 1 g per day. However, the calorie content of the diet should remain high - depending on the patient’s weight, from 2200 to 3000 kcal (a potato-egg diet without meat and fish is used).

Iron supplements and other medications are used to treat anemia. When diuresis decreases, it is stimulated with diuretics - furosemide (Lasix) in doses of up to 1 g per day. In a hospital setting, in order to improve blood circulation in the kidneys, intravenous drip-concentrated solutions of glucose, hemodez, rheopolyglucin with the introduction of aminophylline, chimes, trental, and papaverine are prescribed. Antibiotics are used with caution in chronic renal failure, reducing doses by 2-3 times; aminoglycosides and nitrofurans are contraindicated in chronic renal failure. For detoxification purposes, gastric lavage, intestinal lavage, and gastrointestinal dialysis are used. The washing liquid can be a 2% solution of baking soda or solutions containing sodium, potassium, calcium, magnesium salts with the addition of soda and glucose. Gastric lavage is performed on an empty stomach, using a gastric tube, for 1-2 hours.

In the terminal stage, the patient is indicated for regular (2-3 times a week) hemodialysis - an artificial kidney machine. The appointment of regular hemodialysis is necessary when the level of creatinine in the blood is more than 0.1 g/l and its clearance is less than 10 ml/min. Kidney transplantation significantly improves the prognosis, however, in the terminal stage, poor organ survival is possible, so the issue of transplanting a donor kidney should be decided in advance.

Prevention

Prognosis of chronic renal failure

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

PN is a serious disease of the urinary system associated with a decrease or complete absence of its functional activity. Symptoms of kidney failure in women depend on the type of pathology or stage at which the disease is located. The consequence of the disease is a violation of the water-electrolyte balance, poisoning of the body with metabolic products. In the absence of adequate treatment, the result is death.

Features of renal failure in women

Pathology, according to statistics, is more common in women than in men. This pattern is fully explained by the anatomical features of the genitourinary system.

The urethra in females is larger in diameter and shorter in length; it is the entrance gate for pathogenic microflora. Further spread of the infection occurs along the ascending path, that is, from the urethra through the bladder and ureters. It is active infectious inflammation and further proliferation of connective tissue that leads to impaired kidney function.

Types and stages of renal failure in women

There are two main forms of the disease: acute and chronic. Each type goes through several stages, differing in clinical picture and diagnostic data.

With (ARI), four periods are distinguished:

• elementary;
• oligoanuric;
• polyuric;
• recovery period.

Chronic renal failure or chronic renal failure also consists of four stages:

• initial or latent;
• compensated;
• intermittent;
• terminal.

Causes of PN in women

In the etiology of this disease, it is worth highlighting two main points: the reasons due to which the deficiency was directly formed and the risk factors that determine the predisposition of a particular woman to the development of pathology, but do not cause it.

The causes include the following:

• damage to the pelvicalyceal system by bacteria or viruses (Staphylococcus aureus, Koch's bacillus or mycobacterium tuberculosis, influenza virus and others);
• active autoimmune process - inadequate functioning of the immune system, in which antibodies are produced to its own healthy cells;
• active growth of a benign or malignant tumor, compressing surrounding tissues;
• impaired blood supply to the kidney due to arterial thromboembolism, arterial spasm, atherosclerotic process or gradual sclerosis;
• removal of a kidney, after which an adequate blood filtration process in the paired organ was not restored;
• previous surgical intervention, difficult postoperative period;
• pregnancy;
• urolithiasis disease.

Risk factors include:

• poor nutrition, excessive consumption of protein foods, foods containing dyes and preservatives;
• sedentary lifestyle, passivity;
• presence of bad habits: alcohol abuse, smoking, drug addiction;
• hereditary predisposition;
• old age: fifty years and older;
• obesity;
• diabetes mellitus, leading to all kinds of metabolic disorders;
• long-term use of medications that have a toxic effect on the organ;
• congenital anomaly of the kidneys and urinary system as a whole.

Symptoms of acute renal failure

Signs of renal failure in women directly depend on the course of the pathology and the phase of development. The initial period of acute renal failure has an acute onset and is characterized by:

• severe pain in the lumbar region;
• decreased diuresis;
• nausea;
• vomiting;
• weakness;
• dizziness;
• less often – the patient’s lethargy and impaired consciousness.

Some changes also occur in the organs of the cardiovascular system:

• heart rate increases;
• blood pressure gradually increases;
• a systolic murmur appears on auscultation of the heart;
• the mutedness of the first and second tones is determined;
• a heart rhythm disturbance develops.

During the oligoanuric phase the following is noted:

• decreased diuresis up to anuria;
• increasing signs of intoxication;
• change in urine color to pink or red.

With adequate treatment, at the end of this phase there is some improvement in the patient’s well-being.

During the polyuric period, diuresis is gradually restored, laboratory parameters return to normal. Clinical manifestations mostly include:

• weakness;
• lethargy;
• arterial hypertension with a heart rate of 60–80 beats per minute.

The recovery period speaks for itself, the body is completely restored, the functioning of the urinary system is preserved.

During pregnancy

During pregnancy, some women develop renal failure syndrome due to compression of the ureters or vessels supplying the organ. In this case, the main symptoms are:

• a sharp decrease in the volume of urine excreted up to its complete absence;
• arterial hypertension;
• proteinuria - the appearance of a large amount of protein in the urine;
• swelling of tissues, mainly on the lower extremities and face;
• weakness, nausea, vomiting, unusual for the second and third trimester;
• pallor of the skin.

If such a clinical picture develops, you should urgently consult a doctor who will decide on hospitalization in the urology department.

Signs of chronic renal failure

Compared to acute renal failure, this type of disease develops slowly, due to various pathologies, for example, low-grade inflammation of the parenchyma.

In the latent stage of chronic renal failure, women have virtually no symptoms; in rare cases, fatigue may gradually increase during normal physical or mental stress, and dry mouth may appear. Changes in blood and urine tests are minor.

During the compensated stage, the body activates compensatory mechanisms that increase the functioning of the renal apparatus. Due to this, the volume of urine excreted increases to 2.5–3 liters. Along with it, there is a loss of protein and microelements, which negatively affects the water-electrolyte balance and metabolism in cells.

During the intermittent phase, the following changes occur:

• oliguria or anuria appears;
• blood and urine values ​​differ sharply from normal values;
• Intoxication of the body increases.

Complaints mostly include:

• dizziness;
• weakness;
• nausea;
• vomiting;
• drowsiness;
• disturbance of consciousness up to stupor and stupor;
• tachycardia;
• increased sweating;
• pale skin;
• a sharp increase in blood pressure.

At the terminal stage:

• intoxication encephalopathy and other structural disorders of the nervous system are formed;
• mental disorders in the form of apathy, mutism (silence) are noted;
• there is a complete lack of appetite;
• from the gastrointestinal tract: diarrhea, regurgitation of food, vomiting, flatulence;
• no urine is released.

The endocrine and cardiovascular system functions inadequately. The pathological process ends in death.

Diagnosis of kidney failure

It necessarily begins with interviewing the patient, collecting an anamnesis of the disease and life, and a general examination, after which the doctor decides which test to prescribe. To confirm the presence of renal failure, a woman needs to undergo tests and undergo instrumental examination.

Among laboratory methods, the most important are general, biochemical blood tests, and general urinalysis. Markers of this disease include:

• proteinuria – the presence of protein in the urine, in particular albumin;
• change in urine sediment - fragments of erythrocytes and leukocytes are determined;
• disturbance of water-electrolyte balance, decrease in the amount of certain microelements in the blood.

Biochemical analysis shows an increase in the concentration of creatinine, urea and a decrease in the glomerular filtration rate of GFR.

In order to visualize the affected organ, the doctor sends the patient for an ultrasound of the kidneys and radiography with contrast. During the examination you can determine:

• the presence of a tumor, stones;
• change in the contour of the organ due to the proliferation of connective tissue, shrinkage of the kidney during the infectious process;
• structural disorder of the pyelocaliceal system;
• blockage of the ureter;
• decreased blood supply to tissues for one reason or another.

Complications

Complications of renal failure should be divided depending on the form of the disease. In case of acute renal failure in the absence of adequate medical care, the following consequences are observed:

• suppression of the immune response with further development of sepsis and infectious-toxic shock;
• pulmonary edema;
• heart rhythm disturbance;
• pericarditis;
• malignant hypertension;
• uremic gastroenterocolitis;
• peripheral or central polyneuropathy.

With chronic renal failure, complications are expressed at the third and fourth stages of development. Often formed:

• thrombocytopenia;
• uremic pneumonitis;
• myocarditis or pericarditis;
• congestive heart failure;
• encephalopathy with subsequent neurological and mental disorders;
• osteomalacia;
• sepsis and infectious-toxic shock.

Treatment

Therapy is based on two main points: diet and taking specialized medications. It is worth remembering that treatment is selected individually by the doctor, taking into account the woman’s age and the severity of the disease. The use of traditional methods is prohibited; if you treat kidney failure with herbs alone, you can only achieve the development of complications that were described just above.

Diet

The diet involves a balanced diet, eating foods low in protein and table salt. The amount of fluid that enters the patient’s body per day is taken under control. The goal pursued by the doctor in this case is to lower blood pressure and reduce the load on the renal glomeruli.

The set of recommended products may vary depending on which microelement needs to be replenished in the body. For example, if the level of potassium decreases, the diet should contain more dried fruits and nuts, and if there is a deficiency of magnesium, the emphasis should be on fresh vegetables, fruits, and cereals.

Medication

As for medications, infusion therapy often comes to the fore - intravenous administration of solutions of microelements and glucose to restore water and electrolyte balance. Additionally, in rare cases, the doctor recommends oral tablets with a complex of vitamins and minerals.

To relieve arterial hypertension, two main groups of drugs are prescribed: sartans (angiotensin receptor blockers) and angiotensin-converting enzyme inhibitors (ACE inhibitors). Treatment of arrhythmias is selected by a cardiologist depending on the type of disorder.

For widespread edema and anuria, to restore daily diuresis, take diuretics - diuretics. In clinical practice, loop and potassium-sparing medications are most often prescribed.

The rehabilitation period after acute renal failure usually takes six months or a year. During this time, the woman must be registered at the dispensary. The chronic form of the disease implies constant monitoring of the patient’s well-being, but complete recovery cannot be achieved through outpatient or inpatient treatment.

Kidney failure provokes irreversible processes in organs and tissues of the whole body. It develops when there are disturbances in the functioning of the heart, a sharp drop in blood pressure, dehydration, cirrhosis of the liver, damage to organs by toxic substances or harmful microorganisms. Kidney failure is characterized by general malaise, intoxication, and disturbances in the functioning of other organs, in particular the gastrointestinal tract, heart, and brain. As the pathology progresses, patients notice skin manifestations and the functioning of the respiratory system is disrupted.

In acute renal failure, tissue death of these organs occurs, which is accompanied by loss of their functions. The clinical picture depends on the stage of the pathological process.

Table. Stages of renal failure.

Chronic renal failure: signs

With chronic inhibition of kidney function, the death of nephrons and replacement of dead cells with connective tissue is possible. At stage 4 of the pathological process, the kidneys stop functioning, urine is not excreted, which causes changes in the electrolyte composition of the blood.

Latent stage

Symptoms of the disease at this stage depend on the pathology that provoked the occurrence of impaired renal function.

1. Edema. They can appear not only in the morning, but also during the day. Usually their size depends on the amount of liquid taken per day.
2. Increased pressure, not caused by obvious factors.
3. Strong pain in the lumbar region.

Attention! There is a possibility of complete absence of characteristic symptoms of the disease if renal failure occurs due to polycystic disease or glomerulonephritis.

Signs indicating the presence of an infectious process in the body:

• fast fatiguability;
• problems with sleep, most often patients report insomnia;
• loss of appetite, patients often refuse most foods.

Important! These symptoms can indicate an extensive list of diseases. You cannot rely solely on a person’s well-being to make a diagnosis of kidney failure. If you notice the listed symptoms, it is advisable to consult a doctor and then conduct a full diagnostic examination.

The latent stage of the pathology can be suspected by the frequent urge to urinate at night. To find out whether this deviation is a symptom of kidney disease, you need to consume a minimum amount of fluid during the day. If a temporary decrease in the amount of fluid consumed does not affect the number of urinations, it is advisable to undergo an examination.

If early signs of kidney failure are ignored, additional symptoms will become noticeable as the disease progresses.

1. Intense thirst even if the patient regularly drinks the required amount of fluid. You should make sure that this symptom is not caused by chronically high blood pressure.
2. A decrease in the amount of hemoglobin in the blood, electrolyte disturbances that can be detected by taking a blood test. Also often diagnosed is a decrease in the amount of vitamin D, a decrease in the level of parathyroid hormone without symptoms of osteoporosis.

Attention! If you notice the disease at a latent stage, you can completely eliminate the negative symptoms. To do this, it is important to undergo a diagnostic examination, then follow the recommendations of the doctor who prescribed the course of treatment.

Azotemic stage

If the prescribed treatment is ineffective, as well as the symptoms of the latent stage of renal failure are ignored, irreversible pathological processes appear in the structure of the renal tissue. The clinical picture of the disease is characterized by the following signs.

Intermittent stage

The intensity of the symptoms of renal failure that have already appeared increases, and additional abnormalities also arise.

1. Pathologies of lipid metabolism, an increase in the amount of cholesterol in the blood, which can be detected during testing. The listed disorders are provoked by pathologies in the structure of the walls of blood vessels, as well as brain cells.
2. Increased amount of phosphorus in the blood. As a result, the initial stage of osteoporosis occurs, salt deposits appear in the cells.
3. Patients complain of pain in the joints. Usually, unpleasant sensations occur periodically, but the pain appears sharply and is of high intensity.
4. The kidneys do not excrete purine compounds, since their functioning processes are disrupted. As a result, secondary gout develops, and the intensity of pain in the joints increases.
5. Malfunctions of the heart, chronic arrhythmia, extrasystole. Gradually, the course of these diseases worsens. Pathologies in the functioning of the heart are provoked due to an increase in the amount of potassium. If the patient does a cardiogram, signs of microinfarctions will be detected.
6. Changes in appearance. The patient's face becomes puffy, and the salivary glands increase in size. Both strangers and the patient himself regularly note the presence of the smell of acetone from the mouth. An unpleasant taste appears in the mouth.

Attention! These signs indicate an increase in the amount of uremic toxins in the body.

Terminal stage

Replacement treatment is required. Hemodialysis is performed; it can be replaced by peritoneal dialysis. Sometimes these procedures are combined. Failure to artificially support kidney function can lead to death.

The main symptoms indicating the transition of the disease to the terminal stage are given below.

1. The kidneys cannot fully produce urine. Excretion products are excreted in minimal quantities. As a result, swelling occurs. They appear visually, and damage to internal organs also occurs. The most dangerous complication that can lead to death is pulmonary edema.
2. Itching of the skin. Usually this deviation manifests itself so strongly that patients cannot ignore it, and scratches appear on the skin. The patient's complexion takes on a gray-yellow hue.
3. Nosebleeds often occur. There may also be periodic bleeding from the gums. Traces of small intracellular bleeding can be seen on the skin. They usually occur even with minimal mechanical impact. The predisposition to bleeding is caused by a large amount of uremic toxins, which quickly accumulate in the body and are excreted extremely slowly. In some cases, bleeding occurs in the gastrointestinal tract, which worsens the symptoms of anemia.
4. Electrolyte disturbances that lead to serious mental and neurological pathologies. There is a risk of paralysis, prolonged depression, and the development of manic disorders is possible.
5. A persistent increase in blood pressure that cannot be reduced even with the help of potent medications. The course of heart failure also worsens.
6. The patient experiences difficulty breathing, congestion occurs in the lungs, which often provoke the onset of pneumonia.
7. Uremic gastroenterocolitis. Patients indicate frequent vomiting, diarrhea, and nausea also occurs periodically.

Attention! At stages 3 and 4 of chronic renal failure, there is a threat to the patient’s life. To prevent the occurrence of dangerous symptoms, you should undergo a course of treatment when the first symptoms of abnormalities in the functioning of the kidneys are detected.

Specific symptoms that help determine chronic renal failure, focusing on the clinical picture of the disease, occur during irreversible processes in the organs. In order to promptly diagnose the disease in the initial stages, it is necessary to regularly take blood and urine tests, and also consult a doctor if weakness or decreased ability to work appears.

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