In the article we will consider the stages of chronic renal failure.
Pathology is a violation that occurs against the background of various conditions, which often lead to serious consequences for human life and he alth. Due to this disease, the kidneys actually stop performing their functions that keep the body working.
What is the pathogenesis of chronic kidney disease?
The essence and nuances of the disease
CNP is not necessarily a disease of the urinary system or kidneys. Due to various pathologies of the body, for example, diabetes, the death of structural kidney components is observed. And the kidneys are responsible for filtering urine and excreting it.
Against the background of the acute form of this disease, kidney failure can develop rapidly, and in the presence of a chronic course, this occurs slowly and gradually, sometimes over several months, but a steady tendency to progression is possible. This isis an irreversible disorder. Kidney failure does not occur suddenly. It is the result of diseases that attack the nephrons, which are elements of the urinary system, they are also part of the kidneys. So, kidney failure can be the result of an autoimmune disease, pyelonephritis, glomerulonephritis, diabetes, polycystic kidney disease and cirrhosis of the liver.
Against the background of certain inflammatory processes, the death of nephrons is gradually carried out. Initially, sclerotic changes are observed, months pass, and they increase even more. As a result, the kidney ceases to perform its tasks and necessary functions.
Damage to even fifty percent of nephrons can go unnoticed by humans. And only when the indicators in the form of creatinine and urea begin to change and linger in the body, will kidney failure begin to develop. Thus, it is necessary to take appropriate tests at least once a year, and, in addition, visit a doctor in order to avoid this disease. According to the generally accepted classification, kidney failure is in the category "Diseases of the genitourinary system". This disease is classified under code No. 18.9. She should be treated by a nephrologist.
Now let's move on to consider the provoking factors that cause this complex disease.
Causes of kidney failure in children and adults
This disease is based on various ailments that affect the human body at different life periods. We are talking about congenital kidney diseases, gout, diabetes,metabolic problems, stones, lupus erythematosus and so on. Any chronic poisoning with various substances can be a provoking factor.
Classification of chronic renal failure by stages will be considered later in the article.
Disease during pregnancy
Chronic kidney failure syndrome is a dangerous condition during pregnancy. In this regard, even at the stage of planning a child, you need to consult a doctor and undergo an examination. In the event that a woman already suffers from a chronic form of this disease, then the specialist must assess the risks associated with the possibility of bearing a fetus. There are situations when, due to a too severe form of kidney failure, women had to terminate their pregnancy, due to the fact that it was life-threatening. Provoking factors leading to kidney failure in pregnant women is pyelonephritis along with urolithiasis, cystitis and other diseases of the urinary system.
Pyelonephritis, which occurs in pregnant women, is especially insidious, since this disease can resemble the symptoms of toxicosis. In some situations, it is simply impossible to find out why pyelonephritis occurs in pregnant women.
In the event that the risk to the patient and the fetus is minimal and she is allowed to bear, the doctor will prescribe an absolute restriction of physical activity along with bed rest at the slightest exacerbation. A special diet combined with medication and stay inhospital will help to significantly reduce the manifestation of kidney failure and give birth to a baby.
It is worth noting that there are clear indications for terminating a pregnancy in a woman with this disease, we are talking about increasing the level of creatinine in the blood to 200 micromoles or more. Pregnancy planning is prohibited if a creatinine index of 190 micromoles per liter of blood is detected in the blood. The thing is, the higher this indicator, the more likely the development of preeclampsia. And such a diagnosis is already a real threat to a woman's life, since it can lead to a stroke along with acute kidney failure.
Regardless of the stage of chronic renal failure, there is a risk for the fetus in the form of premature birth. In this case, the baby will need intensive care. Every year, five to ten children out of one million are diagnosed with such a diagnosis. The causes of the disease are congenital diseases, in the form of pyelonephritis and various nephropathies, hydronephrosis, polycystic kidney disease or acquired ailments, such as the development of diabetes.
With this disease, anemia is observed in children along with increased fatigue, headache, developmental delay, thirst, and so on. At school age up to fourteen years old, an increased growth of the child is observed, which must be said unfavorably in the presence of developing renal failure. With this disease, the kidneys do not grow together with the body, there is a violation of metabolism, and at the same time, the state of the urinary system worsens. In this case, the risk of mortality is very high. At present, with adequateWith the right treatment, children with kidney failure can live up to twenty-five years, especially if treatment was started before the age of fourteen.
Next, we will find out how the pathology in question manifests itself and what its main symptoms are.
Symptoms of the disease
The pathogenesis of chronic kidney disease should be known to everyone. At the beginning of its appearance, kidney failure may not manifest itself in any way. As already noted, signs may not be observed up to fifty percent damage to kidney function. In the case of the development of pathology, patients begin to feel weakness along with fatigue and drowsiness. The following symptoms may also be observed:
- Frequent urination, especially at night. Dehydration may occur due to failure of urine output.
- The appearance of nausea with an attack of vomiting.
- Probably thirsty and dry mouth.
- There may be aching pain and bloating.
- Diarrhea along with nosebleeds, frequent otolaryngological diseases and colds, as well as anemia can not be ruled out.
At the late stage of the disease in the stage of decompensation of chronic renal failure, patients suffer from asthma attacks, even loss of consciousness is possible. All symptoms develop slowly. Now let's look at the stages of this disease, and, in addition, let's talk about the classification and degrees of development of kidney failure, which occurs in a chronic form.
So, what are the stages of chronic renal failure? About itnext.
Creatinine stages
Staging on creatinine is determined not only by symptoms, but also based on tests. The first stage is the latent or initial stage of chronic renal failure. In the event that you take a blood test, then the level of creatinine will only slightly exceed the normal rate and will be 1.6 milligrams. Normally, this indicator is 1.2 milligrams, and this means that the kidneys are functioning normally. It is worth noting that the latent stage does not manifest itself in any way.
At the initial stage of chronic renal failure, ammonia synthesis is carried out by creatinine, but it is usually reduced. The renogram shows some changes. As a rule, it is impossible to suspect the onset of the disease without a complex of tests. Therefore, kidney failure at this stage is rarely detected and is completely accidental. This disease is detected by creatinine when the test results are on hand.
The next stage of chronic kidney failure is called polyuric. The level of creatinine at the same time increases to 2.7 milligrams. The kidneys begin to cope poorly with their assigned responsibilities. Some of the functions that must be performed by the kidneys are taken over by the liver and other organs.
We continue to consider the stages of chronic renal failure in pathological anatomy.
Symptoms at this stage of the disease are severe weakness, especially before lunch, along with a strongthirst and low body temperature. The nature of the renogram is usually gentle in this case. At this stage, glomerular filtration is reduced. Further, the level of creatinine will increase more and more, new symptoms and complications will appear.
The next stage of chronic renal failure is called intermittent. Against its background, the level of creatinine rolls over and very much exceeds the norm of 4.5 milligrams. At this stage, the volume of excreted urine increases and its environment changes. Urine usually becomes alkaline. At this stage, the urea level doubles. Decreased levels of calcium and potassium. In general, the stages of chronic renal failure are very easy to recognize by the level of creatinine.
Symptoms of the disease are weakness, in addition, the following manifestations are observed:
- Muscles may begin to twitch. Seizures may occur.
- Skin may become dry.
- In addition, there are pronounced manifestations of anemia.
- There is an increase in arterial hypertension.
- Probable nausea with gagging.
- Constipation is not excluded, and at the same time the associated bloating.
The third stage is the terminal one. At this stage, sleep problems may occur. The psychological state worsens to a great extent. There is a very strong itching of the skin. Seizures become much more frequent. At the same time, the creatinine index is high, and the urea values, exactly as well as the residual nitrogen, are also overestimated. The disease is progressive at this stage. In the event that at the firstsymptoms of the disease do not go to the doctor, then the transition from one stage to another passes very quickly. At the initial stages, the pathology develops against the background of inflammatory pathologies.
At the stage of decompensation, the glomerular filtration rate decreases to 29-15 ml/min. Tubular secretion decreases, the patient has persistent azothermia for urea in the range of 8-20 mlmol/l and for creatinine 0.2-0.5 mlmol/l.
We have described the stages of chronic renal failure according to creatinine. What other classification is there?
Classification of pathology and the degree of its development
This disease is widespread among the entire population of the globe. According to statistics, from sixty to three hundred people per one million inhabitants of the planet per year fall ill with it. With intensive treatment, the survival rate is over fifty percent.
There is also a classification of the disease according to severity:
- At Grade 0, there is no disease, but there are risk factors in the form of other diseases.
- The first degree is the initial one. In this case, there is any kidney disease.
- Chronic renal failure in stage 2 is pronounced. Against its background, symptoms of intoxication begin to appear in the body.
- Heavy in nature is the third degree. Against its background, phosphorus and calcium metabolism is disturbed in the body, and, in addition, anemia with creatinemia is growing.
- The fourth degree is terminal. Conservative treatment is not effective in this case.
- 5 stage of chronic renal failure. Patients have severe renal impairment. There is a need for replacement therapy.
Absolutely each of the stages has its own clear manifestations, which only a doctor can evaluate.
In the stage of decompensation of chronic renal failure and in the terminal stage, the prognosis will be unfavorable, even despite hemodialysis. Kidney transplantation is not a guarantee of a favorable outcome, since it is very difficult to find a transplant organ with perfect histocompatibility.
What are the complications of this disease?
Chronic kidney failure in many cases is in itself a consequence of long-term pathologies existing in the patient. Complications directly from kidney failure occur, as a rule, against the background of a severe stage of the disease. Most often, complications in the form of heart failure are observed, among other things, a heart attack is possible along with severe hypertension.
This pathology also has a detrimental effect on the activity of the nervous system. Then the patient is threatened with convulsions along with the development of a nervous breakdown up to dementia. During treatment in the form of dialysis, thrombosis is very often possible. But the most dangerous complication is kidney necrosis. Patients can fall into a coma, as a result of which such patients often die.
Terminal symptoms
The terminal stage is the final stage in the development of failurekidneys. It is also considered the most severe and, unfortunately, incurable. This involves a complete failure of the he althy functioning of one kidney or both at once. Against this background, the glomerular filtration rate decreases to a minimum value, despite the ongoing treatment. Severe uremia can occur, with the body actually poisoning itself with its own waste products.
This condition leads to the development of lesions of the cardiac and vascular system. Reinforced therapy with dialysis not only heals, but also injures. It can support vital functions, but it can lead to severe hypertension, as well as severe anemia and thrombosis. With this method of treatment, the functions of the digestive system are very seriously affected. Often, patients die due to emerging heart pathologies.
Treatment depends on the stage of chronic renal failure.
Kidney failure in children
Chronic kidney failure in children is a non-specific syndrome that occurs as a result of a decrease in the homeostatic function of the kidneys, which is caused by their severe progressive disease.
The stages of chronic renal failure are also distinguished by creatinine in children.
According to the generally accepted international classification of pathologies, the end stage of kidney damage, unspecified and other manifestations of this disease in young patients are distinguished. In science, there are many different classifications of renal function failure, based on the following principles: on the criterion of creatinine concentration,on the glomerular filtration rate, on the staging of clinical symptoms, and, in addition, on tubular dysfunctions.
As for the epidemiology of this dangerous disease in children, according to statistics, from three to fifty children out of one million are diagnosed with kidney failure. Every year, four to six children out of one million who are under the age of fifteen must receive mandatory replacement treatment due to their chronic kidney failure.
What causes chronic kidney failure in children?
Chronic insufficiency of this organ in children may manifest itself due to the influence of such factors:
- Due to early decline in kidney function.
- Due to torpid progressive course of nephropathy.
- Due to the increasing instability of cell membranes.
- Due to renal dysembryogenesis.
- Due to the influence of drugs.
The risk group for developing this disease includes children with the following diagnoses:
- When diagnosed with severe uropathy.
- Against the background of tissue renal dysembryogenesis.
- For hereditary nephritis.
- On the background of tubulopathy or sclerosing variants of nephritis.
Among other things, the reasons for the development of such a dangerous pathology in a child can be acquired or congenital diseases. Among congenitalpathologies distinguish nephropathy, joining systemic diseases along with pyelonephritis, and, in addition, chronic or subacute specific glomerulopathy. Nephropathies that can cause kidney failure include polyarteritis nodosa along with hemorrhagic vasculitis, which is characterized by a subacute course, and so on. Among congenital pathologies, the disease in question in children is most often provoked by the following ailments:
- Presence of polycystic or hypoplastic kidneys.
- Nephrocalcinosis along with congenital forms of hydronephrosis and more.
The treatment depends on the stage and clinic of chronic renal failure.
CHF treatment methods
The treatment program is as follows:
- The underlying disease that caused the uremia needs to be treated.
- The mode must be observed.
- He althy nutrition shown.
- Fluid intake should be adequate.
- Electrolyte imbalance needs to be corrected.
- Carrying out the fight against azotemia.
- Correct acidosis.
- Treatment of arterial hypertension.
- Anemia needs to be treated.
- Get rid of uremic osteodystrophy.
- Exclude infectious complications.
Diet and sample menu
The main rule of therapeutic nutrition for kidney disease is to reduce s alt and liquid in the diet as much as possible. In addition, it is required to reducemenu the amount of protein food and include natural antioxidants in the diet.
Below is an example menu for CRF.
Monday:
- 1st breakfast: pudding, fruit juice.
- 2nd breakfast: grated carrots with sugar.
- Lunch: vegetable soup, boiled beef.
- Snack: rosehip broth.
- Dinner: protein omelet, tea.
Tuesday:
- 1st breakfast: oatmeal porridge with milk, salad with vegetables, fruit juice.
- 2nd breakfast: fruit.
- Lunch: borscht, meatballs, kissel.
- Snack: rosehip broth.
- Dinner: cottage cheese casserole, apple and carrot salad, tea.
Wednesday:
- 1st breakfast: egg white omelette, beet salad with apples.
- 2nd breakfast: fruit.
- Lunch: borscht, boiled pork and vegetables, mashed potatoes, compote.
- Snack: rosehip broth.
- Dinner: chicken meatballs, coleslaw with apples, tea.
Thursday:
- 1st breakfast: oatmeal porridge, vegetable salad, fruit juice.
- 2nd breakfast: fruit.
- Lunch: potato soup, beef stroganoff, vegetable stew, berry jelly.
- Dinner: boiled potatoes with sour cream, apple pancakes, tea.
Friday:
- 1st breakfast: apple and cottage cheese casserole, carrot salad, fruit juice.
- 2nd breakfast: fruit.
- Lunch: potato soup, boiled chicken, compote.
- Snack: rosehip broth.
- Dinner: dumplings with cottage cheese, stewed plums, tea withmilk.
On Saturday and Sunday, you can repeat the menu of any days of the week.
Disability
To obtain a disability with the development of the disease in question, it is necessary to pass a medical commission. True, such a patient is recognized as able-bodied only if at least the initial or latent stage of this disease is found in him. In this case, a person may be able to serve himself, he will have only a slight lesion of the internal organs and unexpressed symptoms. Such patients, as a rule, are transferred to light work, assigning the third group of disability.
The second group of disability is determined for the patient with the development of the terminal stage of chronic renal failure and significant violations of internal systems and organs. But at the same time, a person still retains the ability to work, and, in addition, to serve himself independently in everyday life.
The first group is given to a person who has a severe terminal stage of this pathology. Among other things, this can be awarded in case of serious damage to the body, and, in addition, against the background of a kidney transplant. In everyday life, such patients definitely need the help of relatives and relatives.
In order to apply for disability, patients need to contact the doctor for the results of studies and tests, among which special attention is paid to biochemical parameters of blood, X-ray of the skeletal system and ultrasound of the kidneys. As a result, the conclusion of the attending physician should be obtained.doctor. With these documents, a person is sent to pass the commission.
After determining the disability group, the patient is assigned light work, and, in addition, retraining for one of the professions. Or, if a person has a terminal stage, proper home care can be determined, among other things, a supportive treatment or rehabilitation program is drawn up.
It should be remembered that often renal failure in patients develops in the presence of diabetes of various types, and, in addition, in those patients who suffer from urolithiasis or hypertension. Such categories of patients need to be examined more often by doctors, taking prescribed medications in order to prevent such a dangerous complication as chronic kidney failure.
We examined the stages of chronic renal failure by creatinine. The diet and menu were also described.
