The kidneys perform an important function in the body. They cleanse the blood of harmful substances and toxins, removing them naturally. Poisoning, various diseases, and even pregnancy can affect the proper functioning of this organ. All this can cause kidney necrosis.
General information
Renal necrosis is a condition in which the structure of an organ changes. It can occur due to a large number of reasons. The disease affects the papillae, tubules, even the cortical substance of the kidney. Most often, the disease develops as a complication of an uncompensated and prolonged course of any inflammatory processes in the urinary system.
Pathology causes tissue death, resulting in changes in blood flow to other organs. Kidney necrosis develops according to several scenarios. It can be a consequence of ischemic changes in the parenchyma or appear after an injury. Such changes are always dangerous for human he alth and life, as they can lead to complete kidney failure or to the development of kidney failure, which will disruptfunctioning of other vital organs.
Renal necrosis can spread to the tissues of the heart, liver and brain. But here much depends on the degree of development of the disease and the cause of its occurrence. If the disease progresses rapidly, then the chances of saving a person's life are slim.
What comes from
The reasons that can provoke the appearance of this pathology include:
- poisoning with various pesticides, poisons, s alts of heavy metals;
- difficult birth;
- pregnancy with placental abruption;
- failed abortion;
- infectious and inflammatory diseases (most often pyelonephritis);
- various endocrine pathologies;
- bacteriological sepsis;
- impaired blood flow through the parenchyma, kidney infarction;
- urolithiasis;
- decreased immunity;
- traumatic injuries in which blood flow to the organ is disrupted.
All causes of kidney necrosis can be divided into several subgroups, they can be: infectious-inflammatory, traumatic and other. Various circulatory disorders can also lead to pathological changes.
Views
In medicine, there is a classification of varieties of necrosis. It helps to understand the causes of the disease and to prescribe the right treatment:
- Papillary type. As a rule, it develops as a complication of acute pyelonephritis, in the case when there isobstruction of the ureter by a calculus or obstruction of the outflow of urine.
- Cork type. A rare type of disease, more often occurs in women as a complication after childbirth. May be accompanied by sepsis. Also, damage to cortical tissues is often detected in newborns. Pathology is dangerous because its symptoms are mixed with signs of the underlying disease, against the background of which the following are observed: hematuria, fever, impaired urine outflow, renal failure, high intoxication of the body.
- Necrosis of the epithelium of the convoluted tubules of the kidney on a micropreparation and a real organ is characterized by damage to the cells of the nephron tubule. Usually this disease develops due to exposure to toxic substances in the body. In addition, pathology can appear due to a violation of blood flow to the organs as a result of inflammation, trauma, sepsis or shock. Also, the progress of necrosis of the epithelium of the tubules of the kidney can be surgical interventions, traumatic injuries, mechanical pressure on the organs or its tubules, taking toxic drugs.
- Cortical leakage. The disease is characterized by the death of the cells of the kidney cortex. Most often diagnosed in girls at different stages of pregnancy. The cause of the pathology can be intoxication with glycols, infection with gram-negative bacteria. If cortical necrosis of the kidneys occurred against the background of pathological processes after an unsuccessful abortion or during sepsis, endoscopic shock may be the consequence. In this case, the patient's condition deteriorates rapidly and develops especially acutely. Symptoms are most often classic, but with the death of the kidney cortex canthere is complete anuria.
- Focal necrosis. In this case, pathogens are considered the cause of tissue death. The disease can develop under the influence of pale treponema, tubercle bacillus, mycobacterium leprosy.
The disease can occur not only in adults, but also in children. Necrosis of the kidneys in this case most often manifests itself in the form of a papillary or cortical type. Treatment of pathology is similar to therapy in adults.
Symptomatics
There are several signs indicating that irreversible changes are taking place in the body:
- appearance of protein in the urine;
- blood in urine;
- nausea;
- deterioration of general well-being;
- lack of appetite;
- vomit;
- drowsiness, impaired perception of information, apathy;
- increased body temperature;
- prolonged and sharp pain in the lumbar region.
The first symptom of kidney necrosis that a person notices is pain in the lumbar spine. They may be accompanied by poor he alth and lack of performance. It is also noted the presence of frequent urination, which is later replaced by anuria. In this case, the patient can leave no more than 50 milliliters of urine per day. This condition is very dangerous, since the fluid does not come out, pressure rises, urine can enter the brain or lungs, causing swelling. A patient with these symptoms needs emergency help. Often, the symptoms of the underlying ailment, which led to the pathology, join the above signs.
Stages of acute renal tubular necrosis
Let's consider this issue in detail. The initial stage is characterized by weak changes. In this case, the disease can be diagnosed only after laboratory tests. Most often, changes relate to the composition of urine. It contains leukocytes, erythrocytes, proteins and platelets. At this stage, the patient is concerned about pain in the lumbar region.
At the second stage, necrotic processes cover tissues, the filtration function of the kidneys decreases, and the outflow of urine is disturbed. At this moment, a person develops severe weakness, apathy, lack of appetite, the patient may complain of pain in the legs and frequent urination.
At the last stage, necrosis affects the organ completely, suppressing its functions. At this point, the pressure rises, diuresis occurs. The patient's body is poisoned by toxins and metabolic products, the person is in serious condition.
Diagnosis
Renal necrosis is treated by a nephrologist. It is to him that you need to make an appointment for the diagnosis of the disease. In the event that the disease progresses, it is worth calling an ambulance at home. To determine pathological changes, as a rule, use:
- blood and urine tests;
- Ultrasound of the kidneys and ureters;
- urography;
- CT and MRI of the organ.
In the event that a person needs emergency assistance, they conduct biochemistry of blood and urine, ultrasound. These data will be enough to make an accurate diagnosis.
Medic altreatment
The use of conservative medicine in the treatment of kidney disease involves addressing the root cause. If necrosis has developed against the background of pyelonephritis, then it is treated with antibiotics. Usually, broad-spectrum drugs are used. They are administered subcutaneously or intramuscularly, in severe cases, jet administration is practiced.
Antibacterial therapy is used to stop necrotic inflammatory processes in the tissues of the kidneys. If the cause of the development of the disease was poisoning, then detoxification is applied. In this case, it is necessary to remove toxins and poisons from the human body as soon as possible in order to improve kidney function and improve the patient's condition.
Additionally, the doctor may prescribe diuretics.
Hemodialysis
This method is used in case of cessation of the outflow of urine. With the help of hemodialysis, it is possible to compensate for the patient's condition. The situation can become much more complicated if there is no apparatus for this procedure in the intensive care unit. After all, a person may not survive transportation.
Additional methods
In addition to the above measures, doctors can apply the following procedures:
- blood transfusion;
- plasmapheresis;
- excision or removal of a kidney;
- clustering of the calyx and pelvis of the damaged organ.
This is necessary to get the true picture.
Complications
Against the background of necrosis, such severediseases like kidney failure and tissue death in the brain or other vital organs. The most severe complication is the rapid progression of the disease, which leads to death.
Forecast and prevention
Doctors believe that if one kidney is affected, you can count on a favorable prognosis, since it can be amputated. If the death of tissues affected both organs at once, then the further outcome depends on the treatment of diseases.
If the pathological process cannot be stopped with the help of hemodialysis, medications and other procedures, then the chance of recovery is minimal.
Recommended for prevention:
- timely treat inflammatory diseases;
- visit a neurologist regularly;
- strengthen the immune system;
- diet;
- avoid hypothermia.
There is no special prevention of kidney necrosis, but you can prevent the development of the disease if you monitor the condition of the body.
Conclusion
Renal necrosis is a dangerous disease that can be fatal. Preventing tissue death is very difficult. If you do not turn to a specialist in time and do not stop the destruction, then you can face serious complications. It is impossible to cure the disease on your own, therefore, at the first suspicion of a kidney pathology, it is necessary to urgently consult a doctor. Unfortunately, the time at which a positive outcome is possible is limited.
