Acute renal failure (ARF) is a pathological condition in which there is a violation of the functioning of the kidneys. The disease is very dangerous because there are a lot of reasons for its development, and the symptoms appear unexpectedly, which requires urgent medical care. What factors contribute to the development of pathology and what is the treatment of acute renal failure, we will analyze in the article.
What is OPN
In simple terms, acute renal failure is the sudden loss of the ability of the kidneys to remove toxic substances, excess fluid and potassium from the body. In this regard, there is a disorder of the water-s alt and electrolyte balance, the general metabolism is disturbed. All this has a negative impact on the functioning of all body systems.
AKI develops suddenly. As a rule, this happens in a few hours or days and requires immediate medical action.
Mainly with timelyin the treatment of acute renal failure, organ function can be restored completely. Fatal outcomes due to this disease are rare and occur in advanced stages in the absence of medical therapy. The disease mostly affects the elderly.
Stages of disease
Developing, acute renal failure goes through several stages.
- The first stage is characterized by slight changes in the functioning of the kidneys. The amount of urine excreted is slightly reduced. This stage goes unnoticed, as there are practically no obvious signs of the disease.
- In the second stage, the work of the kidneys worsens, the volume of urine decreases significantly. A blood test may show an increased creatinine value. And due to the fact that there is an accumulation of fluid in the body, the patient has swelling and disturbances in the functioning of the cardiovascular system.
- At the third stage, the nephrons begin to die, and the urinary ducts fill with blood plasma. A person develops tachycardia, dry skin, and signs of intoxication. There are times when a person in this stage falls into a coma.
- The next stage - comes only with effective therapy. The volume of urine increases, filtration is restored in the nephrons.
Reasons
Since there are a lot of reasons for the occurrence of acute renal failure, they are usually divided into several groups, depending on the provoking factors.
Prerenal (non-renal). They account for up to 80% of all cases of the disease. Occurs as a result of impaired blood supply to the kidneys and a decrease infiltration speed. Provoking factors can be:
- renal hypoperfusion;
- bleeding;
- large fluid loss, such as severe vomiting or diarrhea;
- burns;
- hemolysis;
- liver failure;
- pathology of the heart;
- infection.
Renal. They make up to 40% of cases of acute renal failure. The reasons will be lesions in the kidneys themselves, which may occur due to inflammatory processes, the action of toxins and drugs, or the pathology of the vessels located in the organ. The factors that cause the disease are:
- intoxication with drugs, toxic substances, animal bites, heavy metals, alcohol;
- pyelonephritis;
- glomerulonephritis;
- thrombosis;
- atherosclerosis;
- aneurysm;
- kidney injury.
Postrenal. Occur due to pathologies that disrupt the normal outflow of urine. But kidney function is preserved. They account for up to 10% of all cases. Urinary tract obstruction occurs for the following reasons:
- urolithiasis;
- ureter injury;
- tumor processes;
- inflammatory processes;
- hematomas;
- bladder sphincter spasms;
- prostatic hyperplasia.
Risk factors
Usually, acute kidney failure can occur due to diseases such as:
- diabetes mellitus;
- pathology of the kidneys and liver;
- cardiovascular disease;
- hypertension;
- old age;
- pathology of peripheral vessels.
Symptoms
Symptomatics in acute renal failure will depend on its stage and provoking disease.
- At first, a person feels general malaise, loss of appetite, drowsiness, symptoms of poisoning.
- Further, the amount of urine decreases and its color changes, becoming darker.
- May cause hallucinations, convulsions, nausea, vomiting.
- Skin turns pale and may bruise.
- The patient is very swollen.
- Signs of tachycardia.
- Breach of stool.
- Bloating.
- Sleep disorders.
- Pale skin.
You may also have bad breath and a rash.
Diagnosis
In order to find out the exact diagnosis and degree of kidney damage, it is necessary to carry out a series of diagnostic measures, which will be indicated by a therapist or a doctor of a narrow speci alty - a nephrologist.
First of all, the anamnesis of the disease is collected, hereditary factors and the presence of chronic diseases are specified. The following procedures may then be prescribed:
- biochemical and general blood tests, in which special attention is paid to the level of red blood cells, hemoglobin, the presence of urea and creatine;
- urinalysis, including its specific daily gravity and bacteriological studies;
- immunological research;
- determination of blood pressure;
- ECG;
- ultrasound examination of the kidneys;
- MRI or CT;
- endoscopic examinations;
- taking a sample of kidney tissue for biopsy.
Treatment of pathology
Since this disease develops suddenly and progresses rapidly, the treatment of acute renal failure should be carried out only in a hospital setting. The duration of therapy depends on the degree of development of the disease, the patient's condition and the response of his body to the ongoing therapeutic manipulations. The main principle of the treatment of acute renal failure is to identify and eliminate the causes that caused the pathology.
You should know how to behave with the sick before the ambulance arrives. Required:
- try to calm the person;
- put it on a flat surface with your feet slightly raised;
- ensure the flow of fresh air and get rid of excess clothing.
When diagnosing a clinic of acute renal failure, treatment is prescribed individually. The effectiveness of therapy depends on how quickly the causes of this condition are identified.
Treatment of acute renal failure by stages is the most effective. For example, when diagnosing the initial stage of the development of a disease, the main goal will be to eliminate the cause of its occurrence. In the second and third stages, it is necessary to restore kidney function and eliminate all complications.
Let's take a closer look at the therapeutic methods used in the treatment of acute renal failure.
- First you need to eliminate the causes of the appearance of pathology: stop takingmedicines that could provoke the development of the disease, remove toxins, poisons and more from the body.
- Then medications are prescribed to restore water and electrolyte balance. If the pathology was provoked by a sharp loss of fluid (for example, during bleeding), intravenous administration of special solutions is used. If fluid retention occurs in the body, diuretics are prescribed.
- If the test results show increased potassium values, calcium supplements are used.
- Medicines that can normalize heart rhythm are recommended for heart rhythm disturbances.
- If the cause of the disease is infectious processes, clinical standards for the treatment of acute renal failure require the use of antibacterial agents recommended by the doctor.
- Anemia is diagnosed with iron supplements.
- If symptoms of intoxication are observed, gastric lavage procedures or the introduction of sorbents can be carried out.
- When detecting the presence of a large amount of toxic products in the blood, the patient undergoes hemodialysis. A special device mechanically pumps the patient's blood through special filters that prevent the reverse penetration of unnecessary substances - toxins, excess potassium and others.
- Surgical intervention may be used in some cases. This method is appropriate in the presence of mechanical obstruction of the outflow of urine.
Practically in all cases passestreatment of acute renal failure in intensive care.
After the acute symptoms of the disease are relieved, drugs that improve microcirculation in the kidneys can be prescribed.
Diet
Proper nutrition with the above therapy plays an important role. During the treatment of acute renal failure, the recommendations of doctors will necessarily include the observance of a special diet. It completely eliminates the use of foods that can burden the kidneys.
Despite the fact that nutrition is selected individually, the principles of treating acute renal failure with a diet will be the same for all patients with this diagnosis.
- Restricting the intake of foods rich in potassium. For example, bananas, potatoes, tomatoes. Recommended consumption of apples, carrots, strawberries.
- Restrict s alt intake.
- Protein-free diet (prescribed in most cases).
AKI in children
The causes of the development of the disease in childhood will be the same as in adults. But congenital anomalies are also possible. They can be hereditary or occur due to fetal hypoxia and intrauterine development disorders. Such conditions are rarely diagnosed, but can lead to irreparable consequences.
Treatment of acute renal failure in children will be aimed at eliminating the cause of the disease and restoring the functionality of the organ.
A newborn baby who has shown symptoms of the disease must be placed in an incubator in which the temperature regime will be observed. Every 2-3 hours, the child's body position is changed andlight massage.
Possible Complications
Without appropriate treatment, the patient may experience serious complications that threaten to become irreversible. Since the kidneys play a very important role in the body, the pathological processes taking place in them disrupt the work of the whole organism. People who have AKI with a complete loss of organ functionality will depend on hemodialysis throughout their lives. Another way to restore the functioning of the organ will be its complete transplant.
But the worst consequence of the disease is death.
Prevention
In order to prevent the development of acute renal failure, it is necessary to carry out a number of preventive measures.
These include the following.
- Maintaining normal water balance.
- Avoiding nephrotoxic drugs.
- Use all medications only when prescribed by your doctor. This is especially true for people predisposed to AKI (heredity, history of kidney disease).
- Therapy for diseases of the kidneys and urinary tract should be determined by the attending physician. It is necessary to cure the pathology to the end, preventing the disease from developing into a chronic form.
- No contact with toxic substances/poisons.
- Treatment of chronic diseases, especially those that can affect kidney function.
- Timely completion of medical examinations.
- During pregnancy, follow all recommendationsattending physician and undergo screening tests on time. During the bearing of a child, it is necessary to eat right, give up bad habits and not take medicines that are prohibited in this state.
Doctors forecast
Doctors' forecasts directly depend on the time of contacting a medical institution. Approximately half of the patients who went to the doctor in time, the functionality of the kidneys resumes completely. In some patients, for certain reasons (for example, due to age, intolerance to certain drugs), the functions of the organ are partially restored.
If left untreated, acute renal failure can go into a chronic stage, which is fraught with the development of serious complications that cannot be treated. For this reason, pathologies of other organs and systems can develop that can be fatal.
Conclusion
Acute kidney failure is a disease with a high lethal outcome. It is worth remembering that with timely access to a doctor, the risk of serious complications is minimized. Any pain in the kidneys and lower back, pain when urinating is a reason to visit the hospital as soon as possible and take the necessary tests.
