Renal failure is a complete or partial loss of the kidneys of their physiological functions. It develops slowly, sometimes over decades. More often women are ill than men. In some cases (usually with congenital pathologies), children get sick. Chronic renal failure does not have a reverse course - there are no cases in medicine when a person could be cured and fully restore kidney function.
Difference between acute and chronic course
Acute kidney failure is characterized by a sharp onset of symptoms, high fever, fever, chills, cessation of urine outflow, and off-scale indicators of protein and leukocytes in the urine. If you take blood from a patient for biochemistry, creatinine and urea will be at a critical level. In the case of timely hospitalization and medical care, it is possible to restore normal kidney function. Carry out treatment at homeunacceptable - it could cost the patient's life.
Chronic flow is almost asymptomatic for many years. Tests can help identify the onset of kidney dysfunction - creatinine and urea levels will help with this. A sick person is characterized by a pale, tired, asthenic appearance. Often patients are very thin, emaciated. Temperature (unlike in the acute stage of kidney dysfunction) rarely rises.
Causes for the development of the acute stage of the disease
It is possible to classify all possible causes and symptoms of acute kidney failure into three groups:
- Prerenal causes: Liver and heart problems. Cardiomyopathy, arrhythmias of various origins, pre-infarction condition, pulmonary embolism, heart failure - all this can cause the kidneys to stop working. Cirrhosis, hepatosis, fatty degeneration of the liver can also serve as a trigger in the development of acute renal failure.
- Renal causes: poisoning, snake and insect bites, alcohol intoxication, kidney damage with uric acid s alts, physical injuries of the kidneys during fights, stab wounds. The symptoms of acute kidney failure are impossible to miss: severe nausea, vomiting, fever, cessation of urine output, severe swelling, loss of consciousness, loss of touch with reality.
- Postrenal causes: blockage of the ureters, congenital malformations of the kidneys, too large stones in the tissues, the passage of blood clots, sand, pus.
Causes for the development of the chronic stage of the disease
CHF is characterized by slow development, it can progress unnoticed by the patient for many decades. Here are the main reasons for its development:
- chronic glomerulonephritis, pyelonephritis;
- poisoning and overdose of certain drugs;
- chronic alcoholism and drug addiction;
- blocking the urinary tract for a long time;
- associated diseases: diabetes, liver and gallbladder dysfunction, gout, scleroderma, obesity and many others.
What symptoms indicate the development of the disease
At the initial stage of the development of CRF, the patient rarely worries. Occasional aching pain in the lower back. Urine may acquire an unpleasant odor, sometimes there is a sediment in it. At the initial stage, the symptoms of kidney failure in women also appear in weakness, asthenia, depression and decreased performance.
The second stage is called "oliguric" by doctors. Symptoms of chronic kidney disease become more noticeable:
- decrease in daily urine volume;
- bad smell and change in texture;
- no urination for seven to eight hours becomes the norm;
- swelling of the face and limbs;
- persistent rise in temperature to 37 degrees for a long time;
- muscle twitches, nervous tics, itchy skin;
- nausea,vomiting, pallor, weakness.
When at least one phenomenon from this list appears, you should definitely be examined by an experienced nephrologist. Ultrasound, biochemical blood test will help to quickly assess the patient's condition.
Symptoms of kidney failure in women
In the weaker sex, kidney dysfunction manifests itself a little differently than in men. In women, any disruption of the water-s alt balance affects the nervous system. Hence - frequent mood swings, irritability, tearfulness. They are also characterized by the accumulation of fluid in the lower extremities, respectively - if women often have swollen legs, then this may be a symptom of urinary system dysfunction. By the way, an interesting fact is that women, as a rule, survive the kidney transplant procedure much easier.
Symptoms and treatment of kidney failure in men are somewhat different. They are more likely to have a fever and have a life-threatening fever.
A symptom of kidney failure in men is also a tendency to swelling of tissues above the waist - hands, face, fingers.
Men are much more difficult than women to survive the period after kidney transplantation - mortality increases several times. Symptoms of kidney failure in people, regardless of gender, are both pronounced and completely invisible.
Description of each stage of the disease
There are four stages in the development of CRF, each of which brings the kidneys of a sick person closer to complete and final dysfunction.
- Latent stage. Patient so farfeels well, from time to time only weakness and drowsiness worries, but they quickly pass. From time to time, an unpleasant smell of urine may appear. Clinically, the picture is also not very different from the norm: creatinine levels are normal, GFR can be reduced, but not less than 50%. In the second phase of development of the latent stage, creatinine and urea levels may be slightly exceeded - a competent doctor will not leave this moment unnoticed.
- At the azotemic stage, the pathology of the kidneys begins to progress more rapidly. The volume of daily urine output decreases, edema appears. Clinical analysis indicators typical for this stage: creatinine 0.14-0.44, GFR 20-50%.
- Uremic stage requires immediate hospitalization of the patient and start of hemodialysis. A sick person at this stage is practically unable to independently maintain a normal lifestyle. Clinically, at this stage, the creatinine level rises to 0.72-1.24, the glomerular filtration rate is 5-10%
Prognosis and treatment of chronic renal failure
After an episode of acute renal failure, most often doctors manage to completely restore the function of the urinary system. In the case of a chronic course, everything is more complicated. In most cases, the patient is forced to change his lifestyle after the diagnosis.
Need to apply for disability, as full-time work will no longer be possible. Hemodialysis takes a lot of time. And the kidney transplant procedure is too serious a blow to the whole organism as a whole. Whatever the life of a patient with chronic renal failure - being on dialysisor an operation to replace a kidney with a donor - life will be divided into "before" and "after" and will never be the same as before.
Diet for kidney failure
Recovery and normal well-being largely depends on nutrition. Treating the symptoms of kidney failure is impossible without limiting protein and s alt.
Spicy and s alty foods cause fluid retention. For a patient with CNP, this is unacceptable. The water-s alt balance of the body is already seriously disturbed, and the patient also “finishes” him with s alt.
You also need to reduce your protein intake. You can eat only lean meat - for example, chicken or turkey fillet. Perfectly suited species of marine fish. To make up for the lack of he althy fats - unrefined olive oil. From carbohydrates - any vegetables, fruits. Exclude ready-made muffins, factory sweets, chocolate, cakes with fat cream. Any alcoholic and sweet carbonated drinks are prohibited.
Hemodialysis procedure
CHF patient needs outside help to cleanse his blood. His kidneys are no longer able to do this. Therefore, at the terminal stage, all patients are forced to attend the hemodialysis procedure. As a rule, it is necessary for the patient three to four times a week. To facilitate the procedure, a special fistula is sewn into the vein on the arm (so as not to injure the vein each time).
One treatment lasts approximately four to five hours. During this time, through connected to the fistulathe catheter pumps out part of the patient's blood, mechanically cleaned in a special reservoir. Purified, it returns to the body again through the catheter. In this way, the entire mass of the blood of a sick person is processed.
With the help of hemodialysis, it was possible to extend the life of patients with chronic renal failure by 15-20 years. Yes, at first it is difficult for patients - the body is shocked by such interventions. But after a couple of months, people get used to it and calmly live on with a full and happy life. Europe now even has a special travel program for people on dialysis.
Disability in chronic renal failure
Symptoms of chronic renal failure prevent the patient from leading a normal life. To have money for living, you can apply for disability. To do this, you need to be examined by the main specialist doctors (this can also be done in a hospital) - a nephrologist, phlebologist, ophthalmologist, endocrinologist. Take an extract from the medical history from the therapist. Pass an ECG and, if necessary, attach the results of ultrasound, MRI, X-rays and other examinations to the package of documents. You also need to make copies of your passport, SNILS, document on the place of permanent registration.
With this package of documents, the patient must go to the MSEC commission located in the area at the place of residence of the sick person. Sometimes the commission passes without an appointment, in some cases you have to wait about a month. The amount of the disability pension of the first group for 2018 is eleven thousand nine hundred rubles, plus subsidies for utilitiespayments, travel benefits and medicines.
Pregnancy in patients with chronic renal failure
Modern medicine allows patients with CRF to conceive and bear a fetus. Of course, the outcome of pregnancy largely depends on the stage and condition of the kidney tissues of the expectant mother.
If you are pregnant and suspect you have CKD, check for the following symptoms of kidney failure in women (treatment may be needed immediately):
- A sharp decrease in the volume of daily urine.
- Jumps in blood pressure.
- Uncharacteristic earlier swelling of the face and limbs.
- Vomiting, nausea.
- Signs of poisoning or intoxication of the body.
- Paleness, weakness, asthenia, drowsiness, loss of consciousness.
If you have at least one of the above conditions, you should not hesitate, you must immediately consult a doctor.
Comorbidities
The symptoms of kidney failure never come alone. This is a very serious pathology, which entails a gradual disorder of many functions.
Here is a list of concomitant CNP diseases:
- impaired outflow of bile, cholecystitis and cholestasis;
- due to constant intoxication, the liver may not be able to cope - hepatosis and replacement of he althy adipose tissue;
- Protein synthesis disorders, muscular dystrophy due to a sharp reduction in amino acids;
- decreased immunity - frequent colds, susceptibility to infectious diseases;
- women have disorders of the nervous system.
Figures, facts and statistics on kidney failure
Here are some interesting facts and statistics about this condition:
- 65% of cases of acute renal failure are associated with operations or physical injuries of the lumbar region.
- In Soviet times, the main cause of chronic renal failure was glomerulonephritis. To date, this condition most often provokes diabetes.
- In hot countries, kidney failure develops most often due to parasitic invasions and infectious diseases.
- The hemodialysis procedure for one patient costs the budget almost 1 million rubles.
- The life expectancy of a patient on timely hemodialysis can be 15 years or more.
- In terms of the number of kidney transplants performed, our country occupies one of the last places in world medicine (this situation has developed due to corruption and poor interaction between provincial hospitals and budget sources).
- Nephrologists of the Russian Federation are looking forward to the adoption of a new version of the law on transplantation.
