Chronic kidney disease is a collective diagnosis that includes any pathology of this organ with a decrease in the effectiveness of their functioning. He althy kidneys remove excess water and waste from the blood. This organ is also involved in the control of blood pressure and the formation of red blood cells.
When chronic kidney disease occurs, their functioning is disrupted, so they cannot fully remove harmful substances. And the patient's condition is characterized by severe fatigue, insomnia, the appearance of swelling, memory impairment. When the first signs appear, it is imperative to carry out a diagnosis and treatment, which the doctor will prescribe.
Features of the disease
Chronic kidney disease (according to ICD-10: N18) is characterized by a pronounced deterioration in the functioning of these organs for more than three months. The kidneys act as a sort of body filter. Several tens of liters of blood pass through them per day, which is cleared of toxic substances and waste products.
With the development of chronickidney disease is a replacement in the organ of functional connective tissue or the death of nephrons. Such pathological processes lead to irreversible changes in the kidneys and disruption of their ability to fully perform their functions of purifying the blood and removing excess water.
This disease leads to a significant deterioration in the quality of life and can even lead to death, which can only be avoided with complex manipulations, in particular, such as hemodialysis or kidney transplantation.
Development stages
According to the classification, chronic kidney disease is divided into several stages, depending on the course of the pathology. Doctors distinguish 5 degrees:
- latent;
- compensated;
- intermittent;
- decompensated;
- terminal.
When the first stage occurs, chronic kidney disease practically does not manifest itself in any way. Patients have practically no complaints, except for increased fatigue. Lab tests show a small amount of protein in the urine.
In the second stage, patients still have the same symptoms, but they occur much more often. Changes in laboratory parameters are noted in urine and blood. Daily urine output decreases.
As the third stage proceeds, there is a subsequent decline in kidney function. In the blood test, there is an increase in the level of urea and creatinine. General he alth is deteriorating significantly.
At the fourth stage, the irreversible happenschange in kidney function. Steady edema is observed, the work of the heart is disturbed, skin itching occurs, erosive changes in the skin and mucous membranes develop.
The fifth degree of severity of chronic renal failure is characterized by the cessation of the functioning of this organ. In this case, an increased content of urea is observed in the blood. In addition, electrolyte metabolism is disturbed and uremia occurs. The patient needs constant blood purification.
Depending on the classification of chronic kidney disease, symptoms are characteristic for each degree of pathology. The stage of the lesion is determined by such criteria as the glomerular filtration rate and indicators of protein in the urine. Most patients are not even aware of the presence of the disease at the initial stage and may even ignore the emerging signs with further progression of the disease.
Causes of occurrence
Chronic kidney disease mostly occurs in people with metabolic syndrome. In particular, provoking factors include obesity, hypertension and diabetes mellitus. They have a detrimental effect on the kidney nephrons.
In addition, it provokes chronic kidney diseases - pyelonephritis and glomerulonephritis. It should be noted that women suffer from such disorders much more often than men. Also among the reasons are the following:
- appearance of neoplasms;
- autoimmune disorders;
- consequences of poisoning;
- complications after injury;
- alcohol abuse.
It is often quite difficult to determine the causes of chronic kidney disease, since the pathological process may not have an established etiology.
Main symptoms
Symptoms of chronic kidney disease are directly related to the violation of the process of formation and excretion of urine, accompanied by signs of intoxication. Among the main symptoms of the disease can be identified:
- violation of the process of urination;
- change in urine parameters;
- nausea and vomiting;
- lethargy and weakness;
- dry mucous membranes;
- itching of the skin;
- loss of appetite;
- constant thirst.
From the side of the cardiovascular system, such disorders as pain in the sternum, increased heart rate, numbness of the extremities can be noted. All of these symptoms can vary considerably, as each patient has a different medical history.
Diagnostics
With complaints about the course of kidney disease at stages 1-2, patients rarely apply. Pathology can be detected quite by accident during the treatment of inflammatory processes of the genitourinary system or with poor urine and blood tests. If changes in the urinary system are observed, then a comprehensive diagnosis of chronic kidney disease is required, which includes:
- laboratory blood test;
- urinalysis;
- ultrasound;
- tomography.
Based on test results, sex and agethe patient is determined by the peculiarity of the course of the pathological process. Additionally, consultation with other specialists may be required. Based on the diagnosis, a method for treating the disease is selected.
Providing treatment
Treatment of chronic kidney disease largely depends on the stage of the disease. At the initial stage, therapy is aimed at preserving the maximum number of functioning cells of the named organ. Treatment is carried out using special medications, as well as following a special diet.
It is imperative to eliminate the factor that provoked the occurrence of chronic renal failure. Unfortunately, it is impossible to completely cure it. You can only maintain the functioning of the urinary system and alleviate the general well-being of the patient. Later stages require hemodialysis or kidney transplant.
With timely diagnosis and competent therapy, the prognosis is quite favorable. Even with continuous hemodialysis, you can prolong the life of the patient and maintain his performance.
However, it is worth remembering that this disease in its later stages can be fatal. That is why, at the first sign of it, you should definitely consult a doctor. During the treatment of chronic kidney disease, clinical guidelines must be followed very strictly.
Drug therapy
In the process of treatment, first of all, it is necessary to normalize the pressure, since it has a rather bad effect onthe course of the disease. To correct this condition, you need to use the following drugs:
- calcium channel blockers (Felodilin, Verapamil, Amlodipine);
- ACE inhibitors (Captopril, Renitek, Enalapril);
- receptor blockers (Losartan, Valsartan, Eprosartan).
As part of the therapy, it is imperative to maintain a normal level of phosphorus in the blood. Excess of the content of this element can provoke very serious consequences for the body:
- rapid progression of pathology;
- increased risk of mortality;
- calcification of tissues and blood vessels.
For this, phosphate binders are prescribed, which have the ability to block phosphates in the intestines. Among the best drugs are such as Sevelamer, Renagel. They are highly effective and rarely provoke side effects. If there is no improvement in well-being when using these drugs, then vitamin D is additionally prescribed. It helps to normalize metabolism.
In the course of a chronic disease, anemia often develops. To increase hemoglobin, iron gluconate, "Erythropoietin", is used. In patients with elevated cholesterol levels, the disease develops much faster than with a normal metabolism. That is why they are assigned "Doppelherz Active Omega-3", as it allows you to stabilize lipid levels.
Physiotherapy
Physiotherapy is carried out during stage 1-3 of the disease and is verygood complementary treatment. It is worth remembering that they have certain contraindications. These include:
- severe intoxication of the body;
- heart failure;
- infectious processes in the kidneys;
- arterial hypertension;
- chronic diseases in the acute stage.
Patients are prescribed, as a rule, electrophoresis, hydrotherapy, UHF therapy. In addition, they are shown chloride, radon and sodium baths. These procedures activate the work of the kidneys, have an anti-inflammatory effect, and also improve well-being.
During electrophoresis, the required useful substances enter the body. This technique guarantees the exclusion of the occurrence of allergies.
Substitution therapy
In advanced disease, replacement therapy, such as hemodialysis or peritoneal dialysis, may be required. Hemodialysis is a method of cleansing the blood of accumulated toxic substances. During the procedure, the patient's blood goes through the stage of filtration and purification. Using a similar technique, you can:
- remove toxic substances;
- stabilize pressure;
- normalize acid-base balance.
Among the main contraindications for the procedure, it is necessary to highlight the presence of cardiovascular pathologies, malignant tumors, acute infectious diseases.
The device "artificial kidney" allows a person to prolong life. The procedure must be carried out 3once a week. The duration of one session is 4 hours.
Kidney transplant
At the very last stage, kidney transplantation is indicated. An organ can be transplanted from a living person or a deceased person. A new he althy kidney is transplanted into the iliac region or in place of the affected organ. In some cases, the person's own kidney is left. This technique has certain contraindications. These include:
- malignant neoplasms;
- acute inflammatory processes;
- heart failure;
- old age;
- HIV infection.
A living person under the age of 18 cannot be a kidney donor. Old age is also a contraindication. The operation is performed under general anesthesia and takes 2-4 hours.
The kidney is placed in the place prepared for it, then this organ is connected to the artery, ureter and vein. A catheter connected to a urine collection device is inserted into the bladder.
With a properly performed transplantation, literally in 1-2 weeks the transplanted organ begins to function normally. After that, the patient must take immunosuppressive drugs throughout his life to avoid rejection of the donor organ.
Dieting
When the disease occurs, a special diet is used. It is imperative to limit the consumption of proteins, since when they break down, they form special substances that contain toxins. Necessarilyyou need to reduce the amount of fat consumed in your daily diet. In particular, the presence of unsaturated fats, an excess of which provokes an increase in cholesterol levels, should be minimized.
It is necessary to minimize the intake of s alt in the diet, as with its excess, excess fluid accumulates in the body and slows down the process of removing toxins. It is advisable to cook food without s alt at all.
It is important to stop drinking alcohol, as it disturbs the water balance and has a toxic effect on the body, thereby increasing the load on the kidneys. Fried foods should be excluded from the diet, as this cooking method significantly increases the concentration of fats.
It is important to limit fluid intake, while its daily rate is selected exclusively by the attending doctor. As a drink, you can use tea, a decoction or infusion of wild rose, clean water.
Disease in children
Chronic renal failure is very rare in childhood. And basically, cases of illness in children are associated with certain pathologies:
- congenital anomalies;
- fetal development disorder;
- preterm birth;
- low birth weight.
Kidney disease can be hidden for a long time. They appear at school age with increased stress. Often this is an acute nephrotic syndrome. The child shows signs of acute poisoning of the body, and heneeds urgent drug therapy in a hospital setting.
Before starting therapy, you need to conduct a study of urine and blood, as well as check the concentration of protein in the body. Most often, drug treatment is carried out, but in difficult cases, dialysis is indicated. This method of therapy aims to purify the blood by administering a drug.
Possible Complications
If you ignore the existing signs at the initial stage of the course of the disease, then the changes can become almost irreversible. Chronic kidney disease can provoke complex pathological processes in changing the functioning of many organs and systems. Among the main complications are the following:
- heart attack, ischemia;
- malignant hypertension;
- infertility;
- pathology of the thyroid gland;
- diabetes;
- osteoporosis;
- decreased immunity.
The most basic complication is hypertension and diseases of the cardiovascular system. It is they who lead to the death of the patient.
Prophylaxis
Prevention of chronic kidney disease should begin before the age of 40. Preventive measures must include:
- to stop smoking and drinking alcohol;
- weight normalization;
- limiting s alt intake, canned foods.
For prevention purposes, it is very important to consume enoughliquids and it is better if it is pure water. You should not take diuretics, painkillers, vitamins and biological supplements on your own. You should try to minimize contact with toxic substances. Rigid diets, hypothermia and starvation can worsen the functioning of the kidneys.
Prevention of pathology involves a planned medical examination. It is important to regularly monitor blood pressure, sugar levels and the condition of internal organs.
