Modern medicine can offer a cure for almost any disease. The development of this field of science does not stop, experts conduct research and experiments so that there are no diseases left that cannot be eliminated. Unfortunately, this moment is still very far away. Chronic renal failure is one of the most difficult diseases for doctors to deal with. CKD is not uncommon in humans. After all, almost half of the pathologies associated with the kidneys, sooner or later lead to a chronic disease. There are quite a few causes and symptoms of this disease, but the result is the same: the kidneys practically cease to perform their basic functions, thereby disrupting the normal functioning of the body. In this regard, there is a serious threat to human life and he alth.
CHP: what is it
CKD is an ailment that occurs when nephrons die or are displaced by connective tissue. Nephrons are important structural units of the kidneys. These particles take part in the processes of blood purification, absorption of electrolytes, getting rid of excess water and s alt. ATthe result of the disease is the extinction of the main functions of the kidneys.
Accordingly, because of the malfunctioning of one organ, others also suffer. The general condition of the patient worsens significantly, other systems of the body are put at risk. Modern medicine boasts the latest developments and technologies. However, 50% of kidney diseases develop into CRF. The kidneys play a vital role in the life of the body. Keeping them working properly is the immediate responsibility of every person who cares about their he alth.
Today, many experts call this phenomenon chronic kidney disease (CKD). This emphasizes the possibility of developing a severe form of pathology even at the initial stage of the disease. CRF according to ICD-10 is in the class "Diseases of the genitourinary system". Therapy in most cases is handled by a nephrologist.
Types of Chronic Kidney Failure
It would be more correct to say the stages of the disease. After all, the classification of CRF as such simply does not exist. In this case, we will consider the four main stages that the disease goes through if it is not treated. It is worth noting that all of them are associated with the destruction of the renal glomeruli and the appearance of scar tissue in their place.
So, the degrees of CRF from the most harmless to the most life-threatening:
- Initial. Filtration is about 65 ml/min, which is basically normal. However, at this stage, some deviations are already observed, expressed in violation of night and daytime diuresis. Patients rarely complain abouthe alth at the initial stage, because the signs of kidney failure are not so pronounced here.
- Compensated. The disease begins to progress, which affects the he alth of the patient. Working capacity is significantly worsened, the level of fatigue increases, and a feeling of dry mouth appears. Filtration is at the level of 30-60 ml/min. The nephrons are dying, but urea and creatinine are still at normal levels.
- Intermittent. In this case, the filtration of the kidneys is 15-30 ml / min, the level of dryness of the skin increases. The patient suffers from a deterioration in general well-being, his appetite disappears, and the volume of urine excreted increases significantly. Creatinine and urea levels are already outside the normal range.
- Terminal. The classification of CRF would be incomplete without mentioning the most severe form of the disease. There is a filtration rate in the region of 10 ml/min. The patient's skin becomes flabby and changes color. A person falls into a state of apathy, constantly wants to sleep and moves little. Changes occur due to an increase in the level of nitrogenous slags in the blood. If doctors do not take action at this stage, the patient will most likely die.
Causes of disease
CHP - what is it? As noted above, the abbreviation stands for "chronic renal failure." Accordingly, the causes that give rise to this pathology lie in the disruption of the work of the same organ. In other words, various kidney diseases, if you do not pay attention to them, sooner or later develop intochronic stage. That is, the appearance of CRF is just a matter of time. But in order to prevent such a development of events, it is necessary to monitor your he alth and undergo examinations on time.
List of causes of chronic kidney failure:
- virtually all kidney diseases: hydronephrosis, pyelonephritis, etc.;
- disturbance of the urinary tract, including the presence of kidney stones;
- diseases related to the cardiovascular system, such as hypertension;
- diabetes mellitus, in this case, in the course of treatment, it is necessary to adhere to the diet prescribed for CRF.
Symptoms and appearance
There are quite a few signs of this disease. Let's start with how the appearance of patients is changing. In the first two stages of the disease, you will not observe practically any changes. The first signs of chronic renal failure, reflected in the appearance, will begin to appear when glomerular filtration is significantly reduced.
So, in most cases, the following problems are observed:
- Disorders related to the skin. Anemia develops, the skin becomes dry, its color changes to yellow-gray.
- Suspicious bruises appear out of nowhere, no bruise or blow.
- There are red spots on the skin, which are characterized by severe itching.
- There is swelling on the face, upper and lower extremities, abdomen.
- The condition of the muscles worsens, they become flabby. As a result, there is a significant decreasehuman performance, sometimes there are convulsions and muscle twitches.
- Dry skin does not go away even during times of great excitement or stress.
Other signs of kidney failure
Let's consider the rest of the symptoms of CRF, which occur in most cases:
- Problems with the nervous system. The patient falls into a state of apathy, sleep worsens, even in the daytime there is inexplicable fatigue. A person becomes inattentive, memory deteriorates significantly. The level of learning and perception of information is reduced to a minimum.
- Nitrogen imbalance. It occurs when the kidney filtration rate is 40 ml/min or less. Blood uric acid and creatinine levels rise, resulting in bad breath and joint damage.
- Urine excretion. There is one peculiarity here. In the initial stages of the disease, the volume of urine excreted increases, but as the condition worsens, the patient goes to the toilet less and less. This is due to significant disturbances in the body and the appearance of edema. In rare and most severe cases, there is complete anuria.
- Water-s alt balance. Everyone knows that this ratio plays an important role in the functioning of the body. Failures in the system lead to disruption of the heart, and sometimes to its stop. The patient constantly feels thirsty, with a sharp rise, dizziness and blackouts occur in the eyes. It becomes difficult for a person to breathe, muscle paralysis grows.
Complications
According to ICD-10, CRFassigned code N18.9, which is referred to as "Chronic kidney disease, unspecified." The disease itself is characterized as a consequence of a long course of ailments associated with the kidneys. Complications occur in most cases at the very last stage: terminal. However, there are problems expressed in heart failure and hypertension. The patient is also likely to have a heart attack, the consequences are different in each specific situation.
It's no secret that CRF has a negative impact on the nervous system. Complications are expressed in the development of convulsions and nervous disorders. In particularly difficult situations, the patient may develop dementia. Thrombosis often occurs during the treatment of CKD with dialysis. The most dangerous complication is kidney necrosis. If urgent medical care is not provided, then a fatal outcome is likely.
Diagnosis
Before you fight a disease, you must first diagnose it. Leave this matter to a specialist. The diagnosis of chronic renal failure is made on the basis of the results of studies conducted by the attending physician. To finally verify the presence of this disease, it is necessary to carry out a number of laboratory measures, including:
- biochemical blood and urine tests;
- Zimnitsky test;
- ultrasound examination of the kidneys.
These procedures allow you to detect a decrease in the level of glomerular filtration, an increase in the level of urea and creatinine. These indicators are the main criteria for CRF. Blood and urine tests are a must,because without them it is impossible to make a correct diagnosis.
There are quite a lot of methods for detecting a disease, we have indicated the most common ones above. Particular attention should be paid to nephroscintigraphy, which can be used to assess the functional activity of the kidneys. The method is based on the rate of accumulation of the radiopharmaceutical separately in each kidney.
CKD during pregnancy
It is worth noting that pregnancy is always associated with a significant burden on the kidneys. Accordingly, if a woman has chronic renal failure, then the process of bearing a child proceeds with complications. Pregnancy aggravates the pathology, it begins to progress.
Why is this happening? The fact is that during pregnancy, renal blood flow increases, which stimulates excessive tension of the glomeruli, and as a result, some of them die. In addition, blood clots form in the capillaries due to increased work of the blood coagulation system.
CKD according to creatinine can be divided into three stages: latent, stable and progressive. Before you have a baby, you need to check with all doctors, including a nephrologist. If a woman has creatinine at a stable or progressive level, then pregnancy should be postponed. Otherwise, there will be a lot of complications, including fetal malformations and severe anemia in the mother.
Diet
If the doctor diagnosed chronic renal failure, then the patient should immediately tune in to limiting his desires in food. This is due to the fact that some products havenegative impact on the kidneys, which complicates an already severe disease. Protein should be consumed in moderation, preferring dairy.
Meat and fish can be eaten, but preferably boiled. It is not recommended to fry meat, it is better to bake or stew it. This method allows you to withdraw or at least reduce the amount of extractives. Cottage cheese, eggs, cereals, legumes, cheese, nuts and cocoa can be eaten, but very rarely and in small portions. The same can be said for potatoes, bananas, meat and fish.
Products containing essential oils should be excluded from the diet. These include onions, garlic, all herbs in their pure form. Vegetables and fruits containing potassium can be consumed in small amounts.
Your doctor will tell you more about the diet for chronic renal failure, because each case is individual. It must be said that such therapy is prescribed only in the early stages of the disease, then it will be too late. If you stick to proper nutrition, you can reduce the level of intoxication and slow down the development of chronic renal failure.
CKD treatment
Therapy for this disease is prescribed taking into account the identified stage of the disease and the presence of other ailments. Methods of treatment directly depend on this. The initial stage often goes unnoticed, it is extremely rare to detect the disease. Accordingly, there is no therapy at this stage.
The disease in most cases is detected at a compensated stage and then intensive treatment begins immediately, possibly withsurgical intervention. At this stage, the task is to transfer the disease back to the initial level and finally get rid of it there. If no measures are taken, then the disease will move to the next stage, where it will be even more difficult to cope with it.
The intermittent stage is characterized by high risks, so surgery is not performed here. In this case, detoxification therapy is used. The operation can be carried out only when the function of the kidneys is restored.
If the disease progresses strongly and has already passed to the terminal stage, then the treatment should be carried out very carefully and carefully. At the moment, we are talking about a person's life, so doctors have a heavy burden of responsibility. A carefully planned treatment regimen, which the patient will fully adhere to, is able to cope with the disease. However, this requires a lot of work on both sides.
Therapy Methods
It has already been said above that CRF is a disease in which the functioning of the kidneys is impaired due to the death of nephrons. In order to prevent this event, the following treatment is recommended:
- relieve the load on those nephrons that are still functioning normally;
- strengthen the immune system to prevent the penetration of nitrogenous waste into the body;
- adjust electrolyte balance;
- purify the blood with peritoneal dialysis.
Some doctors recommenduse physical therapy. With its help, you can speed up the process of removing nitrogenous toxins from the body. It is especially useful in this case to take infrared baths or visit a sanatorium.
Sometimes excess potassium is found in the course of the disease. It can be removed with a cleansing enema or after taking laxatives. Due to this, the concentration of the microelement in the intestine decreases.
If the above methods do not help, then the doctor has to move on to peritoneal dialysis. It is prescribed to those patients who have a very severe form of the disease. The process is as follows: a special drug is injected into the patient's abdominal cavity through a catheter. After he is saturated with decay products, he is taken back. This procedure can be done at home, but it should be done by a professional.
Kidney Transplant
There are cases when even dialysis cannot help a person, and then specialists are forced to take extreme measures. A kidney transplant is a radical solution to the problem of CKD. The code for this disease in the international classifier of diseases is No. 18.9. It is worth noting that the ailments there are located from the very first stage to the most severe. 18.9 is the latest code for kidney failure disease.
It should be noted that most patients resort to this method, as they discover pathology too late. The operation is performed in special nephrological centers. Kidney transplantation can only be performed by a highly qualified surgeon. Mainthe problem is finding a donor, sometimes this process takes decades. After a successful operation, the patient must take hormones and cytostatics for the rest of his life. There are cases when a new kidney does not take root, and then a second surgical intervention is necessary.
To prevent such a development of events, you should carefully monitor your he alth and in case of any suspicious symptoms, consult a doctor. Timely diagnosis can save a person's life, so it is recommended to approach he alth problems with all seriousness.
Treatment at home
With a diagnosis of chronic renal failure, patients spend most of their time at home. A hospital stay is necessary in case of surgery and in the last stages of the disease. In other situations, a person can stay at home, regularly fulfilling the requirements of the attending physician and visiting him regularly.
In order to relieve the load on intact nephrons, certain requirements must be followed:
- avoid drugs that are toxic to the kidneys;
- reduce physical activity to a minimum, but do not completely abandon them;
- sources of the disease must be identified and eliminated in a timely manner;
- it is recommended to take medicines that can remove toxins from the body;
- stick to a diet (relevant in the initial stages of the disease).
Disability due to chronic renal failure
To get a disability groupwith chronic renal failure, you need to go through a medical commission, on the basis of the conclusion of which a decision will be made. The patient will be considered able-bodied if he has one of the first three stages of the disease. In this case, the person has minor damage to the internal organs, the symptoms are pronounced, but not much. Such patients are transferred to light work and assigned to the third group of disability.
If a person is diagnosed with end-stage renal failure with significant violations of internal organs, then he is assigned the second group of disability. The ability to work and serve oneself in everyday life is preserved. The first group is assigned only to those who have a terminal stage of the disease caused by complications, a kidney transplant operation has taken place. Such people in everyday life need the help of another person.
In this article, we talked a lot about CRF: what it is, why the disease occurs, what symptoms appear and how to cure the pathology. He alth cannot be bought with money, so do not be lazy to undergo a comprehensive medical examination every six months. Remember that the sooner the disease is detected, the easier it will be to deal with it.
