Kidney diseases of a chronic nature often lead to renal coma - a serious pathology, which in medicine is considered to be the last stage of advanced kidney disease, which caused failure of this organ and led to intoxication of the whole organism. Without timely treatment, this pathology leads to death. The coma develops very quickly, over two days. Without first aid, in 99% of cases a person dies.
Characteristics and description of the problem
Renal coma is the last stage of chronic kidney diseases associated with disruption of their activity and leading to kidney failure, poisoning of the body.
As the pathology of an organ progresses, its tissues become thinner, overgrown with connective tissue, which leads to disruption of its functioning. Gradually, the person's condition worsens, a huge amount of urine is excreted from the body, but it is not excreted in sufficient quantities.nitrogenous substances. As a result, a large amount of nitrogen begins to accumulate in the human blood, azotemia and acidosis develop. All this leads to severe intoxication. The work of the liver is also disturbed, it is not able to process toxins, therefore, over time, it is also poisoned, liver failure develops.
Symptoms of the pathology are rapidly progressing, kidney failure, coma develops, and in the absence of emergency medical care, death occurs. It is important to treat in a timely manner in order to save a person's life.
Renal coma: pathophysiology
The first important sign of a developing coma is azotemia. A person in this condition will experience an increase in nitrogen, urea and creatinine in the body. The second important sign is a violation of the water-s alt balance, since the kidneys lose the ability to concentrate urine, which is manifested by polyuria. The patient develops oliguria and anuria.
The kidneys then stop retaining sodium, leading to s alt wasting, i.e. hyponatremia.
The third important sign is a violation of the composition of the blood and tissue fluid, acidosis appears. The last sign is the development of hyperkalemia.
Causes for the development of pathology
Coma usually develops in chronic renal failure. With a long course of kidney disease, toxins accumulate in the body, which appear as a result of metabolism. But kidney pathologies do not always cause coma. She canappear as a result of intoxication with medications, especially antibiotics. Also, a renal coma appears due to a state of shock, prolonged diarrhea and vomiting, blood transfusion in case of incompatibility with the patient's blood, and also due to poisoning with methanol or industrial poisons.
When inflammation of the kidneys, which can be caused by a number of reasons, blood circulation in the organ is disturbed. It stops receiving the necessary amount of blood and nutrients. As a result of this, oliguria appears, then anuria, then the concentration of urea, creatine and uric acid in the body increases, which leads to the appearance of symptoms of renal coma.
Thus, the main reasons for the development of pathology include:
- No treatment for chronic kidney disease.
- Violation of the outflow of urine as a result of the formation of stones in the bladder, prostate adenoma.
- Development of urolithiasis, renal colic, which progresses to coma.
- Poisoning with drugs, poisons.
- Benign or malignant neoplasms in the ureter or renal pelvis.
Symptoms and signs of disease
A person does not immediately lose consciousness in a renal coma. Symptoms indicating a critical condition may manifest as asthenic syndrome, weakness, pain in the head, lethargy. The following signs are also observed:
- Dyspepsia. A person's appetite, body weight decreases, anorexia develops. There is dryness in the mouth,bitter taste, constant thirst. The activity of the digestive tract is disrupted.
- Characteristic appearance. There is dry skin, pallor, swelling of the face. Constant itching develops. Which brings torment, when combing the skin, wounds form on it that do not heal for a long period of time. Sometimes uric acid crystals appear on the skin in the form of powder.
- Hemorrhage. Women develop uterine bleeding, men may bleed from the nose. Breathing is disturbed, shortness of breath develops, blood pressure drops.
- Intoxication of the body is the cause of the disorder of the central nervous system. A person's reactions to external stimuli are disturbed, hallucinations, delirium appear, he falls into a stupor, and then into a coma. Muscle cramps may also occur.
If the above symptoms of renal coma are detected, emergency care should be provided immediately. In 99% of cases, falling into a coma, a person does not get out of it.
Often this disease develops in pets. For example, a renal coma in a cat will show signs in the form of intense thirst and frequent urination, the acquisition of a brown tint of the tongue. In this case, the animal must be immediately taken to the veterinarian.
First Aid
When the first signs of pathology appear, urgent hospitalization of the patient is required. To prevent the development of irreversible consequences, it is necessary to provide first aid for a renal coma:
- Detox treatment. In this case, it is necessaryadminister intravenous glucose, insulin, as well as Neocompensan, Hemodez to the patient. This contributes to the normalization of urination, blood pressure, excretion of urea from the body.
- Take a solution of sodium chloride in order to normalize the process of urination. But the solution is administered only in the absence of hypertension.
- Strofinin is used to normalize blood circulation, homeostasis disorders are corrected.
- It is necessary to do gastric and intestinal lavage to remove toxins.
- To save life, the patient needs to undergo hemodialysis, that is, to purify the blood using a special apparatus.
If treatment has not been started, the person loses consciousness. Often in this state he enters a medical institution. The smell of ammonia from the mouth makes it possible to make a preliminary diagnosis.
Diagnostic measures
To determine the severity of the pathology, a blood test is performed for the level of creatinine and urea. Their concentration indicates a further course of action. It is also important to review the results of previous diagnostic tests, if any.
The doctor prescribes an ultrasound of the kidneys, x-rays of the pelvic organs. According to the research, a conclusion is made about the state of the parenchyma, stones in the bladder and kidneys are detected. In severe cases, CT is performed.
Usually, the diagnosis of renal coma is not difficult, especially when a person has a long historydiseases. When the history is difficult due to the patient being in a coma, the diagnosis is based on symptoms and laboratory blood tests.
Therapy
Treatment of patients takes place in the intensive care unit. As drug therapy, drugs are used, the action of which is aimed at eliminating the causes of the development of pathology. Usually, the doctor prescribes intravenous diuretics, glucose and saline. "Heparin" is used to reduce blood clotting. In case of kidney failure, hormonal medications are used.
Also used as a treatment machine therapy:
- Hemodialysis.
- Plasmapheresis.
Rehab
During the rehabilitation period, prevention and treatment of the cause that caused the development of coma is carried out. In case of violation of the outflow of urine and the presence of stones that caused loss of consciousness, the surgeon performs surgery to remove them. In the presence of a tumor, surgery is also performed. If a person has been poisoned by poisons or medicines, his stomach and intestines are washed, they are given sorbents, and contact with dangerous substances is excluded in the future.
When a patient is in a coma or immediately after leaving it, food is provided using a dropper. After some time, it is allowed to consume a small amount of water and food, which should not contain fat. From the patient's diet, it is necessary to exclude all products that contribute to the appearance of ammonia in the body, proteins of animal and vegetable originnot to be consumed.
Complications and consequences
With this pathology, the central nervous system suffers especially strongly. In people who have undergone such a condition, the character often changes, memory and thinking are disturbed. Therefore, it is important to contact a medical facility when the first signs of pathology appear.
Forecast and prevention
Prognosis is usually poor. With untimely treatment or its complete absence, in 99% of cases a fatal outcome occurs. With adequate timely treatment, the patient's life can be saved.
For the purpose of prevention, it is recommended to treat kidney diseases in a timely manner. If you experience unpleasant symptoms, you should visit a urologist. It is also important to lead a he althy lifestyle and review the diet. Doctors recommend periodically undergoing an examination of the kidneys using ultrasound in order to monitor their condition. This also applies to people diagnosed with BPH.
You can not use medications without a doctor's prescription, as this can provoke poisoning and the development of coma. People who, by virtue of their profession, come into contact with chemicals, must adhere to safety rules. In case of food poisoning, immediately flush the stomach and intestines, and then call a doctor.
