Patients who are faced with urological pathologies hear from doctors the term kidney parenchyma. What is it, most often, they do not ask specialists and remain in the dark.
The concept and main functions of the kidney parenchyma
Parenchyma is the main tissue of the organ. Its constituent parts are the cells of the medulla (inner layer) and cortical (outer layer) substance. The structure of the tissue is smooth, in appearance it resembles a capsule in which the organ and elements of the urinary system are placed.
The main function of the parenchyma is the removal of metabolic products from the body and, as a result, the creation of conditions for maintaining the natural internal state of the organ.
The thickness of the kidney tissue in a he althy person of the middle age group is from 15 to 23 millimeters. If the patient has ever had infectious diseases, there are untreated inflammatory and chronic processes of the urinary system, this will lead to thinning of the tissue. However, the parenchyma has the ability to gradually recover.
Now you will not be afraid of the term kidney parenchyma,what it is and what its functions have become known.
Distinguishing features of primary and secondary forms of the disease
Primary and secondary wrinkled kidney differences are insignificant. They lie in the factor that provoked the development of pathology - a concomitant disease.
Patients diagnosed with damage to their own arterial tissues develop a primary shriveled kidney. The main precursors of this form of pathology are: high blood pressure, in which hypertensive crises are observed, and milder diseases of the heart and vascular system.
If a patient has pathologies of the excretory system, his parenchyma begins to thin and lose its functional ability, respectively, a pathology develops - a secondarily wrinkled kidney.
Etiology
Studying the features of the pathology, one should know the reasons under the influence of which such a disease as a secondarily wrinkled kidney develops:
- infection of an organ by tuberculosis bacteria;
- bacterial lesion of the tubules of the kidney of a non-specific nature;
- defeat of glomeruli;
- formation of stones in the organ cavity;
- diabetes.
All of these diseases lead to circulatory disorders. Lack of blood leads to unilateral or bilateral wrinkling of the organ. The process can last for years, and in weakened places, connective tissue first grows, and then a scar forms.
Consideringthat the secondarily wrinkled kidney has different causes of formation, and against its background, renal failure develops, this diagnosis is quite common in urology. Each patient needs regular medical examination and extra-renal blood purification procedure, which allows to remove toxic substances from the organ.
Clinical picture and formation mechanism
At the first examination, doctors cannot make a final diagnosis. However, there are a number of symptomatic manifestations that are characteristic exclusively for nephrosclerosis. The most striking is the violation of the function of urine excretion, as the patient indicates when collecting an anamnesis. Analysis of biological material shows that the daily rate is exceeded. At the same time, more urine is excreted at night than during the day.
Less obvious manifestations include:
- Presence of protein in the urine.
- Urine specific gravity below normal.
- Blood pressure steadily elevated.
- There were cases of hypertensive crisis.
- There is pain in the lumbar region.
Secondary shriveled kidney is a macropreparation for which a characteristic feature is the partial preservation of shape, while reducing weight and size. With the progression of the pathology, the color of the organ changes. In the initial stage, the kidney has a clear shade of blood, and with its lack, the organ acquires a gray tint, visible scars appear on the surface. Bleeding sites are not detected.
A probable cause of clinical indicators can primarily be considered the deposition and blockage of renal vessels by cholesterolplaques that led to the development of hypertension. Pathologies of the stroma, tubules and glomeruli, for example, inflammation or dystrophy, often act as secondary causes.
The preliminary outcome of treatment may be favorable, provided that the patient is diagnosed with primary shriveled kidney. Treatment by regular hemodialysis will lead to the development of chronic type suburemia.
In conclusions, doctors often indicate such a fact as a physiological change in the parenchyma (there is a degeneration into connective tissue).
According to the clinical picture, the diagnosis is made: secondarily wrinkled kidney.
Methods of modern diagnosis of the disease
The information obtained during the initial examination and the results of the tests is not enough to finally diagnose the patient. In this situation, doctors resort to modern diagnostic methods to determine the cause, form and severity of the pathology.
So, the patient can be prescribed:
- general and clinical blood count;
- re-examination of urine;
- ultrasound diagnostics of the kidneys;
- lumbar x-ray;
- magnetic resonance imaging;
- contrast computer diagnostics.
Most of the time, multiple tests and one full body scan, possibly with a contrast agent, will suffice.
At the first consultation, the doctor should conduct a thorough history taking. itwill allow you to establish what lifestyle is acceptable for the patient, whether he has chronic or concomitant pathologies, whether the treatment of the genitourinary system has ever been carried out. Mandatory palpation of the kidneys and examination of the skin for a rash.
Only a qualified and experienced urologist can correctly prescribe treatment and make a diagnosis of "secondary wrinkled kidney"
Therapeutic methods to eliminate pathology
Pathology "secondary wrinkled kidney" treatment primarily involves symptomatic and aimed at combating the underlying cause that provoked the development of the disease.
In cases where a patient has a pathology exclusively accompanied by high blood pressure, and symptoms of kidney failure do not appear, doctors prescribe a s alt-free diet.
If symptoms of kidney failure are identified, the withdrawal of blood pressure medications is the first priority. The diet involves the rejection of the use of meat in all forms, including meat broths. This will help reduce nitrogenous toxins.
If primary treatment fails, surgery is needed, followed by hemodialysis and donor organ transplantation.
Recommended diet for sickness
The s alt-free diet provides for the exclusion from the use of such foods: meat, fish, citrus. Prohibited spicy, sour, s alty and spicy. It is also necessary to completely abandon coffeedrinks and pure coffee, smoked meats and sausages, chocolate, sorrel, onion and garlic, spinach and asparagus.
It is necessary to control the daily volume of liquid. It should not exceed one and a half liters, including first courses.
Animal protein intake should be kept to a minimum. Ideally, it should be replaced with vegetable or soy. The calorie content of food should be high, with the content of polyunsaturated acids. The consumption of foods containing phosphorus, potassium and magnesium should be reduced.
How to prevent the development of nephrosclerosis
Measures to prevent the disease are very extensive, but the main ones are as follows:
- It is necessary to treat infectious diseases in time.
- Follow a dietary regimen.
- Control metabolism.
- Prevent the development of diseases of the genitourinary system.
- Be active.
- Prevent kidney injury.
- Drink only purified water.
Patients prone to developing kidney pathologies are advised to undergo regular preventive examinations by a nephrologist.
Prognosis for recovery
In most cases, with a diagnosis of "secondary wrinkled kidney", the prognosis for recovery is unfavorable. It is impossible to completely overcome the disease, it is only possible to maintain a stable condition of the patient.
Under certain conditions and if anypossibility, you need to have a kidney transplant.
