End Stage Renal Disease
Chronic kidney disease (CKD) is damage to the kidneys or a decrease in their function for 3 months or more. The disease is classified into several stages, which differ in tactics of patient management and the
End Stage Renal Disease
Chronic kidney disease (CKD) is damage to the kidneys or a decrease in their function for 3 months or more. The disease is classified into several stages, which differ in tactics of patient management and the risk of developing terminal renal failure and cardiovascular complications.
Causes of disease
Causes of kidney disease:
- (Acute renal hemodynamics (shock, collapse);
- Intoxications of various genesis (insect bites, snakes, drugs, household poisons);
- Infectious diseases (hemorrhagic fever, leptospirosis, etc.);
- Acute kidney disease (acute pyelonephritis, glomerulonephritis);
- Urinary tract obstruction and impaired urine outflow (urolithiasis, urinary tract tumors, etc.);
- Kidney removal;
Causes of chronic renal failure:
- Kidney disease (chronic pyelonephritis, glomerulonephritis);
- Metabolic disorders (gout, amyloidosis, diabetes mellitus);
- Congenital renal pathology (narrowing of the renal arteries, polycystosis, underdevelopment of the kidneys);
- Rheumatic diseases (scleroderma, hemorrhagic vasculitis, systemic lupus erythematosus);
- Vascular disease (arterial hypertension).
The most common causes of chronic renal failure are glomerulonephritis, congenital malformations of the kidneys, diabetes mellitus, pyelonephritis.
Diagnostic methods include analysis of daily urine, protein in the urine, biochemical blood analysis, urine biochemistry, clinical blood analysis, general urine analysis.
The greatest attention is given to maximum relative density (osmolarity) of urine, glomerular filtration (CF), serum creatinine level.
Symptoms of kidney failure
The chronic form of the disease develops as a result of the progression of acute renal failure. The condition is characterized by the destruction and death of the kidneys (glomeruli, nephrons, parenchyma), as a result, the organ cannot perform its functions – this entails disturbances in the work of other vital organs.
Depending on the degree of damage to the kidney tissue and the severity of the patient’s condition, they distinguish several stages of chronic renal failure with various symptoms:
- Latent stage – there are no clinical manifestations of the disease, so the patient is not aware of his or her condition – however, with an increase in physical exertion, weakness, dry mouth, drowsiness, lethargy, fatigue, urine output in increased quantities occur;
- Clinical stage – clinical symptoms of intoxication occur: nausea, vomiting, pallor of the skin, lethargy, drowsiness, lethargy, a sharp decrease in the volume of urine, diarrhea, bad breath, tachycardia, cardiac arrhythmia, headaches;
- Stage of decompensation – complications in the form of frequent respiratory diseases, inflammatory infections of the urinary organs are added to the signs of general intoxication of the body;
- Compensation stage (terminal or end-stage) – the extinction of the functions of vital organs, a fatal outcome. Clinically, this stage is manifested by symptoms of severe intoxication of the body, impaired functioning of all organs, halitosis, yellowness of the skin, neurological disorders.
If you notice such signs, you should immediately consult a urologist.
The sooner renal failure is identified and treated, the higher the chances of the patient’s recovery.
The acute form of the disease is a reversible condition. To treat it, it is important to determine the causes of the organ malfunction.
If renal failure is not treated, the patient will quickly die.
Treatment for kidney diseases consists of specific treatment for a particular disease and nephroprotective treatment, universal for all kidney pathologies.
Treatment is prescribed depending on the specific disease. With glomerulonephritis, kidney damage with systemic diseases of the connective tissue, doctors prescribe steroids, BIARL (disease-changing antirheumatic drugs). With infectious lesions of the kidneys and urinary tract, antibiotics are used. In diabetic nephropathy, the correction of blood glucose is indicated.
Physical activity, maintaining normal body weight, low protein diet are very important. All patients are required to control diet for the prevention of protein-energy malnutrition.
The main nephroprotective treatment is the blockade of the renin-angiotensin-aldosterone system due to several groups of drugs: angiotensin-converting