Система Orphus

Symptoms of disease - violation of the kidney

Violation of the kidney (renal failure) is a pathological condition which is characterized by complete or partial loss of kidney function for the maintenance of the chemical the constancy of the internal environment of the body. Renal insufficiency is manifested violation of the process of education and (or) excretion of urine, disorders of water-salt, acid-base and the osmotic balance.



Which diseases there is violation of the kidney

The reasons for violations of the kidney

From the point of view of the pathogenesis and development of symptoms distinguish between acute and chronic failure of the kidneys.

Causes of the violation of kidney function is divided into prerenal, renal and postrenal.

1. To prerenal reasons include blood supply disturbance of the kidneys. As is known, the process of renal filtration (the first stage of education urine), depends entirely on the amount of blood flowing into the kidneys, which in turn is determined by the quantity of blood pressure. In most cases, acute renal failure due to a sharp drop in blood pressure and, consequently, the amount of blood entering the kidneys. The cause of the fall of blood pressure is critical state of shock, which is characterized by acute violation of the processes of circulation of the blood. State of shock may occur in cases of severe blood loss, injuries, burns (hypovolemic shock), in violation of the heart (cardiogenic shock in myocardial infarction), septic shock (sepsis), anaphylactic shock (at introduction in a sensitized organism specific allergens), etc. Thus, the critical decline in the number of blood flowing into the kidney filtering process primary urine becomes impossible, and the process of formation of urine stops (anuria).

2. To renal reasons of kidney function are all pathological conditions under which affects renal parenchyma. The most frequent causes of acute kidney failure are sharp glomerulonephritis, interstitial nephritis, intoxication renotrophic poisons, thrombosis of the renal vessels, kidneys, and heart attack etc. It is worth noting that the pathological process may affect as kidney glomes (glomerulonephritis), violating the process of filtration and tubular epithelium (nephritis, intoxication), which leads to their clogging and disruption of the process of reabsorption. One of the forms of renal kidney disease is blockage of the renal tubules hemoglobin of the destroyed red blood cells, which occurs when a massive hemolysis or myoglobin syndrome of compression (crash-syndrome). Renal failure develops also in the bilateral removal of kidneys, and also in massive injuries of both kidneys.

3. To postrenal causes are acute obstruction of the ureters, both kidneys, which may arise in urolithiasis, compression of the ureters ligature (during surgery), hematoma (trauma), tumor. As a rule, simultaneous violation of the functions of both the ureters is quite rare.

In contrast to acute renal failure, developing suddenly, chronic renal failure develops slowly and may long remain unnoticed.

The most frequent causes of chronic renal include chronic kidney disease, which is characterized by slow the destruction of the active parenhima kidney, and the replacement of the connective tissue. Chronic kidney failure is the final stage of such diseases as chronic pyelonephritis, chronic glomerulonephritis, acute infectious disease. In some cases, chronic renal failure occurs in consequence of the defeat of vessels of the kidneys in atherosclerosis and diabetes. Quite rarely cause of chronic renal failure are hereditary diseases: polycystic kidneys, hereditary nephritis, etc.

Thus, at the basis of violations of kidney function of various etiologies are a few basic pathogenetic mechanisms: the decrease of the filtration process (with the defeat of the glomeruli or when the supply of kidneys blood), blockage of the renal tubules and necrosis of epithelial cells of tubules (with hemolysis, poisoning), the inability to remove urine from the conduction disorders of the urinary tract. The overall result of these mechanisms is the reduction or complete cessation of the process of formation of urine. As it is known in the urine from the body are derived unnecessary and toxic substances, as well as excess water and mineral salts. In case of renal insufficiency, the termination of the uropoiesis leads to the accumulation of these substances in the body, which causes the development of the syndrome autointoxication or uremia.

State autointoxication is caused by the accumulation in the body of an excessive number of urea (uremia) and other nitrogen-containing products of decomposition of proteins (azotemia). Many of the products of metabolism of proteins (ammonia, indole, phenols and aromatic amines) are highly toxic and, in high concentrations, cause the defeat of different internal organs. Also there was an increased concentration in the blood of mannitol, creatinine, uric acid, oxalic acid, various enzymes and hormones, as well as some of the ions. Autointoxication is a violation of all types of metabolism and the defeat of the internal organs of the clinical picture of the functions of the kidneys.

Symptoms of kidney function

In spite of the fact that the main laboratory signs of acute and chronic renal insufficiency is similar (especially at the stage uremia), the evolution of these diseases are significant differences.

In the development of acute violations of the kidney distinguish the following periods:

1. The period of initial actions of the pathogenic factor - in which the conditions are created violate the normal functioning of kidneys. The main clinical manifestations at this stage are related to the main disease (hemorrhage, sepsis, traumatic shock and etc.)

2. The period oliguria (anurii). Oliguria this is the state in which the daily number of education and excretion of urine is reduced below the critical level (below 500 ml in 24 hours). Anurii the process of formation of urine stops altogether. The duration of this period is about 2 weeks and is characterized by the accumulation in the urine products of protein metabolism, electrolytes, enzymes, hormones and osmoactive substances. Developing the syndrome of autointoxication (uremia, azotemia). Clinical manifestations at this stage, connected with the defeat of the systems of the body caused by autointoxication. Arise sharp pain in the abdomen, vomiting, shortness of breath, symptoms of the nervous system, drowsiness, and in some cases, with inadequate treatment, a patient may fall into a coma and die. Noted the formation of edema, which in the beginning of disease are located on the face and extremities, and subsequently spread throughout the body (anasarca). Swollen fluid can accumulate in the pericardial and pleural cavity, which can cause a disruption of the heart and lungs.

3. The period of restoration of diuresis - comes after 2-3 weeks from the moment of renal insufficiency. In the first days of the amount of urine reaches about 500 ml. In the following days diuresis progressively increases and comes a phase polyuria (excessive excretion of urine), which is conditioned by the excretion of large quantities of osmoactive substances.

4. The period of recovery. With the restoration of the function of kidneys and excretion of accumulated toxic substances, symptoms autointoxication fall, swelling disappear, and the functions of internal organs is restored. The period of full recovery of the patient can last for 12 months and more.

The development of chronic disorders of the functions of the kidneys is slowly over many years. There are two clinical stage of evolution of the disease: the conservative and the terminal.

Conservative stage is characterized by the slow violation of kidney function, which for some time retain the ability to concentrate and to allocate the urine. The symptoms of this period is primarily due to the chronic diseases, contributing to the establishment of renal insufficiency. In the further destruction of the kidney nephron conservative stage goes into the terminal.

For the terminal stage is characterized by its development uremic syndrome, which manifests weakness, headache and muscle pain, shortness of breath, disorders of smell, taste, paresthesias in the hands and feet, itching of the skin, the appearance of edema, nausea, vomiting. The skin of the patient with uremia are covered with a thin coating of crystals urea, from the mouth of the patient odour of ammonia and urine. Often the skin formed the bruises and trophic ulcers. Disorders of the brain appear mental disorders, irritability, drowsiness or insomnia. As a rule, develops high blood pressure, anaemia. Disturbed the work of all internal organs, with the development of the respiratory and cardiac insufficiency, tamponade heart, gastritis, colitis, pancreatitis and etc.

In the absence of treatment, the patient, as a rule, falls into a coma and dies. Death can also occur from disorders of the heart, lungs, liver, joining of various infections.



Which doctor should I contact if there is a violation of the kidney

  • Urologist
  • Otolaryngologist
  • The emergency doctor


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