June 14, 2013
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Acute renal failure - A condition in which there is a sudden stop or a very sharp decline in the function of both kidneys or a solitary kidney. As a result of this state is shown azotemia That is rapidly growing, and observed heavy water-electrolyte disturbances.
In the same time anuria It is a severe condition of an organism in which completely stops the urine flow into the bladder, or during the day it enters no more than 50 ml. A person suffering from anuria, and no urination, and urge him.
What's happening?
The pathogenesis of the disease is the leading circulatory problems in the kidneys and lowering the level of oxygen being delivered to them. As a consequence, there is a violation of all the important functions of the kidney - filtration . excretory . secretory . As a result, the body dramatically increases the content of the products of nitrogen metabolism, seriously disturbed metabolism.
Approximately 60% of the symptoms of acute renal failure were observed after surgery or injury. About 40% of cases the disease manifests itself in the treatment of patients in a hospital. In rare cases (about 1-2%) developed the syndrome in women during pregnancy .
Distinguish acute and chronic stage renal failure. Clinic of acute renal insufficiency may develop over several hours. If the diagnosis performed in a timely manner, and all measures were taken to prevent such a condition, the renal function recovered completely. Presentation of treatments carried out by a specialist.
It defines several types of acute renal failure. Prerenal kidney failure develops as a result of acute disorders of blood flow to the kidneys. Renal renal failure - the result of renal parenchymal lesions. Postrenal renal insufficiency - a consequence of severe disruption of the flow of urine.
Causes
The development of acute renal failure occurs during the production of traumatic shock, in which the damaged tissue. Also, this condition develops under the influence of reflex shock, reducing the amount of circulating blood due to burns, loss of blood. In this case, the state is defined as shock kidney . This happens when a serious accident, serious surgical interventions, injuries, myocardial infarction , Transfusion of incompatible blood.
A condition called toxic kidney It manifested as a result of poisoning by toxins, intoxication medication, alcohol abuse, substance abuse, exposure.
Acute infectious kidney - Consequences of serious infectious diseases - hemorrhagic fever . Leptospirosis . It can also occur during severe infectious diseases, which is rapidly developing dehydration.
Acute renal failure develops due to obstruction of the urinary tract. This occurs when the patient is growing tumor, there are stones, observed thrombosis, embolism, renal artery, ureter injury occurs. Furthermore, anuria sometimes becomes severe complication pyelonephritis and acute glomerulonephritis .
In pregnancy, acute renal failure is most common in the first and third trimesters. In the first trimester of this condition can develop after a abortion Especially conducted in non-sterile conditions.
Renal failure develops as a result of postpartum hemorrhage and preeclampsia in the last weeks of pregnancy.
It provided a number of cases where you can not clearly define the reasons for which the patient developed acute renal failure. Sometimes this situation is when the disease affects several different factors.
Symptoms
Initially the patient is not directly manifested symptoms of renal failure and signs of the disease, which leads to the development of anuria. It can be signs of shock, poisoning, symptoms of the disease itself. Further symptoms in children and adults manifest decrease in the amount of urine. Initially, its quantity is reduced to 400 ml daily (this state is called oligouriya ), After a patient is allocated not more than 50 ml urine per day (defined anuria ). The patient complains of nausea, he also observed vomiting, appetite disappears.
A person becomes sluggish, drowsy, he had marked inhibition of consciousness, and sometimes there are convulsions and hallucinations.
Changes and skin condition. It becomes very dry, pale, can appear swelling and bleeding. The man breathes deeply and often, he says tachycardia , Disturbed heart rhythm and blood pressure rises. May also marked diarrhea and abdominal distention .
Anuria is cured if treatment is started anurii timely and properly conducted. To do this, the doctor should clearly identify the causes of anuria. If therapy is carried out correctly, the symptoms gradually disappear and anuria period begins when urine output is restored. During the improvement of the patient is characterized by anuria daily diuresis of 3-5 liters. However, in order to health was completely restored, it is necessary from 6 to 18 months.
Thus, the disease is divided into four stages. At the initial stage of the human condition depends on that reason, which provoked renal failure. In the second step oligoanuricheskoy dramatically decreases the amount of urine, or it may be completely absent. This stage is the most dangerous, and if it continues for too long, there may be coma and even death. In the third, diuretic stage the patient is gradually increasing the amount of urine that is released. Then comes the fourth stage - recovery.
Diagnostics
Patients with suspected renal insufficiency or with signs anurii appointed a number of surveys. First of all, is to consult a urologist, biochemical and clinical blood tests, ultrasound, intravenous urography. Anura easy to diagnose, since according to the survey of the patient can understand that he has a long time there was no urination and urgency to it. To differentiate it from the state of acute urinary retention, bladder catheterization is performed to confirm the absence of it in the urine.
Treatment
All patients who have symptoms of acute renal failure, must be delivered urgently to the hospital where the diagnosis and subsequent treatment is carried out in the intensive care unit or in the Department of Nephrology. The leading role in this case is as much as possible before the beginning of the treatment of the underlying disease to eliminate all the causes that led to kidney damage. Given the fact that the pathogenesis of the disease is most often determined by the influence on the shock body, it is necessary to carry out promptly protivoshokovym events . Decisive importance in the choice of treatment is the classification of types of the disease. Thus, in patients with renal failure caused by loss of blood, held its compensation by introducing substitutes. If initially there was poisoning, be sure to carry out gastric lavage to remove toxic substances. When severe renal insufficiency should be carried out hemodialysis or peritoneal dialysis.
Especially serious condition causing end-stage chronic renal failure. In this case completely lost kidney function, and toxins accumulate in the body. As a result, such a condition can lead to serious complications. Therefore, chronic renal failure in adults and children should be subjected to appropriate treatment.
Treatment of renal disease carried out gradually, subject to certain stages. Initially, the doctor will determine the causes that led to the fact that the patient showed signs of kidney failure. Further steps must be taken to achieve a relatively normal urine volume, which is released in a human.
Depending on the stage of renal failure should be conservative therapy. Its purpose - to reduce the amount of nitrogen, water, and electrolytes, which enter the body, this amount corresponded to that derived from the body. In addition, the important thing is to restore the body diet with renal failure, continuous monitoring of its condition, as well as monitoring of biochemical parameters. Especially careful to treatment should be if there is kidney failure in children.
The next important step is to carry out the treatment of anuria dialysis . In some cases, dialysis therapy is used to prevent complications in the early stages of the disease.
Absolute indications for dialysis patient - is symptomatic uremia, a buildup of fluid in the patient, which is not amenable to removal by using conservative methods.
Particular importance is given to feeding patients. The fact that hunger and thirst can dramatically worsen the condition of the person. In this case it is shown low-protein diet , I.e. in the diet should dominate fats, carbohydrates. If a person can not eat on their own, necessarily intravenously administered glucose and nutrient mixture.
Complications
The course of acute renal failure is often complicated by infectious diseases. It is in this course of the disease can end in death.
As complications of the cardiovascular system is circulatory failure . Arrhythmia . hypertension . pericarditis . Often, acute renal failure observed manifestation of neurological disorders. Those patients who are not on dialysis, can celebrate severe drowsiness , Impairment of consciousness, tremors and other disorders of the nervous system. More often such violations occur in the elderly.
On the side GI complications occur often. This may be nausea, anorexia, bowel obstruction.
Prevention
To prevent the development of such a dangerous condition of the body, above all, must be timely to provide qualified assistance to those patients who are at high risk of developing acute renal failure. These are people with severe injuries, burns; those who have just suffered a serious operation, patients with sepsis, eclampsia and others. Very carefully, use those medications that are nephrotoxic .
To prevent the development of chronic renal failure that develops as a consequence of a number of diseases of the kidneys, it is necessary to prevent the exacerbation of pyelonephritis, glomerulonephritis. It is important for chronic forms of these diseases is required to observe strict diet prescribed by your doctor. Patients with chronic kidney disease should be monitored regularly by a doctor.
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