Chronic renal failure - a slow decline in renal function over time. In the early stages of chronic kidney disease may not cause any symptoms. Significant impairment of renal function usually occurs within a few months or years. Changes can occur so slowly that the symptoms become noticeable as long as the kidney would not function several times worse healthy kidney.
Causes and risk factors
At the final stage of chronic renal failure kidney can no longer excrete enough fluids and waste. Patients with this disease need dialysis or a kidney transplant.
Diabetes and high blood pressure - the two most common causes of chronic renal failure.
However, many other diseases can cause kidney damage, including:
- Autoimmune disorders (such as lupus and scleroderma);
- Birth defects of the kidneys;
- Some toxic chemicals;
- Glomerulonephritis;
- Damage or injury;
- Kidney stones and infection;
- Problems with the arteries that supply blood to the kidneys or moves within the kidney;
- Some painkillers and other drugs (such as drugs used to treat cancer);
- Reflux nephropathy - a disease characterized by the influx of urine to the kidneys;
- Other kidney disease.
Symptoms
In the early stages of chronic renal failure, it may have the following non-specific symptoms:
- Lack of appetite;
- General malaise and fatigue;
- Headache;
- Itchy and dry skin;
- Nausea;
- Unexplained weight loss.
With further deterioration of renal chronic kidney disease can cause symptoms such as:
- Abnormally dark or light skin;
- Pain in the bones;
- Symptoms associated with the work of the brain and nervous system (eg, drowsiness or confusion, difficulty concentrating or thinking, numbness in hands
Numbness of hands - not such a harmless symptom
, Feet, or other body parts; muscle twitching or convulsions);
- Bad breath;
- Frequent bleeding or blood in the stool;
- Excessive thirst;
- Frequent hiccups;
- The weakening of libido and / or impotence;
- Delayed menstruation (amenorrhea)
- Shortness of breath;
- Sleep disorders such as insomnia, restless leg syndrome and obstructive sleep apnea;
- Swelling of the feet and hands;
- Vomiting, usually in the morning.
Diagnostics
Almost all stages of chronic renal failure are present hypertension and symptoms of nerve damage. For the diagnosis is usually made on the analysis of the creatinine
Creatinine - will talk about the work of the kidneys
and protein levels in urine. After the diagnosis of chronic renal failure patients need every two to three months to give blood for analysis. Physicians check the level of calcium, albumin, cholesterol, electrolytes. Changes in test results can talk about the deterioration in the patient's condition.
Causes of chronic renal failure was detected by computed tomography, magnetic resonance imaging, ultrasound, and / or kidney biopsy.
Treatment
Control of blood pressure may slow further kidney damage. The most commonly used for this angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers. For successful treatment it is necessary to keep the pressure at 130/80 mm rt.st.ili below.
Patients with chronic renal insufficiency are also encouraged to stop smoking, limit your intake of fatty foods, exercise regularly, control blood sugar
Blood sugar - one of the main indicators of human health
and to avoid the abuse of salt and potassium. If necessary, it can be assigned to medications that lower blood cholesterol.
Stages of the disease opredleniya
Firstly, it is necessary to determine which disease has led to the loss of renal function. In the event that at this stage it is not possible - that is disease discovered accidentally - is necessary at least to make sure that there are no body comorbidities. Usually, doctors recommend reorganization of foci of infection. This means that the carious teeth, sexually transmitted diseases, diseases of the nose and throat, and other infectious diseases must be promptly cured. It should also be borne in mind that all of the common cold, SARS and influenza disease only worsen chronic kidney disease and can lead to serious complications.
The second step to curb the disease is the adjustment of blood pressure
. If it affects the kidneys such diseases as chronic glomerulonephritis, chronic pyelonephritis, often developing hypertension, which in turn is detrimental to the glomerular apparatus of the kidneys
. The maximum allowable numbers of blood pressure at which the kidney is still intact - 130/90 mm
. Hg
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. If pressure readings above 140/100 for example, the tiny blood vessels in the nephrons can not withstand such onslaught and begin to die
. In each kidney there are more than one million nephrons
. In addition, kidney inherently have high functional reserves
. This means that even with 50% loss of nephrons people will not feel any ailments
. However, this does not mean that you can continue to continue to live like this
. Survivors nephrons (glomerular apparatus) assume the dead load and, thus, work overload, which results in a short time and their death
. That is why it is very important to keep blood pressure normal, namely 120/80 mm
. Hg
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. Until now, the clinics of the former USSR can find "the best doctors in the world" - Soviet doctors
. These people, by measuring the pressure of the patient, start asking questions like: "What is your working pressure? "Based on the conventional wisdom that supposedly everyone has their blood pressure
. From these doctors should be run
. The ideal blood pressure is considered to be pressure 110/70 or 120/80 mm
. Hg
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.
The figures are lower than those specified above, or not say that you "own" the pressure, they suggest that the body has lodged a disease, and the disease is an urgent need to diagnose and treat! In the case of kidney disease, such as treating physicians prescribe usually ACE inhibitors, which allow to correct blood pressure.
The next step after adjusting the pressure support is considered in patients with kidney diet. The choice of diet is carried out is determined by the doctor and based on the fact at what stage the disease. As a rule, the so-called low-protein diet, which can slow the progression of kidney disease and improves health. This treatment is called conservative therapy. However, when such treatment is not giving results and completely lose their kidney function, there comes a very serious period in the life of a person suffering from chronic renal failure.
The doctors immediately prescribe dialysis
Dialysis - maintains normal body
- This is an extreme measure, for now the only way a person will be supported life. Moreover, trying to resort to dialysis usually already when creatinine clearance less than 10 mL / min, and its level in the plasma becomes higher than 0, 1 g / l, i.e. avoiding prolonged existence uremia. Because experience has shown that a prolonged state of uremia, deep degeneration, encephalopathy and other complications of CKD significantly impair the results of hemodialysis and do not allow the operation kidney transplant, so the decision on hemodialysis and kidney transplantation should be taken in a timely manner. From that point begins to go through literally seconds, and any delay - is death.
This situation is quite complicated in many ways. Whatever assured officials of the dialysis centers that international practice has facts when patients are on dialysis, conquered the mountain tops, and women gave birth to healthy children, in fact, the reality of this situation is quite sad. Firstly, not all the available procedures - hemodialysis have a high enough price. Secondly, the freedom of movement of Americans who suffer from chronic renal failure, can move freely around the country, because hemodialysis have virtually all corners of the United States. Nothing of the kind can be said about Russia - dialysis centers there are very few. Therefore, if we can solve the question of funding, the patient will always be tied to one place - the city where there is a center hemodialysis.
In addition, dialysis patients should be on a strict diet. They always want to drink, but the amount of fluid intake should be strictly limited. And most importantly: the name of the "artificial kidney" highly conditional. In addition to filtering the blood of healthy kidney regulates many processes in the body by the hormone. Dialysis same, only cleans the blood from the decay products and removes excess fluid from the body. However, we must recognize that there are patients who are on dialysis for years.
Whatever it was, but a crucial step treatment of chronic renal failure is a kidney transplant
. On this topic can also be read and hear a lot of confidence as a transformed life after kidney transplant
. "As if life begins again"
. To some extent, it's probably because
. No more of these grueling dialysis
. As in the old days - reappears urination (the fact that the complete defeat of the kidneys stop producing urine, and dialysis patients over time forget what it is)
. But we should not forget that the people and remains disabled for life
. The amount of drugs taken at it does not decrease - contrary they become more serious
. The foreign body - the transplanted kidney - the body does not like, and he rejects it
. To lull the vigilance of the body are used immunosuppressive drugs - drugs that also weaken the immune system and against other diseases
.
This is not fully described herein way of life in patients with chronic renal failure. Choose whether this way to prolong his life for a few years, or meet death face to face - the choice is purely personal. This choice requires a slightly different view of things, rather than just narrow-minded perception of existence: to survive at any cost.
Vladimir Burylin
