Why can begin

Uremia is the outcome of acute and chronic renal failure. Acute uremia occurs against a background of acute renal failure as a result of a sudden and total violation of renal circulation, because of which the kidney tissue is not receiving adequate nutrition and dies (renal infarction). The blood accumulates a large number of toxic substances, which cause poisoning of the body. Such a condition can occur when a sharp decrease in blood volume, for example, in shock, a sharp decrease in blood pressure, bleeding, loss of water (for burns, vomiting), for poisoning toxins (such as strong acids poison the insects), with occlusion of a blood clot renal blood vascular occlusion with urinary tract stones.

Chronic uremia - the outcome of chronic renal insufficiency, it is prolonged, sluggish starts with an inflammatory process, which resulted in kidney tissue is slowly replaced by connective tissue with the loss of kidney function, accumulation of metabolic products in the blood and uremia. The leading role played in the development of uremia poisoning metabolic products, normally outputting the urine.

As shown

Formation uremia symptoms depend on the nature of the underlying disease and the rate of increase of renal failure. However, there are some common symptoms that develop in all forms of the disease.

Characteristic appearance of uremic patients. They are sluggish, apathetic, sleepy, puffy face, pale yellowish, while suffering from a long time - with a brown "tan." The skin is thin, dry, loose, hair and nails - dry and brittle. In some patients, the skin appear crystals of urea ("uremic powder"), which causes a painful and they itch, and scratching the accession of purulent infection. In various parts of the body without apparent cause hemorrhages occur. Relatively early in uremia appear muscle weakness, expressed mainly in the muscles of the back, shoulder and pelvic girdle, which makes it difficult getting out of bed.

Among the first signs of brain damage (encephalopathy) include general weakness, impaired attention, memory, sleep Dreams: how to understand our dreams . Later, there is indifference, hallucinations (seeing what is really there), seizures and even coma, with a gradual change of consciousness. In acute uremia, all these signs are growing very fast. The defeat of the peripheral nervous system disorders appear balanced sensitivity and movement. A feeling of pins and needles on the body, numbness and so on. Disturbed taste and smell, vision deteriorates, sometimes there is complete blindness.

The body also accumulates plenty of potassium and magnesium. Such violations of water-salt balance in life-threatening cases. Comes dehydration, loss of fluid in the brain that can go into a coma. There are changes in all internal organs. On the part of the gastrointestinal tract even at the initial stages of uremia appear nausea, vomiting, heartburn, ammonia breath Breath (halitosis) - is sometimes useful to close the mouth .

Diagnostics

Uremia diagnosis is based on laboratory data. Most importantly, the determination in blood of nitrogenous substances - residual nitrogen and its constituents (residual nitrogen - is the total number of non-protein nitrogen in the blood plasma remains after protein precipitation; in the residual nitrogen comprises urea, nitrogen, amino acids, uric acid Uric acid - a normal level? , Creatine and creatinine Creatinine - will talk about the work of the kidneys   and others). All of these indicators will be enhanced, since the kidneys can not cope with the work and the decay products of proteins (nitrogenous substances) are flooding the bloodstream, causing poisoning of the body.

The set of measures for the treatment of patients with uremia include medical protective regime, diet (protein restriction), conservative treatment (elimination of nitrogen metabolism disorders), purification of blood by hemodialysis and plasmapheresis. There is a surgical method of treatment of uremia - a kidney transplant.

  Galina Romanenko

The symptoms of nephrotic syndrome

Patients with nephrotic syndrome complain of weakness, drowsiness, fatigue, dry mouth, loss of appetite, feeling of heaviness in the lumbar region.

Edema in nephrotic syndrome develops very quickly, accompanied by a small separation of urine and have generalized (all tissues, organs and cavities) in nature. For large swellings on the skin appear pale band stretching, the skin becomes dry, flaky, hair and nails - dull and brittle.

When the fluid in the chest cavity first appears dyspnea on exertion and then at rest. Increases due to swelling of the liver, fluid fills the abdominal cavity. The distribution of edema in the later stages of the disease subject to the law of gravity: the bottom of the swelling more. Swelling of the conjunctiva and the retina is often accompanied by blurred vision.

Accelerated removal of the protein leads to shrinkage (atrophy) of muscles, which is especially noticeable after the toe swelling.

Current

By the nature of the flow are three variants of nephrotic syndrome:

• anecdotal, appearing only in the beginning with the outcome of the underlying disease in remission, or recurrent (kidney function while maintaining normal within 10-20 years);
• persistent, when symptoms of the disease persist, despite treatment for 4-8 years without a loss of kidney function;
• progressive transition of 1-3 years in the stage of chronic renal failure Chronic renal failure - what to do and how to be?   (decreased kidney function at which the poisoning of the body's own metabolism products).

Episodic characteristic for allergic nephrotic syndrome, rapidly progressive - Autoimmune diseases of the kidneys (glomerulonephritis). In the elderly is common the second and third variants of the course.

If nephrotic syndrome, diverse and numerous complications: cerebral edema, retinal thrombophlebitis, myocardial infarction, stroke Stroke - a serious brain injury   brain, acute renal failure Acute renal failure - causes and consequences   and others. In carrying out medical treatment may increase the number of complications due to allergic reactions to medications.

Diagnosis of nephrotic syndrome

In the diagnosis of nephrotic syndrome have a large laboratory studies. The main laboratory signs - large amounts of protein in the urine The protein in the urine - a sign of danger, which should not be underestimated   (proteinuria). During the day, a sick person can lose up to 20-30 grams of protein. If the proteins excreted in the urine have a low molecular weight proteinuria is considered to be selective, macromolecular - non-selective, it is a bad sign. Provided as a large number of enzymes, indicating the acute process in the kidneys and the severity of their injury.

Permanent sign of nephrotic syndrome is a reduced amount of protein in the blood plasma (hypoproteinemia), particularly sharp falls albumin. When the content of albumin in the blood drops to a minimum level, the patient has edema.

Elevated levels of serum lipids is also a typical feature of nephrotic syndrome. The functional ability of the kidneys may be normal or reduced.

Treatment

If nephrotic syndrome is very important early admission, update forms and causes of nephrotic syndrome, the definition of the functions of the kidneys.

Appointed salt-free, rich in potassium diet containing animal protein 1 g per kg of body weight of the patient (large protein loads lead to an increase in proteinuria). With symptoms of allergies and autoallergens appointed steroids and cytostatic (inhibit the development of immune processes). To remove the swelling appointed diuretics in combination with drugs potassium (eg Pananginum - potassium excretion in the urine is dangerous to life).

Nephrotic syndrome - a very dangerous condition, it should be treated only in a hospital.

  Galina Romanenko