Chronic kidney disease - a disorder in which kidney function deteriorates. The severity of the disease can vary, but in most cases it is mild to moderate, usually occurs in the elderly and does not develop renal failure. If any form of chronic kidney disease in humans significantly increases the risk of heart disease or stroke. It is therefore important to detect the disease in time and start treatment.

Diagnostics

With a simple blood test can determine how much blood the kidney is filtered for a certain period of time. This is a test - on the glomerular filtration rate (GFR). Normal GFR is 90 ml / min / 1.73 m or more. GFR is reduced if some glomeruli (tiny filters in the kidneys) begin to work less. This is what happens with chronic kidney disease.

Stages of chronic kidney disease

• Stage 1. GFR is 90 or more. At this stage, even normal GFR, however, has found some evidence of renal disease, for example, the presence of protein in urine The protein in the urine - a sign of danger, which should not be underestimated , kidney inflammation Inflammation of the kidney - do not suffer pain , and so on.
• Stage 2. GFR 60-89. The slight decrease in renal function; moreover, revealed certain disease and / or renal damage. Patients with such a measure GFR and without renal disease is not diagnosed chronic renal disease.
• Stage 3. GFR 45-59 (step 3A), GFR 30-44 (Stage 3B). The moderate decrease in kidney function. The presence of any disease or renal impairment is not necessary.
• Stage 4. GFR 15-29. Very serious decline in renal function.
• 5 stage. GFR less than 15. Very severe renal impairment; in this step is usually diagnosed renal failure.

Causes

A number of disorders can lead to kidney damage, affect their function, and, in turn, cause chronic kidney disease. The most common causes of chronic kidney disease are:

• Diabetes. Kidney disease - a common complication of diabetes.
• High blood pressure. Poorly controlled hypertension is a major cause of chronic kidney disease. However, the disease itself can cause high blood pressure. Nine out of ten patients with chronic kidney disease high blood pressure is recorded.
• The aging process. Apparently, the deterioration of kidney function associated with age. Approximately half of people aged 75 or older has one or another stage of chronic kidney disease. Most of the disease does not develop on the third stage.
• Less common disorders that can cause chronic kidney disease: glomerular diseases, such as glomerulonephritis (inflammation of the glomeruli); renal artery stenosis, hemolytic uremic syndrome, polycystic kidney Polycystic kidney disease: severe hereditary disease ; kidney injury caused by toxins and drugs; repeated kidney infections.

Symptoms

In the first to third stages of chronic kidney disease is usually asymptomatic.

Noticeable deterioration occurs in the fourth stage; there are non-specific symptoms such as constant fatigue, fatigue and malaise. With further development of the disease, the following symptoms:

• Violation of clear thinking;
• Poor appetite;
• Weight loss;
• Dry skin and itching;
• Muscle cramps;
• Fluid retention in the body, causing swelling of extremities usually the legs;
• Swelling around the eyes;
• More frequent need to urinate;
• Paleness due to anemia;
• Severe malaise.

At the fifth stage of chronic kidney disease if left untreated, can lead to death of the patient.

What is the difference between renal failure and kidney disease?

Renal failure

Kidney failure occurs when the kidneys partly or completely lose their ability to function normally. Renal failure is dangerous because the liquid waste and toxic substances, resulting from the exchange, it is excreted by the kidneys.

This disease is also the cause of other health problems, such as anemia, hypertension, acidosis (excess acid in the body), violation of cholesterol and fatty acids, and the disease of bone tissue due to lack of the body's hormone produced by the kidneys.

Chronic kidney disease

Chronic kidney disease occurs when a person suffers from increasing with time and, as a rule, the continuous deterioration of renal function. This occurs gradually, over time, usually from a few months to several years. Chronic kidney disease is divided into five stages of severity. The fifth-stage chronic renal failure, also called end-stage renal disease, where there is a complete or almost complete loss of kidney function and the patient requires dialysis Dialysis - maintains normal body   or transplantation to stay alive. The term "renal" means kidney, so another name for kidney failure - "renal failure". Often a slight decrease in kidney function is called renal failure.

In contrast, chronic renal failure, acute renal failure develops quickly, within a few days or weeks.

Acute renal failure usually develops as a result of diseases that directly affect the kidneys, disrupting their blood supply, or the flow of urine.

Acute renal failure is usually not a cause further kidney damage. With appropriate treatment of existing disease, it is often reversible up to complete recovery.

In some cases, however, it may become chronic kidney disease.

Hydronephrosis - a disorder characterized by the expansion of the renal pelvis and a violation of the outflow of urine. This can occur as a result of normal processes, or due to various underlying diseases. Normally, the kidneys filter blood and outputting various wastes in the urine. Then, the urine enters the renal calyx, and then - in the renal pelvis. After that, the urine enters the ureter, the tube that connects the kidney to the bladder. From the bladder through the urethra, the urine leaves the body.

Although the most common cause of obstruction hydronephrosis are different, this violation is linked to some birth defects; sometimes kidney hydronephrosis is a physiological response to pregnancy.

Hydronephrosis may be unilateral, when it affects only one kidney or bilateral.

Complication hydronephrosis is a decline in renal function. Pressurizing excess fluid in the kidneys reduces the volume of blood that is filtered in the body, and can cause structural damage to the kidney cells. This decrease in the function is reversible, if the time to cure the underlying disease, but if hydronephrosis lasts several weeks, the damage may be permanent.

Causes

Hydronephrosis can be caused by many reasons, which are classified depending on whether they are internal (located in the urine collection system) or external (located outside the system).

Internal causes kidney hydronephrosis:

• Stones in the kidneys. This is probably the most common cause of unilateral hydronephrosis; stones often cause obstruction of the urethra.
• Blood clots in the ureter.
• The formation of scar tissue in the ureter.
• Bladder cancer.
• Stones in the bladder Urinary bladder - structure and function .
• Cystocele.
• Bladder neck contracture.
• Impaired ability to empty the bladder, for whatever reason, could lead to bilateral hydronephrosis.
• Various violations of the structure of the urethra.

External causes of hydronephrosis:

• Benign or malignant tumors that compress the ureter and prevent urine output.
• Retroperitoneal fibrosis.
• Cervical cancer.
• Prostate cancer.
• Pregnancy.
• Uterine prolapse.
• Scarring after radiation therapy.
• Prostatic hypertrophy.
• Prostate cancer.

Symptoms

Symptoms of kidney hydronephrosis depend on the underlying cause.

In acute hydronephrosis may appear symptoms such as severe pain in the back Back pain: Do not start the process Extending to the groin, and nausea Nausea - there may be problems with the nervous system , Vomiting, and sweating. In addition, a person may experience renal colic - this pain is one of the most severe pains a person can experience.

Chronic hydronephrosis develops gradually and has no specific symptoms. Nonspecific symptoms may be fatigue, weakness, nausea and vomiting. If due to the decline of renal function occurs imbalance of electrolytes can be observed cardiac arrhythmias and muscle spasms.

Patients with symptoms of acute kidney hydronephrosis need urgent medical attention. In addition, people who have previously been diagnosed with kidney hydronephrosis need to see a doctor for any signs of infection - such as fever, fever or chills. Immediate treatment is also necessary in patients who have previously had one kidney removed.

Treatment

The primary goal of treatment of hydronephrosis kidney - the restoration of the normal flow of urine from the kidneys and reducing and inflammation.

First of all, doctors are taking measures to reduce pain and prevent infection of the urinary tract. If this is not done in time, you may need surgery.

The duration of treatment typically depends on the underlying disease and its complications. For example, if the patient has kidney stones Kidney stones: identify and treat Which is not completely disrupt the flow of urine, he can stay under medical supervision a week or two, until the stones do not pass the ureter. At this time, as a rule, the patient only takes painkillers regularly. When complete ureteral obstruction, infections, and in patients with hydronephrosis one kidney requires surgery.

If congestion is caused by hydronephrosis urine primarily applicable bladder catheterization.

Shock-wave lithotripsy - a common means of treatment for kidney stones, which is also used in the treatment of patients with hydronephrosis of the kidney. During the treatment of kidney stones pulverized using the impact from the outside, and then they will go out of the ureter.