Амилоидоз почек – что это за болезнь? Renal Amyloidosis is a kidney with a system violation of protein-carbohydrate metabolism, When the extracellular accumulation of complex proteido-polisaharidnogo substances-amyloid in the kidney tissue, that leads to disruption of their operation. The prevalence of this disease in the population averages 0,7% (Asia-about 0,2%, for Spain and Portugal- 1,5-2%). The most commonly amiloidozom kidneys are affected middle-aged men (40-50 years).
The causes of primary (Idiopathic) Renal Amyloidosis unknown. Nor is the possibility of hereditary predisposition to the disease. There is also a mutacionnaja, immunological hypothesis and a local cell synthesis. Secondary Amyloidosis can be developed against the background of the following diseases:
In the development of Amyloidosis of the kidney secrete 4 stage, Depending on which vary and clinical manifestations of disease. So, in the latent stage (Preclinical), which can take up to 5 years or more, Renal symptoms as such no, dominated by manifestations of primary pathology (Infections, inflammatory, endocrine, etc. Diseases). In al'buminuricheskoj (proteinuricheskoj) stage occurs and increases renal tissue sealing, in urine can be detected leukocytes, red blood cells and protein. This stage can last 10-15 years. The third stage (otjochnaja, principally nefrotical) is characterized by the development of nefroticski syndrome, manifestations of which are swelling (greater after sleep), reducing the level of total protein in the blood, increase blood cholesterol, as well as a large amount of protein in the urine. Besides, often there was a significant increase in liver size, development of ascites, gidroperikarda, hydrothorax. Azotemicheskaja (uremicheskaja, terminal) stage is characterized by the development of chronic renal failure.
In general clinical blood analysis detected leucocytosis, ESR acceleration, anemia. In biochemical analysis of blood can be detected giperglobulinemija, hypoalbuminemia, giperʙiliruʙinemija, hypercholesterolemia, hypocalcemia and hyponatremia, increased activity of alkaline phosphatase (alkaline phosphatase), increase of β-lipoprotein and Fibrinogen. Pyuria is determined in the urine analysis, proteinuria, цilindrurija, mikrogematuriâ. In the analysis of feces can be detected kreatoreja, steatorrhea and amiloreja. While conducting ECG and Echocardiography may experience the signs of diastolic dysfunction, kardiomiopatii, conduction disorders. The renal ultrasound changes are, specific to each stage of Amyloidosis. Reliable and most informative method of diagnosis of Amyloidosis is renal morphological and Histochemical study of Renal Biopsy tissue.
On the jetiologicheskomu basis of five types of renal Amyloidosis are distinguished:
When symptoms, described earlier, need to see a nephrologist.
With secondary kidney amiloidoze tactics in the first place is the main disease therapy. Among medicines apply desensitizing preparations, unithiol, Colchicine, derivatives of 4-aminohinolina (hingamin, delagil, etc.), hypotensives and diuretics, albumin and plazmozameshhajushhie solutions-if necessary. All patients amiloidozom renal assigned diet with restriction of salt intake and protein. In severe cases, the ineffectiveness of the indicated therapy, and Terminal phase it is possible to use such methods, like chronic renal dialysis, as well as kidney transplantation.
The most frequent complication of renal Amyloidosis is a severe chronic renal insufficiency, which often leads to fatal.
With the aim of preventing this pathology are recommended to diagnose and treat diseases in a timely manner, against which may develop secondary renal Amyloidosis.
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