Chronic renal failure – treatment of disease. Symptoms and prevention of diseases of chronic renal failure

Chronic renal failure – What is this disease? Chronic renal failure is irreversible syndrome of kidney function, that occurs during the 3 months or more. Occurs as a result of progressive loss of nefronov, as a consequence of chronic kidney disease.

Characterized by impairment of excretory functions of the kidneys, formation of uremia, связанного с накоплением в организме и токсическим действием продуктов азотистого обмена (urea, creatinine, uric acid).

Chronic renal failure – The cause of the

1. Chronic glomerulonephritis (the defeat of the clubochkovogo apparatus of the kidney).

2. Вторичные поражения почек, caused:

• – diabetes 1 and 2 type;
• – hypertension;
• – systemic diseases of connective tissue;
• – viral hepatitis "b" and/or "c";
• – system a higher;
• – gout;
• – malaria.

3. Chronic pyelonephritis.

4. Urolithiasis, urinary tract obstruction.

5. Аномалии развития мочевыделительной системы.

6. Multicystic kidney disease.

7. Действие токсических веществ и лекарств.

Chronic renal failure – Symptoms

Patients complain of dryness and bitterness in the mouth, anorexia, pain and heaviness in podlojecna area, loose stools. Concerned about shortness of breath, precordialgia, increased blood pressure. Disturbed blood coagulation, resulting in nasal and gastrointestinal bleeding, skin hemorrhages.

In the advanced stages of heart attacks occur in asthma and pulmonary edema, disturbances of consciousness, up to coma. Patients prone to infections (colds, pneumonias), that, in turn, accelerate the development of renal failure.

Chronic renal failure – Diagnostics

To diagnose diseases apply the following laboratory tests:

1. Общий анализ крови показывает анемию (lower hemoglobin and red blood cells), signs of inflammation (acceleration of SEDIMENTATION RATE-speed sedimentation of erythrocytes, a moderate increase in the number of leukocytes), the propensity to bleeding (reduction in the number of platelets).

2. Биохимические анализы крови – увеличение уровня продуктов азотистого обмена (urea, creatinine, residual nitrogen in the blood), violation of elektrolitnogo Exchange (increase the level of potassium, phosphorus and calcium reduction), decreases total protein in the blood, hypocoagulation (lowering blood coagulability), increase in blood cholesterol, total lipids.

3. Анализ мочи – протеинурия (the appearance of urinary protein), hematuria (the appearance of red blood cells in the urine of more than 3 in the field of view when urine microscopy), цilindrurija (indicates the degree of kidney failure).

4. Проба Реберга – Тореева проводится для оценки выделительной функции почек. Using this sample counting speed clubockova filtering (SKF). This is the main indicator for determining the degree of renal failure, stage of the disease, because it displays the functional condition of kidneys.

В настоящий момент для определения СКФ используются не только пробой Реберга-Тореева но и специальными расчетными методами, taking into account the age of the, body weight, flooring, creatinine blood levels.

It should be noted, that now instead of CHRI, considered obsolete and characterizing only fact irreversible kidney, applies the term CHA (chronic kidney disease) with the obligatory indication of the stage. It should be emphasized, that the determination of the existence and stage of HBP in no way replaces posing the primary diagnosis.

Chronic renal failure – Instrumental studies

1. Ультразвуковое исследование мочевыводящей системы с импульсной допплерометрией (determination of renal blood flow). Spend to diagnose chronic kidney diseases, and allows you to rate the severity of kidney failure.

2. Пункционная биопсия почек. Study of kidney tissue allows to make an accurate diagnosis, determine the version of the disease, to assess the degree of defeat of kidneys. Based on this information, the conclusion is the prediction of the course of the disease and the selection of treatment method.

3. Рентгенологические (Overview, contrasting) Kidney research carried out at stage diagnosis and only patients with I-II degree of renal insufficiency.

Chronic renal failure – Stage of disease

XBP (chronic kidney disease) I: kidney damage with normal or elevated SCF (speed clubockova filtering) (90 mL/min per 1.73 m2). Chronic renal failure is not;

HBP II: damage to the kidneys with a moderate decline in the SCF (60-89 mL/min per 1.73 m2). The initial stage of CKD.

CHA III: Kidney with moderate reduction of SCF (30-59 mL/min per 1.73 m2). CRF compensated;

CHA IV: damage to the kidneys with a significant degree of decline SCF (15-29 mL/min per 1.73 m2). The PROGRESSION of asthma (not compensated);

CHA V: поражение почек с терминальной ХПН (< 15 mL/min per 1.73 m2).

Chronic renal failure – Actions of the patient

The patient should see a doctor-nephrologist.

Chronic renal failure – Treatment

Treatment of chronic renal failure is largely determined by its stage and pace of development, the presence of leading syndromes in the clinical course and characteristics of the main disease, led to the development of chronic uremia.

The initial period of chronic renal failure with benign course of disease (chronic glomerulonephritis, chronic pyelonephritis, Polycystic etc.) can extend over many years, not significantly affecting the overall well-being and without requiring active treatment. In this situation, it is imperative to treating the underlying disease, that helps slow the progression of chronic renal failure.

Another treatment to patients with clinical picture of chronic renal insufficiency, characterized by giperazotemiej, metabolic acidosis, violation vodno-elektrolitnogo balance, difficult controlled hypertension and circulatory. In such cases, it is necessary to carry out the correction of water-salt balance, azotemii, the alignment of the acid-base status, treatment of hypertension, hemorrhagic and anaemic syndromes, maintenance of cardiac activity.

Important components of the therapy become low protein diet (20-60 g of protein per day), limitation of physical activity, monitoring of dietary sodium, an adequate intake of fluids under the supervision of the daily diureza. Good effect is achieved by the use of drugs, improve kidney bloodstream (trental, troksevazin), as well as with furosemide dosages given renal function. Drug treatment should not be administered, without specifying the functional condition of kidneys.

Treatment of chronic renal insufficiency may be as a substitution character: Hepatology program, peritoneal dialysis and kidney transplantation.

Chronic renal failure – Complications

Over time, CKD damages virtually every human body.

Chronic renal failure – Prevention

Renal failure diet plays a very important role. It is determined by the stage, chronic disease, phase (exacerbation, remission). Doctor with patient together make up a food diary, together with an indication of the quantitative and qualitative composition of food.

Malobelkovaja diet with restriction of consumption of animal protein, Phosphorus, sodium contributes to inhibition of progression of renal insufficiency, reduces the possibility of complications. Protein intake should be strictly dosed.