Acute renal failure – treatment of disease. Symptoms and prevention of the disease acute renal failure

Острая почечная недостаточность – что это за заболевание? Acute renal failure is a pathological sindromokomplex, potentially reversible and characterized by sharp violation of the filtration, secretory and excretory functions of the kidneys, that leads to disruption of nitrogen, vodno-elektrolitnogo Exchange and other species.

Morbidity in a population is about 20 accidents 100 th. the population, the structure is dominated by elderly patients.

Острая почечная недостаточность – Причины возникновения

All the reasons for developing acute renal failure can be divided into three large groups-prerenal'nye, Renal and postrenal. The main etiological factors prerenal'nymi LIMITERS are as follows:

• Kidney gipoperfuzija (stenosis of the renal arteries, their occlusion, anevrizme of the abdominal aorta, gepatorenal'nom syndrome, the long reception of angiotensin-receptor antagonists or inhibitors of angiotensin-converting enzyme 2, as well as non-steroidal anti-inflammatory drugs);
• gipovolemiя (when fluid loss due to bleeding, uncontrollable vomiting, massive Burns, diarrhea);
• otjochnyj syndrome (against the backdrop of liver cirrhosis, nephrotic syndrome, congestive heart failure, etc.);
• hypotensive state (in cases of anaphylactic shock, cardiogenic shock, septic shock).

Renal causes of SPD:

• glomerular damage (inflammatory character-cryoglobulinemia, post-viral Glomerulonephritis, System ljupusnyj eritematos, Purpura Shenljajn-Genoha, disease antiglomeruljarnyh basal membranes, thrombosis-tromboticheskaja mikroangiopatia, disseminirovannoe intravascular coagulation, etc.);
• damage to the seminiferous tubules (ischemia, hyperkalemia, uratami, oksalatami, light chains of immunoglobulins, toxic drugs, pigments, radiokontrastnymi substances and heavy metals);
• interstitial nephritis (against the backdrop of receiving antibiotics, NSAIDs, for subsequent pyelonephritis, lymphoma, tuberculosis, Sarcoidosis, etc.);
• Vascular factors (periarteritis nodosa, thrombosis of the renal artery or vein, cryoglobulinemia, thrombotic microangiopathy, vasculitis).

Postrenal'nye causes may be as follows:

• external (ryetropyeritonyealinyi fibrosis, tumor process of pelvis);
• internal (intramural'nymi-prostate hypertrophy, her tumor, urethral stricture, radiation fibrosis, bladder tumor, intraljuminal'nymi-papillary necrosis, blood clot, Stone).

Symptoms of acute renal failure

In the initial phase of SPD in patients with nonspecific symptoms are noted (nausea, drowsiness, generalized weakness, decreased appetite). Then comes phase oligoanuricheskaja, the patient becomes worse, He fizzled, significantly reduced urine output (to 0,5 liter per day), the urine becomes dark color. Oligoanuricheskaja phase is replaced by poliuricheskoj, which is characterized by an increase in the number of 24-hour urine to be allocated to 2 or more litres. The patient has cardiac arrhythmia may occur, paresis of skeletal muscles. Renal function recovery phase usually lasts from six months to a year.

Острая почечная недостаточность – Диагностика

Diagnosis of acute renal failure is performed using the following methods:

• Analysis of urine (is defined proteinurija, potassium loss in urine);
• biochemical blood analysis (hypocalcemia, hyperkalemia, metabolic acidosis, giperfosfatemiя, increasing creatinine and urea, etc.);
• immunological studies (can determine the cause of the development of the SPD, eg, antistreptolizin on after a streptococcal infection, antinuklearnye antibodies indicate an autoimmune process, etc.);
• Renal ultrasonography (defines the size of the kidney, obstruction, status of parenchyma, lohanochnoj ureters extension system, etc.).

Острая почечная недостаточность – Виды заболевания

Acute renal failure can be prerenal'noj (the kidneys are not damaged, the reason is a violation of the circulatory system), Renal (directly to the defeat of kidney tissue) and postrenal'noj (the reason for the level of urinary tract). Also secrete 4 stage in the development of the SPD: primary phase changes, oligoanuricheskuju, poliuricheskuju and convalescence stage.

Острая почечная недостаточность – Действия пациента

When it detects the symptoms, characteristic of SURGE ARRESTERS, It is recommended to consult a specialist.

Treatment of acute renal failure

Treatment of acute renal failure is to identify and correct pre- and postrenal'nyh reasons, abolition of nefrotoksicskih drugs, optimization of cardiac output and blood supply to the kidneys, treatment of complications, as hyperkalemia, metabolic acidosis and other violations vodno-elektrolitnogo balance. In the presence of infection are appointed by jetiotropnye medicines (antibiotics, antivirals), When bleeding stop them and filling volume of circulating blood. With the development of severe complications of dialysis can be performed uremicheskih.

Острая почечная недостаточность – Осложнения

SPD may be compounded by violations of water-salt Exchange, Congestive heart failure, perikarditom, heart rhythm disturbances, hypertension, uremicheskoj coma, etc.

Prevention of acute renal failure

Prevention of the development of this disease is to abstain from applying nefrotoksicnah drugs, rentgencontrastnykh substances in the presence of renal pathology, the use of diuretics (hofitol etc), early diagnosis and treatment of diseases, that can lead to the development of acute renal failure.