Chronic Renal Failure: Symptoms and Treatment
Chronic renal failure is a pathological process in which the kidneys stop functioning fully. The disorder is caused by a variety of diseases, causes, and the localization of which is not always associated with the kidneys. For ailment, the death of the structural tissue of the kidneys, which consists of nephrons and is responsible for the production and filtration of urine, is characteristic.
Depending on the form of the disease, kidney failure occurs three months or more later. Without proper treatment can flow into chronic adrenal insufficiency. Diagnosis of the disease consists of a set of measures, and includes many laboratory tests and instrumental examinations of the patient. Treatment is based on the elimination of the main disorder that led to this ailment, but, in addition, it is necessary to undergo repeated courses of hemocorrection. For complete recovery from chronic renal failure in children and adults, organ transplantation is necessary.
The disorder is an irreversible violation of some of the kidney functions, among them the excretion and filtration of urine. At the initial stage, the disease can go unnoticed for a person, but the more it progresses, the more pronounced the signs — lack of appetite, strong weakness of the body, a change in the skin tone. But the main thing is an increase in the amount of urine released per day. Without proper and timely treatment, there will be a progression of complications that can lead to death.
Renal insufficiency appears as a consequence of other diseases in the body, among them — pyelonephritis, amyloidosis or polycystic kidney disease. Also, the reasons for the appearance of such a disorder of kidney function can be:
- congenital abnormalities in the structure or functioning of the kidneys, the presence of only one kidney or irreversible disturbances in one of them
- deposition of kidney stones
- body weight much higher than normal
- polycystic kidney disease;
- late diagnosis of other kidney diseases;
- Lupus Erythematosus
- a wide range of disorders of the urinary system;
- Failure to follow instructions or abuse of certain medicines
- Oncological neoplasms
- body intoxication
- Acute chemical poisoning
There is a classification of chronic renal failure relative to the stage of symptoms:
- latent — signs are almost not shown. A person can feel a little tired. It is often determined when diagnosing a completely different problem, for the diagnosis of which blood or urine tests were performed;
- compensated — the amount of urine released increases (more than two liters per day), a little puffiness appears in the morning
- Intermittent — Severe fatigue bothers a person, as well as dry mouth. There is a muscle weakness;
- terminal — a sharp change in the mood of the patient, reduced immunity. There is a violation of the work of other internal organs, including the heart and lungs. But most clearly the terminal stage of chronic renal failure is characterized by such a sign as the appearance of a smell of urine from the mouth of the victim.
For each stage, from the above classification, the symptoms of chronic renal failure are characteristic. As mentioned above, during the initial stage of the disease a person may not feel any manifestations or very much feel fatigue, which manifests itself towards evening.
For a compensated form is typical:
- A strong sense of fatigue
- a person emits more than two liters of urine per day;
- dry mouth appears
- There is swelling on the face after sleep.
The intermittent type of illness is accompanied by such signs as:
- A person quickly becomes tired, despite inactive physical activities
- a sharp decrease in appetite
- constant dry mouth, despite severe thirst
- an unpleasant aftertaste appears in the oral cavity
- bouts of nausea and vomiting
- the skin changes in color and acquires a pale yellow tint
- Dryness and flaking of the skin
- slight involuntary twitching of fingers and toes
- pain in the muscles and bones.
With such symptoms of chronic renal failure, there is a possibility of a complicated course of certain diseases, such as angina, pharyngitis and other inflammatory processes of the respiratory system. If medication is administered, the patient’s condition can be improved, but any adverse effects such as severe stress, mental disorders, non-compliance with diet, infection, or surgery will trigger a sharp deterioration in kidney condition and acute symptoms.
The terminal stage is expressed by the following symptoms:
- emotional instability
- violation of sleep patterns — the person sleeps during the day, and awake at night
- changing the shade of the face, it becomes yellowish gray
- burning sensation on the skin
- strong hair loss and fragility;
- a decrease in body weight due to a lack of appetite
- changing the voice timbre
- diarrhea, with a stool of unpleasant odor and dark color
- frequent vomiting,
- the onset of heart failure;
- memory loss
- The person is accompanied by an unpleasant smell — the smell of urine comes from the mouth.
Chronic kidney failure in children is manifested:
- increased volume of excreted urine
- Ankle and face swelling
- lag in growth
- limb deformities
- Your arms and legs lose their normal sensitivity;
- burning sensation at the tips of the toes of the upper and lower limbs;
- muscle weakness;
- Dryness and bitterness in the mouth
- severe abdominal pain
- increased blood pressure;
- reduced immunity, which causes the child to be exposed to various infections
- lowering of hemoglobin.
With late diagnosis or improper treatment, the following complications from renal failure may occur:
- chronic adrenal insufficiency;
- blood clotting disorders that cause bleeding and bruising on the skin
- heart failure;
- myocardial infarction
- insufficient supply of blood to the heart;
- cardiac arrhythmias;
- inflammation of the heart bag
- chronic gastritis;
- deceleration of the purifying and filtration function of the kidneys
- the disappearance of sensitivity in the limbs;
- persistent increase in blood pressure
- impairment of calcium digestibility, because of which a person will be prone to increased bone fragility
- the formation of ulcers in the stomach or duodenum
- reduced sexual desire
- menstrual irregularity or anomaly, not the maturation of the egg;
- birth of a dead fetus if chronic renal failure was diagnosed during pregnancy
- uremic coma, which can lead to the death of a sick person.
Diagnosis of chronic renal failure is carried out in several stages, among which:
- finding out the full history of the disease — when the first signs were revealed, how strong they are, how much urine is emitted per day, how much the person is tired. Studying the patient’s medical history for what could be the cause of the ailment, determining the stage according to the above classification, did the illness concern any of the next of kin
- examining the patient for swelling, changes in the sensitivity of the limbs, and the color of the skin. In addition, the doctor simply can not fail to notice the unpleasant odor of urine from the mouth of his patient;
- conducting a urine test. With this disease, the density of the fluid will be lowered, in the assays will be observed a small amount of protein. In infections, tumors, trauma in urine, erythrocytes will be contained, and in autoimmune disorders, leukocytes. In case the bacterium became the cause of the disease, it will be revealed during the analysis. In addition, it is possible to identify an infectious agent that has become a causative agent of the disease, and to indicate the degree of its sensitivity to medicines. A urine sample is taken through Zimnitskiy. This is done to determine the density and volume of the released liquid;
- conducting a general and biochemical blood test. With such a disease, the concentration of leukocytes will be increased, hemoglobin, erythrocytes and platelets are lowered. A biochemical blood test reveals a high level of uric acid, an increase in the level of potassium, cholesterol and phosphorus, a decrease in calcium and protein;
- hardware diagnostic methods, including ultrasound, CT and MRI, to find the causes of the narrowing of the urine tract. With the help of dopplerography, the passage of blood through the vessels is assessed. Radiography reveals possible violations of the respiratory system, which in some disorders can cause kidney failure. A biopsy is used to fully confirm the diagnosis. During this process, a small piece of kidney tissue is sampled, which will then be examined under a microscope. ECG helps detect cardiac abnormalities.
After receiving all the results of the tests that were performed during the diagnosis, the doctor prescribes treatment.
Treatment of chronic renal failure is based on correct diagnosis and the definition of its stage. At the initial stage, drug therapy is conducted, which is aimed at:
- elimination of high blood pressure;
- stimulation of urine production
- prevention of an autoimmune process, in which the body attacks its internal organs. This is done with the help of hormonal substances
- eradication of anemia with erythropoietins
- decrease in acidity in the stomach;
- medicines containing calcium, vitamin D, which will strengthen the bones and prevent their fractures.
In more serious stages of the disease, other methods of therapy are used:
- hemodialysis, during which blood purification and filtration is performed. It is carried out outside the body, through a special apparatus. Blood enters it from the vein on one hand, passes through the necessary processes and returns to the human body through a tube attached to the other arm. Such treatment is performed for life several times a week or until organ transplantation;
- dialysis is peritoneal, in which there is a similar purification of blood, only with an additional correction of the water-salt balance. This is done through the abdominal cavity of the patient into which the solution is injected and then sucked out
- In fact, kidney transplantation — a suitable organ according to all criteria from the donor is selected. But do not exclude the fact that the kidney can not survive, then the patient will need to undergo all the methods of therapy anew. To prevent this, a course of treatment with drugs that lower immunity is conducted so that it does not begin to reject the new organ.
The diet for chronic kidney failure is an important link in therapy. It provides:
- consumption of high-calorie foods, but not fatty, not salted or sharp, but enriched with carbohydrates. In any quantity you can eat sweets, rice, vegetables and potatoes. It is best if the dishes are cooked for a couple or in the oven. Take small meals five times a day;
- reduced intake of protein;
- the amount of liquid should not exceed two liters per day;
- refusal to absorb beans, mushrooms, nuts, which are saturated with protein
- reception in limited quantities of grapes, dried apricots, coffee and chocolate.
Preventive measures against chronic renal failure consist in:
- Elimination of the causes that can become causative agents of the disease
- managing a healthy lifestyle and refraining from drinking alcohol, smoking and drugs
- rationalization of nutrition, which must be balanced and enriched with calcium and vitamins
- refraining from taking medicines for no apparent reason;
- Regular check-ups with doctors, in order to diagnose the disease in the early stages, increase the chances of complete recovery and prevention of complications.