Nephropathy: Symptoms and Treatment
Nephropathy is a pathological condition characterized by the defeat of the glomerular apparatus and renal parenchyma. As a consequence, the functionality of the organ is significantly reduced, which can lead to the progression of dangerous complications. The etiology of the ailment is quite diverse. It should be noted that kidney nephropathy progresses slowly and in the early stages of development, symptoms may not appear. Therefore, the person himself does not even guess that he develops such a dangerous pathology.
In the late stages of the disease, specific symptomatology appears. The first signs of developing nephropathy are weakness and rapid fatigue, a constant sense of thirst. Further specific symptoms directly depend on the type of ailment that struck the patient.
With the progression of nephropathy, the filtration capacity of the kidneys is very bad. It is also worth noting that patients who have impaired renal function are more prone to various infectious lesions of this organ. Nephropathy can begin to progress in a person of any age category. It is not excluded the development of dysmetabolic nephropathy in children.
- the presence of metabolic disorders (diabetes, gout, etc.)
- poisoning of the human body with heavy metals
- prolonged use of certain pharmaceutical products, such as anti-inflammatory, analgesics and anticonvulsants
- the effect of radiation on the human body
- presence of non-malignant neoplasms of benign and malignant nature
- industrial and household intoxication
- abnormalities of kidney and urinary tract development, etc.
One of the most common types of ailment is dismetabolic nephropathy. It is subdivided into several subspecies:
- oxalate-calcium neuropathy. Such dismetabolic nephropathy in children is more common
- Oxalate. The first signs of ailment appear at any age (even in newborns). If the pathology is not treated, then there is a high risk of urolithiasis;
- Phosphate. The main cause of progression is chronic infection of the genitourinary system
- uratnaya. There are both primary and secondary
- Exchange nephropathy involving cystine.
Also in medicine, the following types of nephropathy are distinguished:
- diabetic nephropathy
- Pregnancy nephropathy
- toxic nephropathy
- gouty nephropathy
- myeloma nephropathy
- Iga nephropathy.
Diabetic nephropathy is characterized by simultaneous damage to both kidneys, which leads to disruption of their functioning. The main cause of the disease is diabetes mellitus. Diabetic nephropathy progresses slowly against the background of diabetes mellitus. Symptoms manifest gradually. Clinicians distinguish 5 stages of diabetic nephropathy:
- asymptomatic. There are no symptoms. Identify the presence of pathology can only be done by analysis;
- Initial structural changes. Blood circulation in the kidneys increases, as well as glomerular filtration;
- Neglected. The concentration of microalbumin increases to 300 mg / day, but there is no pronounced proteinuria. Blood circulation and glomerular filtration is normalized. Some patients may have a slight increase in blood pressure;
- Nephrotic. The blood pressure is constantly increased. In the urine appears protein. Filtration, as well as circulation of blood, is reduced. In humans, there is an increase in ESR and cholesterol. Appear edema;
- uremic. The filtration function of the kidneys is greatly reduced, which causes the accumulation of urea and creatinine in the blood. The level of protein is further reduced, which increases the swelling. Blood pressure can rise to critical levels. Practically in all clinical cases, this stage of diabetic nephropathy gradually turns into renal insufficiency.
Nephropathy of pregnant women is one of the most dangerous complications during the fetal gestation. The reasons for the progress of this condition are not fully understood. At risk are young girls, as well as those who regularly drink alcohol and smoke cigarettes.
Nephropathy of pregnant women is more often diagnosed in the second half of pregnancy. The patient’s blood pressure rises to high figures, edema and proteinuria appear. If the timely treatment of nephropathy in pregnant women is not adequate, the probability of a miscarriage is high. Women with this diagnosis, doctors are observed in a stationary environment, to constantly monitor their condition.
It is also worth noting that nephropathy of pregnant women is not a rare pathological condition. Recently, the progression of the disease has increased significantly.
Toxic nephropathy progresses after poisoning the body with various toxic substances. The first symptom is pain at the site of the kidney projection. Further, the clinical picture of toxic nephropathy is supplemented by such signs:
- blood in urine
- protein in urine and nitrogenous bases.
It is important to carry out treatment of toxic nephropathy as soon as possible, as acute renal failure may develop on its background.
The basis for the progression of gouty nephropathy is the accelerated formation of uric acid with a delayed excretion from the body. As a consequence, the substance gradually accumulates in the bloodstream and the urate forms in the kidneys. If gouty nephropathy continues to progress, this will lead to deformation of the kidney tissue. The excretory and filtering capabilities will be significantly reduced.
The main manifestations of myeloma nephropathy — pronounced proteinuria and the gradual development of renal failure. It should be noted that with this form all the signs that indicate nephropathy are absent. But with this, there is disproteinemia and hyperproteinemia. Also, patients with this diagnosis are often diagnosed with nephronecrosis.
A feature of Iga nephropathy is macro or microhematuria in combination with proteinuria. As a rule, the ailment begins to progress after a few days after the acute ailment of the upper respiratory airways.
Also with Iga nephropathy hyperthermia, arterial hypertension, nephritic syndrome, pain in the lumbar region, dysuric phenomena are observed. Iga nephropathy is also characterized by a recurrent course.
More rarely diagnosed:
- hereditary nephropathy
- contrast induced;
In the early stages of progression, the ailment of symptoms may not be observed at all. But in process of its development such alarming signs appear:
- feeling thirsty
- increased fatigue;
- pain at the site of the kidney projection.
In the later stages of the clinical picture is supplemented by such signs:
- apparent swelling of the tissues
- vascular pressure increases;
- protein structures appear in urine
- Symptoms of pyelonephritis may occur, if infectious agents enter the organ.
The standard diagnostic plan includes:
- kidney ultrasound;
- specific urine calcification tests
- biochemical study of urine
- urinalysis. It makes it possible to identify crystals of salts.
The treatment plan is developed only after the type of pathology that struck the person is accurately established.
Diabetic nephropathy in the first and second stages does not require specific treatment, it is necessary only to maintain the blood sugar concentration within the limits of normal values. As the pathology progresses against the background of diabetes, it is important to follow a special diet. Also, doctors often resort to the administration of ACE inhibitors, as well as hemodialysis. If all these measures are not effective, doctors can resort to organ transplantation.
Treatment of nephropathy in pregnant women is carried out only in a hospital setting. Therapy is as follows:
- strict bed rest;
- preparations with high protein content
- potassium preparations;
- antihypertensive drugs
Treatment of toxic form is carried out by means of forced diuresis, gastric lavage, hemosorption, plasmapheresis, hemodialysis and so on. After normal hemostasis, doctors will begin to carry out anti-shock measures.
Basic principles of treatment of dysmetabolic nephropathies:
- normalizing your lifestyle
- diet food
- drug therapy. To treat the disease appoint vitamin E, vitamin A, vitamin B6, dimefosfon and others.
Treatment for gouty form is primarily aimed at eliminating the underlying ailment-gout, followed by further therapy:
- consuming large amounts of liquid
- The treatment plan is necessarily supplemented by diuretics
- antihypertensive drugs
- antibiotics (in case of attachment of infectious agents).