Patients who are faced with urological pathologies hear from the doctors the term kidney parenchyma. What is it, most often, they do not ask specialists and remain in the dark.
The concept and main functions of the kidney parenchyma
Parenchyma is the main tissue of an organ. Its components are cells of the brain (inner layer) and cortical (outer layer) of the substance. The structure of the tissue is smooth, in appearance it resembles a capsule in which an organ and elements of the urinary system are placed.
The main function of the parenchyma is the elimination of metabolic products from the body and, as a result, the creation of conditions for maintaining the natural internal state of the organ.
The thickness of the kidney tissue in a healthy person of the middle age group is from 15 to 23 millimeters. If the patient has ever suffered an infectious disease, there are untreated inflammatory and chronic processes of the urinary system, this will lead to thinning of the tissue. However, the parenchyma has the ability to gradually recover.
Now you will not be afraid of the term kidney parenchyma, what it is and what its functions are, it became known.
Distinctive features of the primary and secondary form of the disease
Primary and secondary shriveled kidney differences are minor. They are the factor that provoked the development of pathology - a concomitant disease.
Patients who are diagnosed with damage to their own arterial tissue develop a primarily shriveled kidney. The main precursors of this form of pathology are: high blood pressure, in which hypertensive crises are observed, and milder diseases of the heart and vascular system.
If the patient has pathologies of the excretory system, he begins to thin out and lose his functional ability of the parenchyma, respectively, pathology develops - a second wrinkled kidney.
Etiology
Studying the features of pathology, one should know the reasons under the influence of which a disease such as a second shriveled kidney develops:
- infectious organ damage by tuberculosis bacteria;
- bacterial lesion of the tubules of the kidney of a non-specific nature;
- defeat glomeruli;
- the formation of calculi in the body cavity;
- diabetes.
All of these diseases lead to circulatory disorders. A lack of blood leads to unilateral or bilateral wrinkling of the organ. The process can last for years, and in weakened places, connective tissue first grows, and then a scar forms.
Considering that the secondary wrinkled kidney has various causes, and renal failure develops against its background, this diagnosis is quite common in urology. Each patient needs a regular medical examination and an extrarenal blood cleansing procedure, which allows toxic substances to be removed from the body.
The clinical picture and the mechanism of formation
At the first examination, doctors cannot make a final diagnosis. However, there are a number of symptomatic manifestations that are characteristic solely for nephrosclerosis. The most striking is the violation of the function of excretion of urine, as the patient indicates when collecting an anamnesis. Analysis of biological material shows that the daily rate is exceeded. In this case, more urine is excreted at night than during the day.
Less obvious manifestations include:
- The presence of protein in the urine.
- The specific gravity of urine is below normal.
- Blood pressure is steadily elevated.
- There have been cases of hypertensive crisis.
- There are pains in the lumbar region.
Secondarily shriveled kidney is a macro product, for which a characteristic feature is the partial preservation of shape, while reducing weight and size. With the progression of pathology, the color of the organ changes. In the initial stage, the kidney has a clear shade of blood, and with its lack, the organ acquires a gray shade, visible scars appear on the surface. Places of hemorrhage are not detected.
The most likely cause of clinical indicators can be primarily considered the deposition and blockage of the renal vessels with cholesterol plaques, which led to the development of hypertension. Secondary causes are often pathologies of the stroma, tubules and glomeruli, for example, inflammation or dystrophy.
A preliminary treatment outcome may be favorable, provided that the patient is diagnosed with a primarily shriveled kidney. Treatment with regular hemodialysis will lead to the development of chronic suburemia.
In the conclusions, doctors often indicate such a fact as a physiological change in the parenchyma (degeneration into connective tissue occurs).
According to the clinical picture, a diagnosis is made: a second wrinkled kidney.
Methods of modern diagnosis of the disease
The information obtained during the initial examination and according to the results of the analysis is not enough to finally diagnose the patient. In this situation, doctors resort to modern diagnostic methods, which allow to establish the cause, form and severity of the pathology.
So, the patient can be assigned:
- general and clinical blood test;
- repeated urine tests;
- ultrasound diagnosis of the kidneys;
- radiography of the lumbar;
- Magnetic resonance imaging;
- contrast computer diagnostics.
In most cases, a few tests and one full scan of the body, possibly using a contrast agent, are sufficient.
At the first consultation, the doctor must conduct a thorough medical history. This will allow to establish what lifestyle is acceptable for the patient, whether he has chronic or concomitant pathologies, whether the genitourinary system has ever been treated. Be sure to perform palpation of the kidneys and examination of the skin for a rash.
Only a qualified and experienced urologist can correctly prescribe treatment and make a diagnosis of a “second-wrinkled kidney".
Therapeutic methods for eliminating pathology
The pathology of the "secondary wrinkled kidney" treatment primarily involves a symptomatic and aimed at combating the main cause that provoked the development of the disease.
In cases where the patient’s pathology proceeds exclusively accompanied by high blood pressure, and the symptoms of renal failure do not appear, doctors prescribe a salt-free diet.
If the symptoms of renal failure are detected, the abolition of medications that lower blood pressure is primarily prescribed. The diet involves the rejection of meat in all types, including meat broths. This will help reduce the amount of nitrogen toxins.
If the initial treatment is ineffective, surgery is necessary, accompanied by hemodialysis and organ transplantation.
Recommended Diet for Disease
The salt-free diet provides for the exclusion from the use of such products: meat, fish, citruses. It is forbidden spicy, sour, salty and spicy. It is also necessary to completely abandon coffee drinks and pure coffee, smoked meats and sausages, chocolate, sorrel, onions and garlic, spinach and asparagus.
It is necessary to control the daily volume of fluid. It should not exceed one and a half liters, including first courses.
The use of animal protein should be minimized. Ideally, it should be replaced with vegetable or soy. The calorie content of food should be high, with a content of polyunsaturated acids. Consumption of foods containing phosphorus, potassium and magnesium should be reduced.
How to prevent the development of nephrosclerosis
Disease prevention measures are very extensive, but the main ones are as follows:
- It is necessary to treat infectious diseases on time.
- Follow a diet.
- To control the metabolism.
- Prevent the development of diseases of the genitourinary system.
- To live an active lifestyle.
- Avoid kidney injury.
- Drink only purified water.
Patients prone to developing kidney pathologies are advised to regularly undergo a routine examination by a nephrologist.
Prognosis for recovery
In most cases, with a diagnosis of "secondary shriveled kidney", the prognosis for recovery is poor. It is impossible to completely overcome the disease, it is only possible to maintain a stable state of the patient.
Under certain conditions, and if possible, you need to do a kidney transplant operation.