In the article, we consider the stages of chronic renal failure.
Pathology is a disorder that occurs against the background of various conditions that often lead to serious consequences for human life and health. Because of this disease, the kidneys actually stop performing their functions that support the body.
What is the pathogenesis of chronic kidney disease?
The essence and nuances of the disease
KNP does not necessarily act as a disease of the urinary system or kidneys. Due to various pathologies of the body, for example, diabetes, the death of structural renal components is observed. And the kidneys are responsible for filtering urine and its excretion.
Against the background of the acute form of this disease, renal failure can develop rapidly, and in the presence of a chronic course this occurs slowly and gradually, sometimes over several months, but a steady tendency to progression is possible. This is an irreversible disorder. Kidney failure does not occur suddenly. It is the result of diseases that attack nephrons, which are elements of the urinary system, they are also part of the kidneys. So, kidney failure can result from autoimmune disease, pyelonephritis, glomerulonephritis, diabetes, polycystic kidney disease and cirrhosis.
Against the background of certain inflammatory processes, the death of nephrons is gradually carried out. Initially, sclerotic changes are observed, months pass, and they increase even more. As a result, the kidney ceases to fulfill its tasks and necessary functions.
Damage to even fifty percent of the nephrons can go unnoticed by humans. And only when the indicators in the form of creatinine and urea begin to change and are delayed by the body, then kidney failure will begin to develop. Thus, it is necessary at least once a year to take appropriate tests, and, in addition, to visit a doctor to avoid this disease. According to the generally accepted classification, kidney failure is in the category “Diseases of the genitourinary system”. This disease is classified under code No. 18.9. Her treatment should be a nephrologist.
Now we turn to the consideration of the provoking factors that cause this complex disease.
Causes of kidney failure in children and in adult patients
At the heart of this disease are various ailments that in different life periods affect the human body. We are talking about congenital diseases of the kidneys, gout, diabetes, metabolic problems, stones, lupus erythematosus and so on. A provoking factor can be any chronic poisoning with various substances.
The classification of chronic renal failure by stages will be discussed later in the article.
Pregnancy Disease
Chronic type kidney failure syndrome is a dangerous condition during pregnancy. In this regard, even at the planning stage of the child, it is required to consult a doctor and undergo an examination. In the event that a woman already suffers from a chronic form of this disease, then the specialist should assess the risks associated with the possibility of bearing the fetus. There are known situations where, because of too severe a form of kidney failure, women had to terminate a pregnancy because it was life threatening. The provoking factors leading to kidney failure in pregnant women are pyelonephritis along with urolithiasis, cystitis and other diseases of the urinary system.
Pyelonephritis occurring in pregnant women is especially insidious, since this disease can resemble the symptoms of toxicosis. In some situations, it is simply impossible to find out why pyelonephritis occurs in pregnant women.
In the event that the risk for the patient and the fetus is minimal and she is allowed to bear, the doctor will prescribe an absolute restriction of physical activity along with bed rest with the slightest exacerbation. A special diet in combination with medical treatment and hospital stay will significantly reduce the manifestation of renal failure and give birth to a baby.
It is worth noting that there are clear appointments for aborting a woman with this disease, we are talking about increasing the level of creatinine in the blood to 200 micromoles or more. Pregnancy planning is prohibited if a creatinine index of 190 micromoles per liter of blood is detected in the blood. The thing is that the higher this indicator, the more likely the development of preeclampsia. And such a diagnosis is already a real threat to a woman’s life, since with it a stroke is possible along with acute kidney failure.
Regardless of the stage of chronic renal failure, there is a risk to the fetus in the form of premature birth. In this case, the baby will need intensive therapy. Each year, five to ten children out of one million are diagnosed with this. The causes of the disease are congenital diseases, in the form of pyelonephritis and various nephropathies, hydronephrosis, polycystic kidney disease or acquired ailments, for example, the development of diabetes.
In this disease, anemia is observed in children, along with increased fatigue, headache, developmental delay, thirst, and so on. At school age up to fourteen years of age, child's heightened growth is observed, which should be said unfavorably in the presence of developing renal failure. With this ailment, the kidneys do not grow with the body, metabolic disturbance occurs, and at the same time, the state of the urinary system worsens. In such a case, the risk of mortality is very high. Currently, with appropriate treatment, children with kidney failure can live up to twenty-five years, especially if treatment was started before the age of fourteen.
Next, we learn how the pathology in question manifests itself and what its main symptoms are.
Symptoms of the disease
Everyone should know the pathogenesis of chronic kidney disease . At the beginning of its appearance, kidney failure may not manifest itself in any way. As already noted, signs may not be observed up to fifty percent damage to kidney function. If pathology develops, patients begin to feel weak along with fatigue and drowsiness. The following symptoms may occur:
- Frequent urination, especially at night. Due to a malfunction in urine output, dehydration may occur.
- The appearance of nausea with an attack of vomiting.
- Thirst and a feeling of dry mouth are likely.
- Aching pain and bloating may be observed.
- Diarrhea is not excluded along with blood from the nose, frequent otolaryngological diseases and colds, as well as anemia.
At a late stage of the disease, in the stage of decompensation of chronic renal failure, patients suffer from asthma attacks, even loss of consciousness is possible. All symptoms increase slowly. Now we will consider the stages of this disease, and, in addition, we will talk about the classification and degrees of development of kidney failure, which proceeds in a chronic form.
So, what are the stages of chronic renal failure? About it further.
Creatinine Stages
Creatinine stages are determined not only by symptoms, but also on the basis of analyzes. The first stage is the latent or initial stage of chronic renal failure. In that case, if you take blood for analysis, then the level of creatinine will only slightly exceed the normal rate and will be 1.6 milligrams. Normally, this figure is 1.2 milligrams, and this means that the kidneys are functioning normally. It is worth noting that the latent stage does not manifest itself in any way.
At the initial stage of chronic renal failure, creatinine synthesizes ammonia, but it is usually reduced. On the renogram some changes are noticed. It is usually impossible to suspect the onset of the disease without a complex of tests. Therefore, kidney failure at this stage is rarely detected and completely by accident. This creatinine disease is detected when the test results are available on hand.
The next stage of chronic renal failure is called polyuric. At the same time, creatinine level rises to 2.7 milligrams. The kidneys begin to cope poorly with their responsibilities. Some of the functions that must be performed by the kidneys are taken over by the liver with the rest of the organs.
We continue to consider the stages of chronic renal failure in pathological anatomy.
Symptoms at this stage of the disease are severe weakness, especially before lunch, along with intense thirst and lowered body temperature. The character of the renogram is usually gentle in this case. At this stage, glomerular filtration is reduced. Further, creatinine levels will increase more and more, new symptoms and complications will appear.
The next stage of chronic renal failure is called intermittent. Against her background, creatinine levels are off scale and very much exceed the norm of 4.5 milligrams. At this stage, the volume of urine excreted increases and its environment changes. Urine usually becomes alkaline. At this stage, the urea level doubles. The level of calcium and potassium decreases. In general, the stages of chronic renal failure by creatinine level are very easy to recognize.
Symptoms of the disease are weakness, in addition, the following manifestations are observed:
- Muscles may begin to twitch. Seizures are possible.
- The skin may become dry.
- In addition, pronounced manifestations of anemia occur.
- An increase in arterial hypertension occurs.
- Nausea with vomiting is likely.
- Constipation is not excluded, and at the same time, bloating associated with this.
The third stage is terminal. At this stage, sleep problems may occur. To a large extent, the psychological state worsens. Very severe skin itching occurs. Attacks of convulsions are significantly more frequent. At the same time, the creatinine index is high, and the urea values, exactly like the residual nitrogen, are also overestimated. The disease at this stage is very progressing. In the event that you do not go to the doctor for the first symptoms of the disease, then the transition from one stage to another is very fast. At the initial stages, the pathology develops against the background of inflammatory pathologies.
At the stage of decompensation, the glomerular filtration rate decreases to 29-15 ml / min. Tubular secretion is reduced, the patient has persistent azothermia in urea in the range of 8-20 ml mol / L and in creatinine 0.2-0.5 ml mol / L.
We have described the stages of chronic renal failure in creatinine. What else is the classification?
Classification of pathology and the degree of its development
This disease is widespread among the entire population of the globe. According to statistics, from sixty to three hundred people per one million inhabitants of the planet per year get sick with it. With intensive treatment, survival is more than fifty percent.
There is also a classification of the disease according to severity:
- With a zero degree, the disease is absent, but there are risk factors in the form of other diseases.
- The first degree is primary. In this case, there is any kidney disease.
- Chronic renal failure in stage 2 is pronounced. Against its background, intoxication symptoms begin to appear in the body.
- Severe in nature is the third degree. Against its background, phosphorus and calcium metabolism are disrupted in the body, and, in addition, anemia with creatinemia increases.
- The fourth degree is terminal. Conservative treatment is not effective.
- 5 stage of chronic renal failure. Patients have severe renal impairment. There is a need for replacement therapy.
Each of the stages has its own clear manifestations, which only a doctor can evaluate.
In the decompensation stage of chronic renal failure and in the terminal stage, the prognosis will be unfavorable, even despite hemodialysis. Kidney transplantation is not a guarantee of a favorable outcome, since it is very difficult to find an organ for transplantation with ideal histocompatibility.
What complications are observed with this disease?
In many cases, chronic kidney failure is itself a consequence of pathologies that have long existed in the patient. Complications directly from kidney failure arise, as a rule, against the background of a severe stage of the disease. Most often, complications in the form of heart failure are observed, among other things, a heart attack is possible along with severe hypertension.
This pathology also has a detrimental effect on the activity of the nervous system. Then the patient is threatened with convulsions along with the development of a nervous disorder up to dementia. During treatment in the form of dialysis, thromboses are very often possible. But the most dangerous complication is kidney necrosis. Patients can fall into a coma, as a result of which often in such patients a fatal outcome occurs.
Symptoms of the terminal stage
The terminal stage is the ultimate in the development of kidney failure. She is considered the most difficult and, unfortunately, incurable. This implies a complete failure of the healthy functioning of one kidney or both at once. The glomerular filtration rate against this background decreases to a minimum value, despite the treatment. Strong uremia may occur, but it can be said that the body actually poisons itself with its own waste.
A similar condition leads to the development of damage to the cardiac and vascular system. Intensive therapy with dialysis not only heals, but also injures. It can support vital functions, but it can lead to severe hypertension, and, in addition, to severe anemia and thrombosis. With this method of treatment, the digestive system functions very seriously. Often, patients die due to cardiac abnormalities.
Treatment for the stage of chronic renal failure is directly dependent.
Kidney failure in children
Kidney failure of a chronic nature in children is a nonspecific syndrome resulting from a decrease in homeostatic function of the kidneys, the cause of which is their severe progressive disease.
The stages of chronic renal failure in creatinine in children are also distinguished.
According to the generally accepted international classification of pathologies, the terminal stage of kidney damage, unspecified and other manifestations of this disease in young patients are distinguished. In science, there are many different classifications of renal failure, based on the following principles: on the criteria for creatinine concentration, on the glomerular filtration rate, on the staging of clinical symptoms, and, moreover, on dysfunction of the tubules.
As for the epidemiology of this dangerous disease in children, according to statistics, three to fifty out of one million children are diagnosed with kidney failure. Every year, from four to six children out of one million, who are under the age of fifteen, must necessarily receive substitution treatment due to the presence of renal failure, which proceeds in a chronic form.
What triggers chronic kidney failure in children?
Chronic insufficiency of this organ in children can occur due to the influence of such factors:
- Due to early decline in renal function.
- Due to the progressive torpid course of nephropathy.
- Due to increasing instability of cell membranes.
- Due to renal dysembryogenesis.
- Due to the influence of drugs.
The risk group for this disease includes children with the following diagnoses:
- With a diagnosis of severe uropathy.
- Against the background of tissue renal dysembryogenesis.
- With hereditary jade.
- Against the background of tubulopathy or sclerosing variants of nephritis.
In addition, the reasons for the development of such a dangerous pathology in a child can be acquired or congenital diseases.Among congenital pathologies, nephropathies are distinguished that join systemic diseases along with pyelonephritis, and, in addition, chronic or subacute specific glomerulopathy. Nephropathy, which can cause kidney failure, should include polyarteritis nodosa along with hemorrhagic vasculitis, characterized by an subacute course and so on. Among congenital pathologies, the disease in children most often provokes the following ailments:
- The presence of polycystic or hypoplastic kidneys.
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- Dinner: cottage cheese casserole, apple and carrot salad, tea.
Wednesday:
- 1st breakfast: protein omelet, beet salad with apples.
- 2nd breakfast: fruit.
- Lunch: borsch, boiled pork and vegetables, mashed potatoes, compote.
- Snack: rosehip broth.
- Dinner: chicken meatballs, coleslaw with apples, tea.
Thursday:
- 1st breakfast: oatmeal porridge, vegetable salad, fruit juice.
- 2nd breakfast: fruit.
- Lunch: potato soup, beef stroganoff, vegetable stew, berry jelly.
- Dinner: boiled potatoes with sour cream, apple pancakes, tea.
Friday:
- 1st breakfast: casserole of apples and cottage cheese, carrot salad, fruit juice.
- 2nd breakfast: fruit.
- Lunch: potato soup, boiled chicken, compote.
- Snack: rosehip broth.
- Dinner: dumplings with cottage cheese, stewed plums, tea with milk.
On Saturday and Sunday, you can repeat the menu of any days of the week.
Disability
To obtain disability with the development of the disease in question, it is necessary to undergo a medical commission. True, such a patient is recognized as able-bodied only if at least the initial or latent stage of the disease is discovered in him. At the same time, a person may be able to serve himself, he will have only a slight damage to internal organs and unexpressed symptoms. Such patients, as a rule, are transferred to easy labor, assigning a third group of disability.
The second group of disabilities is determined by the patient with the development of the terminal stage of development of chronic renal failure and significant violations of internal systems and organs. But at the same time, the person still retains the ability to work, and, in addition, to serve himself independently in everyday life.
The first group is given to a person who has a severe terminal stage of this pathology. Among other things, such can be awarded in case of serious damage to the body, and, in addition, against the background of a kidney transplant. In everyday life, such patients necessarily require the help of relatives and relatives.
In order to register disability, patients need to consult a doctor for the results of studies and analyzes, among which special attention is paid to biochemical blood counts, an x-ray of the skeletal system and an ultrasound examination of the kidneys. As a result, the opinion of the attending physician should be obtained. With these documents, a person is sent to undergo a commission.
After determining the disability group, the patient is assigned light work, and, in addition, retraining for one of the professions. Or, if a person has a terminal stage, proper home care can be determined, among other things, a supportive treatment or rehabilitation program is drawn up.
It should be remembered that often renal failure in patients develops in the presence of different types of diabetes, and, in addition, in those patients who suffer from urolithiasis or hypertension. Such categories of patients need to be examined more often by doctors, taking prescribed medications in order to prevent such a dangerous complication as chronic kidney failure.
We examined the stages of chronic renal failure in creatinine. Diet and menus have also been described.