Chronic kidney disease is a collective diagnosis, which includes any pathology of this organ with a decrease in the effectiveness of their functioning. Healthy kidneys remove excess water and wastes from the blood. This organ is also involved in the control of pressure and the formation of red blood cells.
When a chronic kidney disease occurs, their functioning is impaired, so they can not fully remove harmful substances. And the patient's condition is characterized by severe fatigue, insomnia, the appearance of puffiness, and impaired memory. If the first signs occur, it is necessary to carry out the diagnosis and treatment, which the doctor will prescribe.
Features of the disease
Chronic kidney disease (ICD-10: N18) - characterized by a pronounced deterioration in the functioning of these organs for more than three months. The kidneys act as a kind of filter of the body. Several tens of liters of blood passes through them per day, which is purified from toxic substances and waste products.
With the development of chronic kidney disease, a replacement in the organ of the functional tissue of the connective tissue or the death of nephrons occurs. Such pathological processes lead to irreversible changes in the kidneys and a violation of their ability to fully perform their functions of cleansing the blood and removing excess water.
This disease leads to a significant deterioration in the quality of life and can even lead to death, which can only be avoided by performing complex manipulations, in particular, such as hemodialysis or kidney transplantation.
Developmental stages
According to the classification, chronic kidney disease is divided into several stages, depending on the nature of the pathology. Doctors distinguish 5 degrees:
- latent;
- compensated;
- intermittent;
- decompensated;
- terminal.
With the course of the first stage, chronic kidney disease practically does not manifest itself. Patients have virtually no complaints other than fatigue. During laboratory tests, the presence of a small amount of protein in the urine is noted.
In the second stage, the same symptoms are observed in patients, however, they occur much more often. In urine and blood, changes in laboratory parameters are noted. Daily urine output is reduced.
With the course of the third stage, a subsequent decrease in the functioning of the kidneys occurs. In the blood test, there is an increase in the level of urea and creatinine. Overall well-being is much worse.
At the fourth stage, an irreversible change in the functioning of the kidneys occurs. Steady edema is observed, the work of the heart is disrupted, skin itching occurs, erosive changes in the skin and mucous membranes develop.
The fifth severity of chronic renal failure is characterized by the cessation of the functioning of this organ. In the blood, there is an increased content of urea. In addition, electrolyte metabolism is disturbed and uremia occurs. The patient needs constant blood purification.
Depending on the classification of chronic kidney disease, symptomatology characteristic of each degree of pathology is observed. The stage of the lesion is determined by criteria such as glomerular filtration rate and protein in the urine. Most patients do not even suspect the presence of the disease at the initial stage and may even ignore the signs that appear with the further progression of the disease.
Causes of occurrence
Basically, chronic kidney disease occurs in people with metabolic syndrome. In particular, provoking factors include obesity, hypertension and diabetes mellitus. They adversely affect renal nephrons.
In addition, it provokes chronic kidney diseases - pyelonephritis and glomerulonephritis. It should be noted that women suffer from such disorders much more often than men. Also among the reasons can be identified as follows:
- the appearance of neoplasms;
- autoimmune disorders;
- consequences of poisoning;
- complications after an injury;
- alcohol abuse.
It is often difficult to determine the causes of chronic kidney disease, since the pathological process may not have an established etiology.
Main symptoms
Symptoms of chronic kidney disease are directly associated with a violation of the process of formation and withdrawal of urine, accompanied by signs of intoxication. Among the main symptoms of the disease can be identified:
- violation of the urination process;
- changes in urine counts;
- nausea and vomiting
- lethargy and weakness;
- dry mucous membranes;
- itching of the skin;
- loss of appetite;
- constant thirst.
From the side of the cardiovascular system, disturbances such as pain in the sternum, palpitations, numbness of the limbs can be noted. All these symptoms can vary significantly, as each patient has a different medical history.
Diagnostics
With complaints about the progression of kidney disease in stages 1-2, patients are treated quite rarely. Pathology can be detected quite by accident when treating inflammatory processes of the genitourinary system or with poor urine and blood tests. If changes in the urinary system are observed, then a comprehensive diagnosis of chronic kidney disease is required, which includes:
- laboratory blood test;
- Analysis of urine;
- ultrasonography;
- tomography.
Based on the obtained analyzes, gender and age of the patient, a specific feature of the pathological process is determined. Additionally, consultation with other specialists may be required. Based on the diagnosis, a methodology for treating the disease is selected.
Treatment
Treatment of chronic kidney disease largely depends on the stage of the disease. At the initial stage, therapy is aimed at preserving the maximum number of functioning cells of the named organ. Treatment is carried out using special medications, as well as following a special diet.
It is necessary to eliminate the factor that provoked the occurrence of chronic renal failure. Unfortunately, it is impossible to completely cure it. You can only maintain the functioning of the urinary system and facilitate the general well-being of the patient. At later stages, hemodialysis or kidney transplantation is required.
With timely diagnosis and competent therapy, the prognosis is quite favorable. Even with continuous hemodialysis, you can extend the patient's life and maintain its performance.
However, it is worth remembering that this disease in later stages can be fatal. That is why, at its first signs, it is necessary to consult a doctor. During treatment of chronic kidney disease, clinical guidelines must be followed very strictly.
Drug therapy
In the process of treatment, first of all, you need to normalize the pressure, since it affects the course of the disease quite badly. To correct this condition, you need to use such drugs:
- calcium channel blockers (Felodilin, Verapamil, Amlodipine);
- ACE inhibitors (Captopril, Renitec, Enalapril);
- receptor blockers ("Losartan", "Valsartan", "Eprosartan").
As part of the therapy, it is necessary to maintain a normal level of phosphorus in the blood. Exceeding the content of this element can provoke very serious consequences for the body:
- rapid progression of pathology;
- increased risk of mortality;
- calcification of tissues and blood vessels.
For this, phosphate binders with the ability to block phosphates in the intestine are prescribed. Among the best drugs can be distinguished such as Sevelamer, Renagel. They are highly effective and rarely provoke side effects. If when using these funds there is no improvement in well-being, then vitamin D is additionally prescribed. It helps to normalize metabolism.
With the course of a chronic disease, anemia often develops. To increase hemoglobin, iron gluconate, erythropoietin, is used. In patients with high cholesterol, the disease develops much faster than with normal metabolism. That is why they are assigned the "Doppelherz Active Omega-3", as it allows you to stabilize the level of lipids.
Physiotherapy
Physiotherapy is carried out during the course of stage 1-3 of the disease and is a very good additional treatment method. It is worth remembering that they have certain contraindications. These include:
- severe intoxication of the body;
- heart failure;
- infectious processes in the kidneys;
- arterial hypertension;
- chronic diseases in the acute stage.
Patients are prescribed, as a rule, electrophoresis, hybrid therapy, UHF therapy. In addition, he shows chloride, radon and sodium baths. These procedures activate the kidneys, have an anti-inflammatory effect, and also improve well-being.
During electrophoresis, the required nutrients enter the body. Such a technique guarantees the elimination of allergies.
Replacement therapy
With the progression of the disease at later stages, replacement therapy, in particular hemodialysis or peritoneal dialysis, may be required. Hemodialysis is a method of purifying blood from accumulated toxic substances. During the procedure, the patient's blood goes through the stage of filtration and purification. Using a similar technique, you can:
- remove toxic substances;
- to stabilize pressure;
- normalize acid-base balance.
Among the main contraindications for the procedure, it is necessary to highlight the presence of cardiovascular pathologies, malignant tumors, and acute infectious diseases.
The device "artificial kidney" allows a person to extend life. The procedure should be carried out 3 times a week. The duration of one session is 4 hours.
Kidney transplant
At the very last stage, kidney transplantation is indicated. An organ may be transplanted from a living person or a deceased. A new healthy kidney is transplanted into the iliac region or to the site of the affected organ. In some cases, a person’s own kidney is left. This technique has certain contraindications. These include:
- malignant neoplasms;
- acute inflammatory processes;
- heart failure;
- elderly age;
- HIV infection.
A kidney donor cannot be a living person under the age of 18 years. Elderly age is also a contraindication. The operation is performed under general anesthesia, and its duration is 2-4 hours.
The kidney is placed in the place prepared for it, then this organ is connected to the artery, ureter and vein. A catheter connected to a urine collection device is inserted into the bladder.
With a correctly performed transplant, in just 1-2 weeks, the transplanted organ begins to function normally. After this, the patient should take immunosuppressive drugs throughout his life to avoid rejection of the donor organ.
Dieting
With the course of the disease, a special diet is used. Be sure to limit the intake of proteins, as decaying, they form special substances containing toxins. It is absolutely necessary to reduce the amount of consumed fats in a daily diet. In particular, the presence of unsaturated fats, an excess of which provokes an increase in cholesterol, should be minimized.
It is necessary to minimize the consumption of salt in the diet, since when there is an excess of it, excess fluid accumulates in the body and the process of elimination of toxins slows down. It is advisable to cook without salt at all.
It is important to stop drinking alcohol, as they upset the water balance and have a toxic effect on the body, thereby increasing the burden on the kidneys. Fried foods should be excluded from the diet, since this method of cooking significantly increases the concentration of fats.
It is important to limit fluid intake, while its daily rate is selected exclusively by the attending doctor. As drinks, you can use tea, decoction or infusion of rose hips, clean water.
Disease in children
In childhood, chronic renal failure is very rare . And basically cases of the disease in children are associated with certain pathologies:
- congenital malformations;
- violation of intrauterine development;
- premature birth;
- low birth weight.
For a long time, kidney disease can occur secretly. They appear at school age with increased loads. Often this is a sharp nephrotic syndrome. The child sharply displays signs of acute poisoning of the body, and he needs urgent drug therapy in a hospital.
Before starting treatment, you need to conduct a study of urine and blood, as well as check the concentration of protein in the body. Most often, drug treatment is performed, however, in complex cases, dialysis is indicated. This method of therapy is aimed at purifying the blood by administering the drug.
Possible complications
If you ignore the signs at the initial stage of the course of the disease, then the changes can become almost irreversible. Chronic kidney disease can provoke complex pathological processes in changing the functioning of many organs and systems. Among the main complications are the following:
- heart attack, ischemia;
- malignant hypertension;
- infertility;
- thyroid pathology;
- diabetes;
- osteoporosis;
- decreased immunity.
The most common complication is hypertension and diseases of the cardiovascular system. They lead to the death of the patient.
Prophylaxis
Prevention of chronic kidney disease should begin before age 40. Preventive measures must include:
- smoking cessation and alcohol consumption;
- normalization of weight;
- restriction of salt intake, canned foods.
In order to carry out prevention, it is very important to consume a sufficient amount of liquid and it is better if it is pure water. Do not take diuretics, painkillers, vitamins, and biological supplements on your own. Care should be taken to minimize contact with toxic substances. Strict diets, hypothermia and starvation can worsen kidney function.
Prevention of pathology involves conducting a routine medical examination. It is important to regularly monitor the pressure, sugar level and condition of the internal organs.