The kidneys perform an important function in the body. They cleanse the blood of harmful substances and toxins, removing them naturally. Poisoning, various diseases, and even pregnancy can affect the proper functioning of this body. All this can cause kidney necrosis.
general information
Kidney necrosis is a condition in which the structure of an organ changes. It can occur due to a large number of reasons. The disease affects the papillae, tubules, even the cortical substance of the kidney. Most often, the disease develops as a complication of an uncompensated and prolonged course of any inflammatory processes in the urinary system.
Pathology causes the death of tissues, resulting in a change in blood flow to other organs. Kidney necrosis develops in several ways. It can be a consequence of ischemic changes in the parenchyma or appear after an injury. Such changes are always dangerous for human health and life, as they can lead to complete kidney failure or the development of renal failure, which will disrupt the functioning of other vital organs.
Kidney necrosis can spread to the tissues of the heart, liver, and brain. But here a lot depends on the degree of development of the disease and the cause of its occurrence. If the disease progresses rapidly, then the chances of saving a person’s life are slim.
What appears
The reasons that can provoke the appearance of this pathology include:
- poisoning with various pesticides, poisons, salts of heavy metals;
- difficult childbirth;
- pregnancy with placental abruption;
- failed abortion;
- infectious and inflammatory diseases (most often pyelonephritis);
- various endocrine pathologies;
- bacteriological sepsis;
- impaired blood flow through the parenchyma, kidney infarction;
- urolithiasis disease;
- decreased immunity;
- traumatic injuries in which the flow of blood to the organ is disrupted.
All causes of kidney necrosis can be divided into several subgroups, they can be: infectious-inflammatory, traumatic and otherwise. Various circulatory disorders can also lead to pathological changes.
Kinds
In medicine, there is a classification of varieties of necrosis. It helps to understand the causes of the onset of the disease and in the appointment of the right treatment:
- Papillary type. As a rule, it develops in the form of a complication of acute pyelonephritis, in the case when there is a blockage of the ureter with a calculus or an outflow of urine is impaired.
- Cortical type. A rare type of disease that occurs more often in women as a complication after childbirth. May be accompanied by sepsis. Also, damage to cortical tissues is often detected in newborns. Pathology is dangerous in that its symptoms are mixed with signs of the underlying disease, against the background of which there are observed: hematuria, fever, impaired urine outflow, renal failure, high intoxication of the body.
- Necrosis of the convoluted renal tubule epithelium on a micropreparation and the present organ is characterized by damage to the tubule of the nephron. Usually this disease develops due to exposure to toxic substances. In addition, pathology may appear due to a violation of the blood flow to organs as a result of inflammation, trauma, sepsis or shock. Also, surgical interventions, traumatic injuries, mechanical pressure on the organs or its tubules, and the use of toxic drugs can serve the progress of kidney tubule epithelium necrosis.
- Cortical course. The disease is characterized by the death of the cells of the renal cortex. Most often diagnosed in girls at different stages of pregnancy. The cause of the pathology can be intoxication with glycols, infection with gram-negative bacteria. If cortical necrosis of the kidneys occurs on the background of pathological processes after an unsuccessful abortion or with sepsis, endoscopic shock may result. In this case, the patient's condition rapidly worsens and develops especially acutely. Symptoms are most often classical, but with the death of the renal cortex, complete anuria can be observed.
- Focal necrosis. In this case, pathogens are considered to be the cause of tissue death. The disease can develop under the influence of pale treponema, tubercle bacillus, mycobacterium leprosy.
The disease can occur not only in adults, but also in children. Renal necrosis in this case most often manifests itself in the form of a papillary or cortical type. Treatment of pathology is similar to that of adults.
Symptomatology
There are several signs that indicate that irreversible changes occur in the body:
- the appearance of protein in the urine;
- the appearance of blood in the urine;
- nausea;
- deterioration in overall health;
- lack of appetite;
- vomiting
- drowsiness, impaired perception of information, apathy;
- increase in body temperature;
- prolonged and sharp pain in the lumbar region.
The first symptom of kidney necrosis that a person notices is pain in the lumbar spine. They may be accompanied by poor health and lack of performance. Frequent urination is also noted, which is later replaced by anuria. In this case, the patient may leave no more than 50 milliliters of urine per day. This condition is very dangerous, since the liquid does not come out, the pressure rises, urine can get into the brain or lungs, causing edema. A patient with such symptoms needs emergency care. Often the symptoms of the underlying ailment, which led to the pathology, join the above signs.
Stages of acute renal tubule necrosis
Consider this question in detail. The initial stage is characterized by slight changes. In this case, the disease can be diagnosed only after laboratory tests. Most often, changes concern the composition of urine. White blood cells, red blood cells, proteins and platelets appear in it. At this stage, the patient is concerned about pain in the lumbar region.
At the second stage, necrotic processes cover the tissues, the filtration function of the kidneys decreases, and the outflow of urine is impaired. At this moment, the person has severe weakness, apathy, lack of appetite, the patient may complain of leg pain and frequent urination.
At the last stage, necrosis affects the organ completely, suppressing its function. At this point, pressure rises, diuresis occurs. The patient's body is poisoned by toxins and metabolic products, a person is in a serious condition.
Diagnostics
A nephrologist is involved in the treatment of kidney necrosis. It is to him that you need to make an appointment to diagnose the disease. In the event that the disease progresses, it is worth calling an ambulance at home. To determine pathological changes, as a rule, use:
- blood and urine tests;
- Ultrasound of the kidneys and ureters;
- urography;
- CT and MRI of the body.
In the event that a person needs emergency assistance, they conduct biochemistry of blood and urine, ultrasound. These data will be quite enough to make an accurate diagnosis.
Drug treatment
The use of conservative medicine in the treatment of kidney disease involves the elimination of the root cause. If necrosis has developed against the background of pyelonephritis, then it is treated with antibiotics. Broad-spectrum drugs are commonly used. They are administered subcutaneously or intramuscularly, in severe cases, jet administration is practiced.
Antibacterial therapy is used to stop necrotic inflammatory processes in the tissues of the kidneys. If the cause of the development of the disease was poisoning, then detoxification is used. In this case, it is necessary to remove toxins and poisons from the human body as soon as possible in order to establish the work of the kidneys and improve the patient's condition.
Additionally, the doctor may prescribe diuretics.
Hemodialysis
This method is used in case of stopping the outflow of urine. With the help of hemodialysis, it is possible to compensate for the patient's condition. The situation can be significantly complicated if there is no apparatus for this procedure in the intensive care unit. After all, a person may not survive transportation.
Additional methods
In addition to the above activities, doctors can apply the following procedures:
- blood transfusion;
- plasmapheresis;
- excision or removal of the kidney;
- clustering of the calyx and pelvis of the damaged organ.
This is necessary to get a true picture.
Complications
Against the background of necrosis, serious diseases such as renal failure and tissue death in the brain or other vital organs can occur. The most serious complication is the rapid progression of the disease, which leads to death.
Forecast and Prevention
Doctors believe that if one kidney is affected, one can count on a favorable prognosis, since it can be amputated. If the death of tissues struck both organs at once, then the further outcome depends on the treatment of diseases.
If the pathological process cannot be stopped using hemodialysis, medications and other procedures, then the chance of recovery is minimal.
As a prophylaxis, it is recommended:
- timely treat inflammatory diseases;
- regularly visit a neurologist;
- strengthen the immune system;
- follow a diet;
- avoid hypothermia.
There is no specific prevention of kidney necrosis, but the development of the disease can be prevented if you monitor the condition of the body.
Conclusion
Kidney necrosis is a dangerous disease that can be fatal. Preventing tissue death is very difficult. If you do not turn to a specialist in time and stop the destruction, then you can encounter serious complications. It is impossible to cure the disease on your own, therefore, at the first suspicion of kidney pathology, it is urgent to consult a doctor. Unfortunately, the time at which a positive outcome is possible is limited.