Renal failure is the complete or partial loss by the kidneys of their physiological functions. It develops slowly, sometimes over decades. More often women are sick than men. In some cases (usually with congenital pathologies), children become ill. Chronic renal failure does not have a reverse course - there are no known cases in medicine when a person could recover and completely restore kidney function.
The difference between acute and chronic course
Acute renal failure is characterized by a sharp manifestation of symptoms, fever, fever, chills, cessation of urine outflow, and an increase in protein and leukocyte counts in the urine. If you take the patient’s blood for biochemistry, creatinine and urea will be at a critical point. In the event of timely hospitalization and medical care, it is possible to restore normal kidney function. It is unacceptable to conduct treatment at home - it can cost the patient life.
The chronic course is almost asymptomatic for many years. Tests can help identify the onset of kidney dysfunction - creatinine and urea can help. A sick person is characterized by a pale, tired, asthenic appearance. Often patients are very thin, haggard. Temperature (in contrast to the acute stage of renal dysfunction) rarely rises.
Causes of the acute stage of the disease
All possible causes and symptoms of acute renal failure in the acute stage can be classified into three groups:
- Prerenal causes: problems with the liver and heart. Cardiomyopathies, arrhythmias of various origins, pre-infarction state, pulmonary embolism, heart failure - all this can cause a kidney to stop working. Cirrhosis, hepatosis, fatty liver can also serve as a trigger in the development of acute renal failure.
- Renal causes: poisoning, snake and insect bites, alcohol intoxication, damage to the kidneys with uric acid salts, physical injuries of the kidneys during fights, stab wounds. The symptoms of acute renal failure cannot be overlooked: it is severe nausea, vomiting, fever, cessation of urine output, severe swelling, loss of consciousness, loss of connection with reality.
- Causes of urinary tract: obstruction of the ureters, congenital malformations of the kidneys, too large stones in the tissues, passage of blood clots, sand, pus.
Causes of the development of the chronic stage of the disease
CRF is characterized by a slow development, it can progress unnoticed by the patient for many decades. Here are the main reasons for its development:
- chronic glomerulonephritis, pyelonephritis;
- poisoning and overdose of certain drugs;
- chronic alcoholism and drug addiction;
- blocking the urinary tract for a long time;
- concomitant diseases: diabetes mellitus, dysfunction of the liver and gall bladder, gout, scleroderma, obesity and many others.
What symptoms indicate the development of the disease
At the initial stage of development of chronic renal failure, the patient rarely worries. Occasionally aching lower back pain. Urine can get an unpleasant odor, sometimes a precipitate is observed in it. At the initial stage, the symptoms of renal failure in women are also manifested in weakness, asthenia, depression and decreased performance.
Doctors call the second stage "oliguric". Symptoms of chronic renal failure become more prominent:
- decrease in daily urine volume;
- bad smell and change in consistency;
- lack of urination for seven to eight hours becomes the norm;
- swelling of the face and limbs;
- persistent increase in temperature to 37 degrees for a long time;
- muscle twitching, nerve tics, skin itching;
- nausea, vomiting, pallor, weakness.
If at least one phenomenon from this list appears, you should definitely be examined by an experienced nephrologist. Ultrasound, biochemical blood analysis will help to quickly assess the patient's condition.
Symptoms of renal failure in women
In the weaker sex, renal dysfunction manifests itself in a slightly different way than in men. In women, any disruptions in the water-salt balance affect the nervous system. Hence - frequent mood swings, irritability, tearfulness. Also, they are characterized by the accumulation of fluid in the lower extremities, respectively - if the legs are often swollen in women, then this may be a symptom of urinary system dysfunction. By the way, an interesting fact is that women, as a rule, experience a kidney transplant procedure much easier.
Symptoms and treatment of renal failure in men are slightly different. They often have fever, they are characterized by a life-threatening increase in temperature.
A symptom of renal failure in men is also a tendency to swelling of tissues above the waist - hands, face, fingers.
Men are much more difficult than women to survive the period after kidney transplantation - mortality increases several times. Symptoms of kidney failure in people, regardless of gender, are both pronounced and completely invisible.
Description of each stage of the disease
There are four stages of the development of chronic renal failure, each of which brings the kidneys of a sick person to complete and final dysfunction.
- Latent stage. The patient feels good so far, from time to time only weakness and drowsiness disturb him, but they pass quickly. An unpleasant smell of urine may appear from time to time. Clinically, the picture is also not very different from the norm: creatinine is normal, GFR can be reduced, but not less than by 50%. In the second phase of the development of the latent stage, creatinine and urea can be slightly exceeded - a competent doctor will not leave this moment unnoticed.
- At the azotemic stage, kidney pathology begins to progress more rapidly. The volume of daily urine output decreases, swelling appears. Indicators of clinical tests characteristic of this stage: creatinine 0.14-0.44, GFR 20-50%.
- The uremic stage requires immediate hospitalization of the patient and the beginning of hemodialysis. A sick person at this stage is almost unable to independently maintain a normal lifestyle. Clinically, at this stage, creatinine level rises to 0.72-1.24, glomerular filtration rate 5-10%
Predictions and treatment of chronic renal failure
After an episode of acute renal failure, most often doctors manage to fully restore the function of the urinary system. In the case of a chronic course, everything is more complicated. In most cases, the patient is forced to change his lifestyle after diagnosis.
It is necessary to fill out disability, as a full-time job will now be impossible. Hemodialysis is time consuming. And the kidney transplant procedure is too serious a blow for the whole organism as a whole. No matter how the life of a patient with chronic renal failure develops - being on dialysis or replacing a kidney with a donor - life will be divided into "before" and "after" and will never be the same as before.
Diet for kidney failure
Recovery and well-being are largely dependent on nutrition. Treatment for symptoms of kidney failure is not possible without limiting protein and salt.
Spicy and salty foods cause fluid retention. For a patient with CNI, this is unacceptable. The water-salt balance of the body is already seriously disturbed, and the patient also “finishes” it with salt.
It is also necessary to reduce protein intake. You can eat only lean meat - for example, chicken or turkey fillet. Great breeds of marine fish. To make up for the lack of healthy fats - unrefined olive oil. From carbohydrates - any vegetables, fruits. Exclude ready-made pastries, factory sweets, chocolate, cakes with fat cream. Any alcoholic and sweet carbonated drinks are prohibited.
Hemodialysis procedure
A patient with chronic renal failure needs help to cleanse the blood. His kidneys are no longer able to do this. Therefore, at the terminal stage, all patients are forced to attend the hemodialysis procedure. As a rule, the patient needs it three to four times a week. To facilitate the procedure, a special fistula is sewn into the vein on the arm (so as not to injure the vein each time).
One procedure lasts approximately four to five hours. During this time, part of the patient’s blood is pumped out through a catheter connected to the fistula and mechanically cleaned in a special reservoir. Purified, it returns to the body again through a catheter. Thus, the entire mass of blood of a sick person is processed.
With the help of hemodialysis, it was possible to extend the life of patients with chronic renal failure by 15-20 years. Yes, at first the patients have a hard time - the body is shocked by such interventions. But after a couple of months, people get used to it and live quietly on a full and happy life. Today in Europe there is even a special travel program for people on dialysis.
Disability in chronic renal failure
Symptoms of chronic renal failure do not allow the patient to lead a former lifestyle. In order to have money for living, you can apply for disability. For this, it is necessary to undergo examinations at the main medical specialists (this can also be done in a hospital) - a nephrologist, phlebologist, ophthalmologist, endocrinologist. Get an extract from a medical history from a physician. Pass an ECG and, if necessary, attach to the package of documents the results of ultrasound, MRI, X-ray and other examinations passed. It is also necessary to make copies of the passport, SNILS, a document on the place of permanent registration.
With this package of documents, the patient should go to the MSEC commission, located in the area where the sick person is registered. Sometimes the commission goes by without an appointment, in some cases you have to wait about a month. The amount of the first group disability pension for 2018 is eleven thousand nine hundred rubles, plus subsidies for utility bills, travel benefits and medicines.
Pregnancy in patients with chronic renal failure
Modern medicine allows patients with chronic renal failure to conceive and bear a fetus. Of course, the outcome of pregnancy largely depends on the stage and condition of the tissues of the kidneys of the expectant mother.
If you are pregnant and suspect you have CRF, then make sure that you have the following symptoms of kidney failure in women (treatment may be required immediately):
- A sharp decrease in the volume of daily urine.
- Blood pressure jumps.
- Unusual swelling of the face and limbs.
- Vomiting, nausea.
- Signs of poisoning or intoxication.
- Pallor, weakness, asthenia, drowsiness, loss of consciousness.
In the presence of at least one of the above conditions, you can not hesitate, you must immediately consult a doctor.
Accompanying illnesses
Symptoms of kidney failure never come alone. This is a very serious pathology, which entails a gradual breakdown of many functions.
Here is a list of concomitant CND diseases:
- violation of the outflow of bile, cholecystitis and cholestasis;
- due to constant intoxication, the liver may not cope - hepatoses and the replacement of healthy fatty tissue;
- protein synthesis disorders, muscular dystrophy due to a sharp reduction in amino acids;
- decreased immunity - frequent colds, susceptibility to infectious diseases;
- in women - disorders of the nervous system.
Figures, facts and statistics on renal failure
Here are some interesting facts and statistics about this condition:
- In 65% of cases, acute renal failure is associated with operations or physical injuries of the lumbar region.
- In Soviet times, the main reason for the development of chronic renal failure was glomerulonephritis. To date, this condition most often provokes diabetes.
- In hot countries, kidney failure develops most often due to parasitic infestations and infectious diseases.
- The hemodialysis procedure for one patient costs the budget almost 1 million rubles.
- The life expectancy of a patient on timely initiated hemodialysis can be 15 years or more.
- By the number of kidney transplants performed, our country occupies one of the last places in world medicine (this situation has developed due to corruption and poor interaction of provincial hospitals with budget sources).
- Nephrologists of the Russian Federation look forward to the adoption of a new version of the law on transplantation.