Kidney failure

Irreversibly damage the majority of nephrons causes a chronic inability to remove waste products via the kidney. The causes are numerous pathological conditions, and damage to the kidneys and urinary tract.

INTRODUCTION

The kidneys are organs of excretion in the urinary system, located in the upper abdominal cavity. The shape is similar to kidney beans beans. The kidneys receive blood from the renal artery, which comes from the aorta. The body at rest, the kidneys receive about 1.2 liters of blood per minute. Kidney function is to maintain the volume of organic liquid, and this objective is achieved by removing, through the urine.

ACUTE RENAL FAILURE

It is a condition characterized by reduced excretion of urine with a consequent change in the volume and composition of organic liquids. There are prerenal, renal and post-renal causes.

Prerenal acute renal failure resulting from a reduced amount of blood that occurs in the kidney. Common causes of this are: bleeding, vomiting, dehydration, burns, shock or cardiac failure.

The most common causes of renal failure, acute renal failure are all diseases, mostly: tubular necrosis, acute glomerulonephritis, renal infarction and cortical necrosis.Sometimes it can also cause severe kidney infection.

Post-renal acute renal failure caused by a variety of reasons that cause urinary tract obstruction with anuria. The most common reasons are: kidney stones, tumor compression, prostate enlargement and stenosis.

In the beginning of the disease the patient has no symptoms that would indicate acute renal failure. At this stage occurs only to a reduced excretion of urine. After that the patient appears malaise, fatigue, and aversion to food. Symptoms are worse if you do not intervene in time. The patient loses concentration and becomes very nervous. In more advanced stages, people fall into a state of stupor, which is occasionally punctuated by episodes of delirium or convulsions. Breathing is very profound, intermittent periods of complete cessation of breathing, the tongue is dry, the muscles tremble involuntarily.Almost regularly, after a few days of the occurrence of anuria, there is bleeding or infection. If it starts at the time of treatment, survival is 5-10 days from the occurrence of renal failure.

CONSEQUENCES

One consequence of the disturbed water balance. Entered the water is eliminated through sweat, intestine and kidney. When there is an inability of elimination of water via the kidneys, then a hiperhidracije. Due to water intoxication leads to digestive, respiratory and heart problems and nervous symptoms.

When an imbalance of electrolytes leads to lasting consequences. Electrical conductivity of the electrolyte solution is higher than the conductivity of the water. Electrolytes play an important function in the body because elektroneutralnost maintain internal solution, water movement etc..

During anuria often comes to a lack of or increase in the concentration of potassium, calcium, sodium and phosphorus in the body which can cause serious heart problems.

The kidney is the organ that regulates the acid-base balance. Metabolic acidosis is a common complication of renal insufficiency. Metabolic acidosis causes cerebral and digestive disorders. Because renal failure leads to the retention of nitrogen compounds.Another important and often poljedica renal insufficiency is anemia. Finally there is another consequence, which is a disorder of coagulation.

THERAPY

In acute renal failure is the most important primary treatment of pathological situations.In acute tubular necrosis, it is important to maintain normal levels of organic liquids, the concentration of substances contained in them. The patient must be stationary, isolated, in bed, to prevent the possible infection. Giving fluids must be offset losses of organic liquids.

Meals must meet energy needs, but also must limit the intake of protein. Particular attention should be paid to the potassium. When the patient overcome the stage of oliguria, food and fluid intake should gradually return to normal. Protein intake should be restricted until the normalized concentrations of urea and creatinine levels. In most patients, measures of child and providing a controlled fluid and electrolytes are not enough. For this reason most often resort to dialysis, which prevents the occurrence of complications.

CHRONIC RENAL FAILURE

Chronic renal failure is the final stage of kidney disease. Irreversibly damage the majority of nephrons causes a chronic inability to remove waste products via the kidney. The causes are numerous pathological conditions, and damage to the kidneys and urinary tract. To chronic renal insuficiijencije often lead: glomerulonephritis, mercury poisoning, kidney infections, congenital anomalies of the kidney, and so on. Among the first signs of renal failure are polydipsia and polyuria. Due to the inability of the remaining nephrons to concentrate the urine leads to an imbalance of electrolytes.

Start of chronic renal failure is unnoticeable. On the third of a functional kidney tissue is processed in the normal amount of a substance. In this way the patient feels no symptoms. Only laboratory tests can show a reduction in glomerular filtration rate and a defective ability to concentrate. The quantity of urine is growing, and the patient has to urinate more often. As a progressive disease progresses, there is a phase in uremic kojo comes to a series of changes hematokemijskih. It emphasizes the increase in urea, creatinine and uric acid, and often leads to anemia. The protein, calcium and sodium are often decreased, while potassium and phosphorus increased. Picture of electrolytes is disturbed. Because anemia patient feels a strong general weakness, and easily fatigued.The patient was pale and feeling sick, poor appetite, and persistent hiccups. Often the patient depressed, anxious or iritabilan. Most of these symptoms disappear when the patient begins treatment with dialysis.

Often in advanced stages of uremia leads to pericarditis. It is an inflammatory reaction of both papers pericardium. It manifests as pain behind the breastbone and a general feeling of weakness.

THERAPY

The main goal of therapy is to preserve the functional integrity of the remaining nephrons. As long as the laboratory findings and the patient's condition does not indicate the risk of uremia, there is no reason for the significant limitation of protein intake. The patient can be taken from 0.50 to 0.75 g of high quality protein (meat, eggs). During dialysis can lead to loss of protein, and these losses must be replaced. The diet should be introduced more vitamins and folic acid. The patient should not be limited or salt intake.Drastically reducing salt intake can cause deterioration of the electrolyte imbalance.

The amount of sodium in the diet is determined by the metered quantity of sodium ejected by the patient for 24 hours. A useful indicator of the daily control of body weight.If the patient's weight increases, meaning that the body retains water, and that there is an excess of sodium in the body.  If there is visible already compromised bone tissue, the patient is given, and vitamin D. For maintenance of renal function is the most important quantity of water that enters the patient in the course of 24 hours.

Hemodialysis is a treatment that must be done regularly and consistently, and it can keep patients alive for several years, or until a possibility of kidney transplantation. In most cases (70-80%) in a patient comes to the acceptance of transplanted kidneys. Then the patient can quickly return to normal life activities.

source: www.zdravbubreg.blogspot.com