Kidney injury in many diseases can lead to irreversible (irreversible or irreversible) renal function impairment.
Causes of chronic renal failure
• High blood pressure
• Obstruction (inhibition) of the urinary tract
• Glomerulonephritis
• Kidney abnormalities such as polycystic kidney disease
• Diabetes mellitus (diabetes)
• Autoimmune diseases, for example. SLE (systemic lupus erythematosus)
Symptoms
In chronic renal failure symptoms develop slowly. At first, people have no symptoms (irregular kidney function can be detected only by laboratory tests). People with mild to moderate renal failure may have only mild symptoms despite an increase in blood urea nitrogen (metabolic waste product in the blood). At this stage the person can urinate several times during the night (nikturija) because the kidneys are unable to return (resorbirati) from water and concentrate the urine, which normally operate at night. The result is a greater volume of urine. High blood pressure (hypertension) occurs in people with renal failure because the kidneys can not excrete excess salt and water. High blood pressure can lead to heart attack (myocardial miokarada) or heart failure.
If kidney failure progresses and the amount of toxic substances in the blood rises, people are starting to feel tired, easily fatigued, poor her mental abilities. As the amount of toxic substances is growing, developing nervous and muscular symptoms, including muscle jerks (fasciculation), muscle weakness and cramps. A person may feel tingling in the arms and legs and lose sensation in some areas.
Seizures (convulsions) may lead to high blood pressure or blood biochemical irregularities due to poor kidney function. The increase in toxic substances also affects the digestive tract, causing loss of appetite, nausea, vomiting, inflammation of the edge of the mouth (stomatitis), and an unpleasant taste in your mouth. These symptoms can lead to malnutrition and weight loss. People with advanced renal failure often get ulcers (ulcers) in the stomach and duodenum (duodenal) or bleeding. The skin may become yellow-brown, and sometimes of urea concentration is so high that it crystallizes forming a white powder on the skin. Some people with chronic renal failure have a very unpleasant itching of the skin of the whole body.
As chronic renal failure affects the blood:
• Elevated concentrations of urea and creatinine
• Anemia (anemia)
• Increased blood acidity (acidosis)
• Reduced concentration of calcium
• Elevated concentrations of phosphate
• Elevated levels of PTH (parathyroid hormone glands)
• Reduced levels of vitamin D
• Normal or slightly elevated concentrations of potassium
Diagnosis
Chronic kidney failure is diagnosed through blood tests. Typically, the blood becomes moderately acidic (acidosis). The increase in the blood of two metabolic waste product: urea and creatinine, which are normally filtered by the kidneys. Calcium levels fall, and phosphorus to grow. The level of potassium in the blood is normal or slightly elevated, but can become dangerously high (significant increase or decrease levels of potassium in the blood affects the heart and can lead to arrhythmias or cardiac arrest). Urine volume remains the same, 1-4 liters a day, regardless of the amount of fluids entered. Usually the person is moderately slabokrvna (anemic). The analysis of urine can detect many anomalies, including irregular cells, and salt concentration.
Prognosis and treatment
Chronic kidney failure is generally worse regardless of treatment and may have a fatal outcome. A person can survive if they make use dialysis or transplantation (transplantation) of the kidney.
Conditions that cause or worsen kidney failure must be corrected as soon as possible. Such actions include correction of sodium, water and acid-base imbalances, removing substances toxic to the kidneys, the treatment of heart failure, high blood pressure, infections, high concentrations of potassium (Hyperkalemia) or calcium (hypercalcaemia) and removal of barriers (obstruct) the flow of urine.
Very precise diet helps to control acidosis and increased concentrations of potassium and phosphate levels. Diets low in protein (0.1 to 0.2 g / kg ideal body weight) can slow the progression of the initial chronic renal failure to end-stage renal failure when they need dialysis or a kidney transplant.
Diabetics usually be treated to one of two ways earlier than people without diabetes (diabetes mellitus).It is recommended that supplementation with vitamins B and C when the diet is very restrictive and began dialysis.
High triglyceride levels, common in people with chronic renal failure, increases the risk of complications such as heart attack (myocardial infarction) and stroke. You can take medication to reduce triglyceride levels (eg, gemfibrozil), although studies have shown that drugs reduce cardiovascular (cardiovascular) complications.
When kidney failure is usually thirst determines how much water to enter. Often the water intake is limited to prevent the concentration of sodium in the blood become too low.
Intake of salt (sodium) is usually not limited if the liquid does not accumulate in the tissues (edema), or if it does not raise blood pressure (hypertension). Should izbjegvati food very rich in potassium, foods with a high content of potassium should not be used in larger quantities.
High blood potassium levels (Hyperkalemia) is dangerous because it increases the risk of irregular heart rhythms and cardiac arrest. If potassium levels become too high, drugs such as sodium polystyrene sulfate can be joined so that the potassium is excreted in feces, but to the recommended emergency dialysis.
If these conditions are present for a long time may be disrupted to create (construction) of bone.These conditions include low kalcitrola (derivatives of vitamin A), decreased intake or absorption of calcium and high concentrations of phosphate and parathyroid hormone (hormone paratieoidne glands) in the blood. The concentration of phosphate in the blood is controlled by limiting intake of foods rich in phosphorus (diet products, liver, legumes, nuts and most carbonated beverages). They can be helpful drugs that bind phosphates such as calcium carbonate, calcium acetate and aluminum hydroxide (antacid).
Anemia is the result of what the kidneys do not produce enough erythropoietin (a hormone that stimulates production of red blood cells). Anemia slow to respond to epoetin, a drug that can be injected into the body. Blood transfusion is given only if the anemia is severe or causes symptoms.Physicians should look for other causes of anemia, particularly dietary lack of nutrients such as iron deficiency, folic acid (folate) and vitamin B12 or excess aluminum in the body.
Bleeding tendency in chronic renal failure may temporarily suppress the transfusion of red blood cells or platelets, or medications such as desmopressin or estrogens. This treatment may be needed after an injury or before surgical treatment or tooth extraction.
Symptoms of heart failure, usually caused by excessive salt and water retention, improved by reducing salt in the diet. Diuretics (furosemide, bumetanide, and torsemide) can also be effective when it is poor kidney function. Moderate or severe high blood pressure treated with standard medications for blood pressure to preserve the remaining cardiac and renal function.
When the initial treatment of kidney failure is no longer effective, considering the long-term kidney transplantation or dialysis.
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