Kidney disease are often asymptomatic

The largest number of chronic kidney disease runs without visible symptoms.

Number of patients who suffer from chronic kidney disease over the last decade, has a continuous increase. As this is a disease that often requires dialysis or transplantation, is of crucial importance is their early detection.

In the group with an increased risk of chronic kidney disease, according to the words of Professor Dr. Ležaić Cherry, Director of the Department of Nephrology, Clinical Center of Serbia, diabetics, older than 60 years, those with high blood pressure and suffered from so-called multisystem disease.

Increased risk, there are also people who drink drugs with toxic effects on the kidneys and those whose closest relatives have suffered from kidney disease.

Vulnerable people at risk for urinary tract obstruction, such as, for example, enlarged prostate, or those who underwent surgery in the pelvic or abdomen - says Dr. Ležaić. -

People with cardiovascular disease - such as heart failure or ischemic heart disease - are also at risk of developing kidney disease. However, there is general agreement that patients with diabetes and hypertension, are the populations at high risk for chronic kidney disease from which to recruit the largest number of these patients. Most of them are mostly or even exclusively, treated in primary care medicine.

Chronic kidney disease is defined as damage to the kidney, or disorder in his work, which takes at least three months - says our interlocutor.

- Kidney damage is manifested pathological changes, or presence of indicators of kidney damage. It may be abnormalities in the composition of blood and urine, or the appearance of the kidneys and urinary tract.

The largest number of chronic kidney disease runs asymptomatic, so if you are not looking for them, patients javaljaju doctors in the advanced stage of disease, with progressive renal insufficiency. Then, says Dr. Ležaić, able to influence the course of the disease significantly reduced or completely lost.

People at risk for chronic kidney disease, need each year to check the condition of their kidneys, says our interlocutor.

Detection of kidney disease should be easy, cheap, with tests that are available. Meet these requirements: blood pressure, urine test strips (proteins, glucose, blood, leukocytes, and whenever possible, so called microalbuminuria): measurement of serum creatinine and calculation formulas of the kidneys. If the test strips detect abnormal findings in urine, it is necessary to evaluate certain biochemical methods. Ultrasound examination is recommended for selected groups. These include patients with symptoms of obstruction, or urinary tract infection, stones, those with positive family kidney disease, such as, for example, polycystic kidney disease.

Prevention measures are designed to detect people at risk for chronic kidney disease. Ii These include control and consistent treatment of hypertension, as well as strict regulation and control of blood sugar levels. It is necessary to treat lipid disorders, limit salt in the diet, and advised to stop smoking, regular exercise, maintaining normal weight and regular annual control of renal function and urine examination.

COUNCIL

When kidney disease is detected, in addition to regular audits of Nephrology, recommended changes in the way of life: smoking cessation, weight reduction and maintenance of the obese body mass index (BMI) between 18.5 kg/m2 and 24.9 kg/m2, a waist circumference below 102 cm for men, respectively, 88 cm for women. It is suggested that controlled protein intake of 0.8 to 1.0 gram per kilogram of body weight. Patients should not drink more than two standard alcoholic drinks per day, and recommended physical activity from 30 to 60 minutes of moderate activity (walking, cycling, swimming) four to seven times a week.

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Endemic Nephropathy

Endemic nephropathy is a family tubulointersitial chronic nephropathy, which occurs in hot spots, endemic, along the river Kolubara, Drina, Sava and Morava. It occurs in areas of South East Europe, and focus have been confirmed in Serbia, Bosnia and Herzegovina, Croatia, Romania and Bulgaria. The disease is clinically manifested in an adult rural population, typically between 30 and 50 years of age, with a slight predominance of females.

The cause of

Etiology of endemic nephropathy is unknown. The possible causes of stress are some elements that are found in traces (lead, cadmium, silicon), live agents (bacteria and viruses), fungal and plant toxins, genetic factors and immune mechanisms.

The clinical picture

Acute phase of illness does not exist. The disease is inconsiderable, relatively asymptomatic and very well tolerated, sometimes even decades. Weakness occurs only at the stage of renal failure, when the anemia is severe and when there is retention of nitrogenous products in blood. Patients complain of vague gastric discomfort. High blood pressure is encountered in about 30 - 40% of patients in advanced stages and in older patients. There is edema of renal origin.

The disease progresses to kidney failure and end-stage renal disease.

Diagnosis

It is based on medical history, epidemiological data, clinical presentation, objective examination, laboratory tests, ultrasound, intravenous urography, renal biopsy.

Treatment

For patients with nephropathy endemdske, whose etiology and pathogenesis are not yet known, consists mainly in higijenskodijetetski regime. Marked renal insufficiency requires hipoproteinski diet, correction of anemia, antihypertensives with existing hypertension in end-stage and active treatment (dialysis and transplantation).

Prevention

Comes down to taking general hygiene measures in terms of lifestyle, diet and drinking water supply from areas not affected.

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Chronic glomerulonephritis

Glomerulonephritis is inflammation of the kidney where the glomeruli are affected, and the possible development of renal failure. The most common causes of glomerulonephritis include: bacteria, viruses and fungi.

STATEMENT

Glomerulonephritis is inflammation of the kidney where the glomeruli are affected, and the possible development of renal failure. The most common pathogens responsible for the development of glomerulonephritis include: bacteria, viruses and fungi.

Acute glomerulonephritis usually occurs after infection of throat or skin beta-hemolytic streptococcus. But the infection can be due to other bacteria or viruses. However, in many cases where it is not preceded by acute glomerulonephritis, the cause is unknown.

Chronic glomerulonephritis can sometimes occur after an acute glomerulonephritis. In most patients the initial symptoms are: swelling of the ankles, reddish color of urine, polyuria, headache and dizziness.

DIAGNOSIS

The simplest analysis that may lead to suspicion of glomerulonephritis is the analysis of urine. If the proteins present in the urine, it is a sign of glomerular damage. Proteinuria can be a sign of lumbar lordosis, renal or lowered orthostatic proteinuria, and proteinuria are the other important findings, which may be obtained from the urine sediment.Analysis of sediment can show a number of erythrocytes. Determination of plasma in one minute, filtered through the glomeruli (in normal conditions is 120 ml / min) is another important test. Testing known even for a layman to determine urea. Increase in urea is often a sign of kidney failure.

A kidney biopsy is done when clinical symptoms and laboratory findings indicate the suspicion of chronic glomerulonephritis. Biopsy to differentiate types of changes in nephropathy. It determines the development of different diseases and creates the possibility of distinguishing primary from secondary glomerulonephritis, which has important therapeutic implications.

Basic Histological are focal glomerulosclerosis, membranous glomerulonephritis, a membrane-ploriferativni glomerulonephritis and focal proliferative glomerulonephritis.

THERAPY

It is important to reduce the patient's physical activity and do not expose it to unnecessary effort, but not absolutely necessary to rest, because it favors catabolism.The patient should be able to protect against influenza infection or cold. The patient should get exactly as much liquid and loses and has to be accurately measured.

When taking food to watch out for the energy needs, but should reduce the intake of salt and protein. The therapy using corticosteroids with symptomatic therapy. If there is a stronger deterioration, the patient has to go on dialysis.

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