Contents
Edema in kidney disease is considered one of the most common symptoms of this kind of pathology. Moreover, they make themselves felt equally often both in the chronic course of the disease and at the stage of acute development.
As soon as the kidneys fail, the body has to deal with the consequences in the form of an excess content of various substances in the blood. The imbalance becomes the reason for the development of puffiness, which affects not only the upper or lower limbs, but also changes the shape of the face.
To avoid such an outcome, doctors recommend that when the first warning signs appear, immediately seek qualified help. Self-treatment, as well as ignoring the problem, can harm overall well-being by triggering irreversible processes in the body.
The main causes of swelling
Schematically, all conditions that indicate a violation of the kidneys against the background of swelling can be divided into two groups. The first includes a directly pathological mechanism that provokes fluid to pour into the intercellular space. The second group covers the diseases themselves, which lead to swelling.
Among the most common causes of edema due to kidney problems is increased blood filtration. Cleaning is carried out through the membranes of special renal glomeruli. Once proteins enter the primary urine, they take a small amount of water with them, which is a direct consequence of osmotic pressure.
Protein reabsorption at the level of the loop of Henley is not fixed, since their molecules are too large. Due to their outstanding size, they cannot pass through the walls of the tubules.
Another cause of bags under the eyes with a feeling of bursting of the skin throughout the body is a reduced protein content in the blood. This happens due to the loss of protein during each urination. Occasionally, other pathologies lead to such an outcome, which are an order of magnitude smaller in medical practice.
Also, often the reason for this change in appearance is a decrease in the ability of the kidneys to provide a sufficient filtration function. Even low blood pressure, which is considered relatively harmless among the inhabitants, can lead to a violation of the normal mechanism of urine filtration. This, in turn, activates the hormonal system, which responds by blocking the standard outflow of waste fluid.
A little less often, an increased concentration of sodium ions, or increased capillary permeability, becomes a harbinger of edema. In the first case, this applies to those patients who consume foods high in salt. In the second variant, this contributes to the easy release of blood components into the intercellular space.
But the most common cause still remains uncontrolled fluid intake, which often occurs during the heat. If we add to this the ability of the renal glomeruli to pass only a certain amount of incoming fluid, then with its excess, the kidneys simply do not have time to cope with the task.
The most serious causes are those diseases in children and adults that activate the mechanisms that lead to the loss of glomerular functionality. This is characteristic of inflammation or sclerosis, when the patient has an overgrowth of connective tissue that does not provide a filtration function.
The most common diseases leading to swelling
It is believed that ailments that cause puffiness all over the body due to kidney problems are limited only to their insufficiency. But the list is actually much broader, covering:
- glomerulonephritis;
- amyloidosis;
- swelling;
- intoxication.
It is glomerulonephritis that is the main culprit in the defeat of the glomerular apparatus. The catalyst for the pathology is damage to the filtration system due to a violation in the immune system. But not all people who are far from medicine understand what reasons can make the immune system work against their own body. The main ones include:
- infections, including streptococci, which cause angina, which can subsequently lead to such a complication;
- autoimmune diseases.
An incompletely treated disease can serve as an impetus for gradual replacement of the kidney tissue with connective tissue, which cannot perform the initial tasks assigned to the body’s natural filter. Over time, the patient’s well-being may deteriorate so much that only emergency hospitalization in a hospital will help him.
Amyloidosis is characterized by the accumulation in the walls of the vessels of the kidneys of the protein of the same name – amyloid. When it does not pass the cleansing barrier, it begins to be deposited in the glomeruli, clogging both them and the nearest capillaries. When the membrane becomes clogged, it simply ceases to function, which leads to the formation of a mechanical obstacle to normal blood flow.
Puffiness here is due to the fact that the remains of toxins accumulate in the blood, and excess fluid cannot find a way out, filling the free space wherever it finds a place.
An important place in a number of diseases leading to edema of varying degrees of severity is occupied by poisoning. We are talking about poisoning with salts of heavy metals, which can occur when:
- labor activity in harmful working conditions;
- long-term residence in unfavorable environmental conditions.
Some salts of heavy metals are localized in the renal membranes. With prolonged accumulation of toxic substances, the mechanism of converting normal tissue into connective tissue is triggered without the ability to cope with the task of filtering urine. The clinical picture ends with classical chronic renal failure.
The traditional symptomatology of such a pathology causes acute or chronic violations of the normal functionality of organs. And not only the glomeruli, but also the tubules are hit, which completely disables the kidneys very quickly.
Another disease from the list of the most common is an oncological tumor of a malignant or benign nature. To determine which type of neoplasm was found in a particular patient, only carefully performed instrumental diagnostics will allow.
Here, the prevalence of edema of the extremities, neck, face will be directly related to the stage of development of the disease, as well as the size of the tumor and whether there are metastases. The rate of spread of the disease is also taken into account.
The more pronounced the pathological changes, the brighter the external signs of pathology will be. This relationship is explained by the compression of blood vessels, tubules and the glomeruli themselves, which, with the progression of the disease, quickly lose their cleansing abilities.
How to recognize renal edema?
There are many reasons for the formation of edema with any localization, including trauma, allergic reactions, body responses to insect bites. Among all this diversity, doctors have learned to recognize signs that indicate the renal origin of edema.
People often confuse renal and cardiac edema. But an experienced doctor will be able to determine the source of the disease with a high degree of probability even during the initial examination. To do this, specialists use differential diagnosis, assessing according to specific criteria.
Typical associated complaints include:
- pain;
- problems urinating;
- neurological manifestations.
Patients experience pain at the stage of acute development of the inflammatory process, and pain can vary in duration and intensity. In clinical practice, the appearance of pain is often fixed even before the patient begins to notice the appearance of edema due to fluid entering the intercellular space. But there are cases when edema occurred suddenly, without being accompanied by characteristic pain in the area:
- lower back;
- projections of the lower ribs.
When renal colic occurs, irradiation is noted in the inguinal zone, the lower limbs on the side that the kidney was affected. It is not uncommon for the condition to be accompanied by:
- nausea;
- vomiting.
The reasons for a sharp deterioration in the condition here will be the movement of stones, or blockage of the ureter, with an accompanying infectious process. If colic took place, then approximately a day after the first attack, edema of varying severity occurs.
Problems with urination are also divided into several categories, differing depending on the characteristics of the underlying disease that caused them. But to summarize, edema with different localization can be called a consequence of the delay in the fluid that has entered the body. The total volume of daily urine decreases.
If everything is fine with a person, then the body will excrete about 70% of all the liquid absorbed per day, which is just over a liter. But as soon as the destabilization of filtration activity is noted along with the filling of the cellular space, the urine output reaches a record low level.
With oliguria, urine output is traced in an amount of not more than half a liter, and with anuria it does not exist at all. The worse the urine goes, the more serious the patient’s pathology and his condition.
Among other changes in urine with renal edema, a change in its color is noted up to a whitish hue or bright yellow. This is explained by the presence of pus during the development of inflammation in the acute stage. A change in the color of urine can be observed if a huge amount of red blood cells – erythrocytes – is noted in the urine. They enter the urine through the Shumlyansky-Bowman capsule.
An important clinical touch is the various manifestations of the strongest intoxication of the body. As soon as toxins begin to accumulate, they immediately turn into irritants of the nervous tissue, awakening unpleasant neurological symptoms.
The most common are headaches that cannot be neutralized with conventional painkillers, drowsiness and sleep disturbances. Muscle, joint, bone pain is also a harbinger of rapidly developing renal edema, which is often accompanied by skin itching.
In advanced stages, an imbalance of electrolytes is possible, which negatively affects cardiac activity. With a shortage of sodium, chlorine, potassium ions, the heart muscle is harder to contract and relax. Which leads to arrhythmia, fainting and even cardiac arrest.
Diagnosis followed by treatment
The very first analysis that a patient will need to take is a general and biochemical blood test. You will also need to determine the rheumatoid factor. A thorough diagnosis is not complete without a general, biochemical analysis of urine.
To eliminate the increased load on the kidneys, you will have to undergo functional kidney tests. But magnetic resonance imaging, as well as computer diagnostics, together with ultrasound, are prescribed according to the circumstances.
The therapeutic course can drag on for a long time, so you should prepare for the fact that with extensive edema, along with a rapidly developing pathology, the patient may even be hospitalized.
Standard treatment is based on prescribing drugs to relieve the underlying ailment, diuretics, and funds to strengthen the vascular wall. Additionally, you will have to follow the rules for maintaining water and electrolyte balance, follow a diet.