Contents
Kidney failure can be chronic – it develops in 40% of patients with serious kidney pathologies. Acute malnutrition occurs in about 200 people per 1 million of the world’s population.
What is kidney failure
If the kidneys for some reason do not cope with all their duties of filtering the blood, removing excess fluid and waste metabolites, the body suffers from intoxication. This condition is called kidney failure.
Pathology is divided into two types – acute and chronic. Differences – in the timing of the occurrence and severity of changes, their possible reversibility:
Acute kidney failure (abbreviated as AKI) – this is an acute and powerful kidney damage that occurs in a matter of days or weeks of illness. With acute renal failure, if timely help is provided, the changes can be reversible. That is, the work of the kidneys can be returned to normal. But this is not always possible, pathology can flow into a chronic process.
Chronic renal failure (today doctors have replaced this term with chronic kidney disease or CKD) are slowly developing changes due to which the kidneys are permanently damaged. Pathology can develop from several months (more than 3) to several years.
Important! Kidney failure is when both organs are damaged. If one kidney is damaged, the second one compensates for the problems, people can feel quite normal and live without any problems.
Causes of Kidney Failure in Adults
“At present, kidney disease and kidney failure, along with cardiovascular and oncological diseases, are the main causes of disability and death,” says nephrologist Natalya Meteleva. The causes of kidney failure are varied.
In addition to primary kidney diseases (glomerulonephritis, polycystic kidney disease, hereditary nephropathy), hypertension and metabolic disorders (diabetes mellitus, obesity, gout), inflammatory diseases, the use of certain drugs, and many other factors lead to the development of chronic kidney disease. And the kidneys turned out to be one of the main organs affected by a new coronavirus infection.
Symptoms of kidney failure in adults
Symptoms will largely depend on the type of pathology, the stage of insufficiency and the existing additional health problems.
If this is acute renal failure, its first manifestation is a sharp decrease in the volume of urine excreted per day or its complete absence (anuria).
In CKD, symptoms come on gradually, slowly. At an early stage, there are:
- the inability of the kidneys to reduce the production of urine at night, due to which patients often get up to go to the toilet at night;
- the volume of urine excreted at night and during the day is approximately equal or even more at night.
As the kidneys become more and more damaged, their filtering and excretion functions suffer. The acid-base balance of the blood changes, its acidification (acidosis) occurs, salts, nitrogenous substances, phosphorus and urea accumulate in the body. This condition is called uremia. Typical for him are:
- decreased appetite or complete aversion to food;
- general malaise, weakness, apathy;
- strong thirst;
- unpleasant taste in the mouth;
- memory problems;
- sleep disorders;
- low body temperature (less than 36,0 ° C);
- nausea or vomiting.
If treatment does not help, toxic substances accumulate, the nervous system is damaged, lethargy, muscle twitching, convulsions, vomiting, and frequent diarrhea may occur. From the skin and from the mouth there is a smell of ammonia or urine. There may be signs of stomatitis, gastritis, tracheitis or pericarditis. If the lungs are affected, shortness of breath may occur.
In the final stage, “uremic frost”, appearing urea crystals, may appear in the nose, neck and chin. There is hypotension, confusion. Possible death due to the development of uremic coma.
People with severe CKD experience severe anemia, brittle bones, heart problems and swelling, and damage to internal organs.
Stages of kidney failure in adults
The process of kidney damage goes through successive stages, gradually replacing healthy cells with rough scars. Each stage has its own key signs by which it is set – this is GFR (the so-called glomerular filtration rate – normally 100 – 120 ml / min) and an indirect sign – the level of creatinine in the blood.
- Early stage of CKD – GFR level is kept at 90 ml/min, there is evidence of kidney damage.
- The second stage – damaged kidneys have a slight decrease in GFR – from 89 to 60 ml / min.
- The third stage – decrease in GFR to 60 – 30 ml / min, increased urine volume, reduced hemoglobin, pronounced anemic symptoms, increased pressure, mainly lower.
- Fourth stage – GFR is 29 – 15 ml / min, there are external signs of renal failure, changes in urine volume, increased pressure.
- Fifth stage – terminal, GFR below 15 ml/min, very little urine is excreted, there is severe uremia, muscles and nervous system suffer, dialysis is needed.
Treatment of kidney failure in adults
Without timely detection of acute renal failure or CKD, the patient may die, so hospitalization, a complete examination and determination of treatment tactics depending on the type of problem are important. Only a nephrologist should treat kidney failure, the patient may need dialysis and medication, sometimes surgery.
Diagnostics
After the doctor talks in detail with the patient and finds out all his complaints, examines him, measures his height and weight, pressure, pulse, checks for edema, it will be necessary to pass a series of tests and undergo several studies. Without them, the diagnosis cannot be confirmed.
Biochemistry of blood determines the levels of final metabolites in the blood: nitrogen, creatinine and uric acid, detects acidification of the blood, changes in the amount of protein and salts.
General blood analysis will reveal anemia, a decrease in both hemoglobin and red blood cells.
Urinalysis will reveal protein, erythrocytes, pathological cells in the sediment.
Biochemistry of urine determines the level of salts, phosphorus, excreted final metabolites.
Ultrasound of the kidneys and urinary tract can identify any diseases that have led to deficiency and require treatment.
Kidney CT or MRI depending on what cause is suspected to be the basis of renal failure.
Kidney biopsy to determine the changes and the possibility of their correction.
Modern treatments
“Unfortunately,” he says. nephrologist Natalya Meteleva, – Renal failure is characterized by a progressive course that is irreversible and as a result may lead to the need for renal replacement therapy: treatment with hemodialysis, peritoneal dialysis or kidney transplantation.
Therefore, when signs of kidney disease appear, it is very important to contact a specialist – a nephrologist. The nephrologist will determine the cause of the disease and select the appropriate treatment method.
The treatment of kidney diseases is very complex, each patient requires an individual approach. In scientific circles, the development of a method for treating kidney failure is called a nephroprotective strategy.
Diet for kidney failure in adults
Before saying a few words about the diet, it must be emphasized that the greatest harm to the kidneys is caused by the independent, unreasonable use of drugs, primarily antibiotics, analgesics and anti-inflammatory drugs.
As a rule, in case of renal failure, the use of foods rich in phosphorus and potassium is limited. It is also useful to minimize the use of various preservatives that contribute to the formation of kidney cysts.
Prevention of kidney failure in adults at home
It is not possible to predict and prevent renal failure in all cases. But with a predisposition to kidney problems, you should take care of your health in advance:
- lead the most healthy lifestyle;
- maintain a healthy weight;
- limit salty foods, alcohol, protein and smoked foods;
- quit smoking;
- be as physically active as possible;
- regularly carry out preventive examinations.
Popular questions and answers
We decided to find out whether it is possible to treat kidney failure at home, by ourselves, with the help of traditional medicine, and asked topical questions nephrologist Natalya Meteleva.