Renal failure in women treatment. Kidney failure in women: signs, symptoms and treatment

04.08.2017

Renal dysfunction associated with various diseases, in medicine is calledkidney failure.

Not a disease, as such, but a condition that occurs in a chronic or acute form. Acute insufficiency is diagnosed every year in 200 Europeans out of a million, half of whom have undergone surgery or kidney injury. The number of people affected by the misuse of medicines has also increased.

The kidneys are a vital organ responsible for removing toxins from the body, regulating blood pressure, producing hormones, and blood formation. In case of insufficiency, the functions of the organ are impaired, health deteriorates sharply, up to death. In order to prevent such a development of events, it is necessary to undergo a survey in a timely manner.

Why does acute kidney failure occur?

For the most accurate diagnosis, classification pathology was associated with the causes that caused it. As a result, there are 3 types acute insufficiency kidneys: prerenal, renal and postrenal.

Prerenal insufficiency provokes a violation of blood flow in the kidneys. Due to the fact that there is a shortage of blood in the organ, urine is not formed in the proper amount, the tissues of the kidneys change.Prerenal renal failureoccurs in 55% of patients. With this pathology kidney symptoms can be called:

• dehydration associated with burns, vomiting and diarrhea, excessive use of diuretics;
• cirrhosis and other diseases of the liver, in which the removal of venous blood is disturbed, edema appears, the work of blood vessels and the heart goes astray, the blood supply to the kidneys worsens;
• a sharp drop in pressure septic shock, allergic reaction, drug overdose.

Renal insufficiency is caused by pathologies of the tissues of the kidney. As a result, even when receiving a sufficient volume of blood, the organ cannot produce urine. This type of insufficiency occurs in 40% of patients. With this pathologysymptoms of kidney failure in humansmay occur due to:

• poisoning with toxic substances, snake and insect venom, heavy metals, drugs;
• destruction of hemoglobin, red blood cells during malaria or blood transfusion;
• autoimmune diseases;
• damage by metabolic products in case of gout and other ailments;
• inflammatory diseases of the body - hemorrhagic fever, glomerulonephritis, etc.;
• thrombocytopenic purpura, scleroderma and other pathologies in which the vessels of the kidneys are damaged;
• injury to the only working kidney.

Postrenal insufficiency is caused by an obstruction in the urinary canal that prevents urine from being passed. Provided that one ureter is clogged, then healthy kidney will work for both organs.

Pathology occurs in approximately 5% of patients. In this case kidney failure symptomswill manifest due to:

• tumors in bladder, prostate and other organs in the pelvis;
• blockage of the ureter by a thrombus, stone, pus or due to a congenital defect;
• ureteral injury during the operation;
• violations of urine output due to the use of medications.
  

Why Chronic Kidney Failure Occurs

When a person is suspected of having chronickidney failure symptomscan be triggered by kidney diseases caused by heredity and congenital diseases, as well as organ damage in gout, urolithiasis, diabetes mellitus, obesity, scleroderma, systemic lupus erythematosus, liver cirrhosis, etc. Also, organ diseases provoke kidney pathology genitourinary system when the urinary ducts overlap over time. Such diseases can be tumors, bladder stones, etc.

The reason for the development of deficiency in chronic forms There can be poisoning with toxic substances, a reaction to medications, pyelonephritis and glomerulonephritis.

How is acute insufficiency diagnosed?

correctly interpretsymptoms and treatmentappoint on the basis of the results of the analyzes - the competence of a specialist. Self-medication for kidney disease is unacceptable, as it is fraught with death. Exist classification I have symptoms depending on the stage of the disease, there are 4 of them:

• initial. There are no special manifestations, only signs of the underlying disease. However, the process of damage to the kidney tissue has already begun;
• oliguric. It is characterized by a decrease in the daily volume of urine to 400 ml, as a result, toxins are retained in the body, a failure of the water-salt balance is detected. In women andsymptoms in menwill be manifested by nausea, vomiting, loss of appetite, lethargy and weakness, shortness of breath. Also characteristic features are abdominal pain, arrhythmia, tachycardia, infections against the background of a weakened body. This stage can last 5-11 days;
• polyuric. It is characterized by the normalization of the patient's condition, the volume of urine excreted is leveled. However, the development of infection, dehydration is likely.
• recovery stage. The kidneys, as before, are ready to perform their functions. This stage lasts from six months to a year.

How is kidney disease diagnosed?

At the beginning of the development of pathology, the patient will not understand what is it, what is itchronic insufficiency will show later, when about 80-90% of the tissues of the organ will cease to function. But it is desirable even before that to pass the diagnosis and starttreatment of kidney failure.

First symptoms in menand women are manifested in the form of weakness, lethargy, excessive fatigue from the usual affairs. Further, the problem of urination is revealed, more precisely, the daily volume of urine is much larger than it should be, which is why dehydration is possible. When the volume of urine begins to decrease sharply, this is a bad sign. Some are starting to wonderhow long to livein the last stage of renal failure. There is no single answer - it all depends on the condition of the patient.

Other symptoms of kidney failure in women, men are reduced to nausea and vomiting, muscle twitching, itching, bitterness in the mouth, hemorrhages on the skin, abdominal pain and the body's susceptibility to various infectious diseases (pneumonia, acute respiratory infections, etc.).

Late stage chronic kidney failure is associated with sharp deterioration conditions, asthma attacks, shortness of breath. A person can often lose consciousness, fall into a coma. In general, the signs of the chronic form resemble those of the acute form, but differ in slow onset.

How to identify kidney failure (diagnosis)

After the doctor determinessymptoms of kidney failure in men, a series of blood tests, urine tests, and hardware research. Each of the analyzes is important in its own way, since it carries the necessary information, namely:

• urinalysis (general). The acute and chronic form of insufficiency will be indicated by erythrocytes, leukocytes, protein, altered urine density;
• bacteriological analysis of urine. It will help to identify an infection that provoked a failure of kidney function, as well as the sensitivity of pathogenic microorganisms to antibiotics;
• blood test (general). If a person haskidney failure thatWill a blood test show? Excess of leukocytes and ESR, decrease in hemoglobin, platelets and erythrocytes, general signs of an infectious and inflammatory process;
• blood test (biochemical). It reveals pathological changes - an increase or decrease in the level of calcium and potassium, phosphorus. Also, against the background of renal failure in both forms, an increase in the level of magnesium and creatine in the blood is observed, but the pH level decreases, which indicates acidification of the blood;
• Ultrasound, CT, MRI. Reveal structural changes in the kidneys, pelvis, ureters and bladder. In the case of chronic insufficiency, a hardware study is performed to identify the cause of the narrowing of the ureters;
• x-ray. Detects pathologies respiratory system that can lead to kidney failure;
• chromocystoscopy. The patient is injected with a contrast agent, then the bladder is examined with an instrument inserted through urethra. The technique is good for emergency diagnosis;
• biopsy. A fragment of the kidney is examined under a microscope in the laboratory if the diagnosis cannot be established;
• ECG. It is carried out for all patients with kidney pathologies to detect disorders in the work of the heart;
• Zimnitsky test. If a classification pathology attributed it to chronic insufficiency, then the Zimnitsky test will show the following changes - an increase in creatinine, urea, phosphorus and potassium, cholesterol against the background of a decrease in protein levels.
  

Treatment for kidney failure

If a person develops an acutekidney failure treatmentshould be carried out immediately in the Department of Nephrology. In case of a serious deterioration in the patient's health, they are placed in intensive care. Treatment will be given according to the causes of kidney failure.

In the case of a chronic form of the disease, therapy is prescribed taking into account the stage of the pathology. For example, at the initial stage, it is necessary to treat the underlying disease and protect the kidneys. If the volume of urine excreted by the body decreases against the background of a deterioration in the condition, pathological changes must be treated. If we are talking about the recovery stage, you need to help eliminate the consequences of a malfunction in the kidneys.

To get rid of the causes of prerenal insufficiency, blood transfusion is done, drugs are administered for arrhythmia, heart pathologies. From renal insufficiency, hormones of the adrenal cortex, cytostatics, antihypertensive drugs, antibiotics or antiviral agents- the specific choice of therapy depends on the factor that caused the insufficiency of the paired organ.

In the case of postrenal insufficiency, stones or tumors that interfere with the outflow of urine should be removed. For this, an operation is performed. To eliminate the causes that provoke chronic insufficiency, measures will be needed to eliminate the underlying disease.

Correction of nutrition with acute renal failure

The first step is to reduce the amount of proteins, since their digestion puts an additional burden on the kidneys. Daily rate protein - up to 0.8 g per 1 kg of body weight. To provide the body with calories, you need to increase the amount of carbohydrates in the diet by introducing potatoes, rice, vegetables and desserts. Salt intake is limited only when it is delayed in the body.

Physicians recommend controlling the daily volume of fluid, you need to drink water by 500 ml more than the volume of urine that is lost per day. You should save the menu from beans, nuts and mushrooms, because they have a lot of protein. With increased potassium in the test results, raisins, dried apricots and natural coffee, dark chocolate and bananas are excluded from the diet.

Prognosis for people with kidney disease

According to statistics, approximately 25-50% of patients with complicated acute renal failure are expected to die. Causes of death of patients:

• uremic coma, in which the nervous system is affected;
• sepsis - a condition when the whole body is affected by an infection;
• severe circulatory disorders.

If there are no complications, then 90% of patients recover.

The prognosis for chronic insufficiency varies depending on the age of the person, the underlying disease, and the state of health in general. Hemodialysis and kidney transplantation from a donor can significantly reduce the percentage of deaths. The following complications may worsen the prognosis:

• atherosclerosis;
• hypertension;
• consumption of food from high content protein, phosphorus;
• increased function of the parathyroid glands;
• kidney injury;
• dehydration;
• urinary tract infection.

Prevention

The main factor that can save the life of a patient with kidney failure is the timely diagnosis of the problem and adequate treatment. If no measures are taken, then the kidney function will be impaired, the course of the pathology will be severe.

At risk are people who often self-medicate. It is worth remembering that many drugs are toxic to the kidneys, and they should not be taken without a doctor's prescription.

Renal failure also occurs in people with high blood pressure, diabetes, glomerulonephritis. These people need to be examined regularly so as not to miss the first symptoms of the disease.

kidney failure is a syndrome that develops as a result of severe impairment of renal function and leads to disorders of homeostasis. When diagnosed with kidney failure, the symptoms occur as a result of violations of the acid-base and water-electrolyte balance in the body.

Kinds

There are two forms of renal failure: acute and chronic. (ARF) is manifested by a sudden deterioration in kidney function. This syndrome is caused by a sharp slowdown or cessation of the excretion of nitrogen metabolism products from the body. OPN leads to disorders of the electrolyte, water, acid-base, osmotic balance, as a result of which the normal composition of the blood is disturbed.

(CKD) is a gradually progressive condition caused by a decrease in the number of functioning nephrons. The symptoms of CKD develop slowly. In the initial stages of the process, the functions of the kidneys remain at the proper level due to the activation of nephrons that do not function normally. With further death of the renal tissue, the deficiency of renal functions increases, which leads to a gradual intoxication of the body with the products of its own metabolism.

Causes

The cause of acute renal failure is diseases that lead to a sudden deterioration in renal blood flow. As a result, the speed decreases glomerular filtration slows tubular reabsorption. The causes of AOP can be:

• shock of various origins;
• severe infectious diseases;
• massive bleeding;
• acute heart failure;
• intoxication with nephrotoxic poisons;
• damage to the vessels of the kidneys;
• acute diseases kidneys;
• obstruction of the urinary tract.

CRF develops as a result of chronic diseases of the kidneys or other organs and systems:

• diabetes,
• hypertonic disease,
• scleroderma,
• systemic lupus erythematosus,
• long-term use of certain drugs,
• chronic intoxication,
• chronic glomerulonephritis, pyelonephritis,
• urolithiasis, etc.

Symptoms

Symptoms of acute and chronic forms of renal failure differ in time of occurrence. With acute renal failure, they develop rapidly, and with adequate treatment, they can disappear quite quickly almost with full recovery kidney function. CRF develops gradually, sometimes over years and decades. At first, it may be asymptomatic, and then the symptoms steadily increase. When diagnosed with chronic renal failure, treatment can improve the condition of patients, but it is almost impossible to completely restore renal function.

Symptoms of acute renal failure

In the first stage of acute renal failure, symptoms of a condition that causes acute renal dysfunction are observed. In infectious diseases, it can be fever, chills, headache, muscle pain. Intestinal infections accompanied by vomiting, diarrhea, headache. With sepsis, intoxication - jaundice, signs of anemia, convulsions (depending on the type of poison). shock states characterized by confusion or loss of consciousness, pallor and sweating, thready pulse, low blood pressure. Acute glomerulonephritis manifested by the release of bloody urine, pain in the lumbar region.

The second (oligoanuric) stage of acute renal failure is characterized by:

• a sharp decrease or complete cessation of urine output;
• symptoms of azotemia (nausea, vomiting, itching skin, loss of appetite);
• disturbances of consciousness (confusion, coma);
• weight gain due to fluid accumulation;
• edema of the subcutaneous tissue (face, ankles, sometimes the entire subcutaneous tissue - anasarca);
• edema vital important organs(lungs, brain);
• accumulation of fluid in the pleural, pericardial, abdominal cavity;
• general severe condition.

With a favorable outcome, after a while, a period of recovery of diuresis begins. At first, urine begins to be excreted in small quantities, and then its volume exceeds normal (polyuria). There is a removal of the accumulated fluid and nitrogenous slags. Then the amount of urine excreted normalizes and recovery occurs.

When improper treatment or its absence after the second period comes the terminal stage. During this period, the signs of kidney failure are as follows:

• shortness of breath, cough, frothy sputum color pink(due to pulmonary edema and the presence of fluid in the pleural cavity);
• subcutaneous hemorrhages, hematomas, internal bleeding;
• confusion, drowsiness, coma;
• spasms or muscle cramps;
• disorders of the heart (arrhythmia).

As a rule, such cases end in death.

CKD symptoms

Signs of CRF begin to appear with significant changes in the renal structure. These include:

• decrease or increase in the volume of urine excreted;
• excretion of more urine at night than during the day;
• swelling in the morning (especially on the face);
• malaise, weakness.

The end stage of CRF is manifested by symptoms of uremia (accumulation of salts in the blood uric acid) and disorders of water-electrolyte metabolism:

• massive swelling of the subcutaneous tissue;
• accumulation of fluid in body cavities;
• shortness of breath, cough (cardiac asthma or pulmonary edema);
• persistent increase blood pressure;
• visual impairment;
• signs of anemia (pallor, tachycardia, brittle hair and nails, weakness, fatigue);
• nausea, vomiting, loss of appetite;
• ammonia smell from the mouth;
• stomach ache;
• weight loss;
• skin itching, "powdered" skin;
• yellowish skin tone;
• fragility of blood vessels (bleeding gums, subcutaneous hemorrhages);
• in women - cessation of menstruation;
• disturbances of consciousness up to a coma.

If in the terminal stage of chronic renal failure the patient is not transferred to, then death is inevitable.

Important! If you experience any of the above symptoms, you should consult a doctor. Kidney failure, like many other diseases, is best treated on early stages. Neglecting your health can cost your life!

Treatment

Treatment of acute renal failure includes elimination of the cause, restoration of homeostasis and impaired renal function. Depending on the cause of AKI, you may need:

• antibacterial agents,
• detoxification therapy (infusions saline solutions, enterosorbents, hemodialysis),
• fluid replacement (infusion of saline and colloidal solutions, transfusion of blood, its components and blood substitutes);
• hormonal drugs, etc.

Hemodialysis - one of the ways - detoxification therapy

To detoxify the body and remove nitrogenous wastes, they resort to hemodialysis, plasmapheresis, and hemosorption. To restore diuresis, diuretics are prescribed. In addition, solutions of salts of potassium, sodium, calcium and other electrolytes are introduced, depending on the type of acid-base and water-electrolyte imbalance. In the stage of recovery of diuresis, it is necessary to ensure that dehydration of the body does not occur. If the work of the heart is disturbed during acute renal failure, then heart preparations are used.

Treatment of chronic renal failure provides for the impact on the cause of the disease, maintaining kidney function and detoxification therapy. In addition, diet in renal failure is of great importance.

In the initial stages, treatment is directed at the underlying disease. Its goal is to slow down the progression or stable remission. For arterial hypertension, antihypertensive drugs. Constant correction of metabolism in diabetes mellitus is carried out. If a cause of CKD- autoimmune diseases, then glucocorticoid hormones and cytostatics are prescribed. In chronic heart failure, drugs that correct the work of the heart are used. If CKD is due anatomical changes, then surgical intervention. For example, the patency of the urinary tract is restored or a large calculus, a tumor is removed.

In the future, against the background of constant therapy of the underlying disease, symptomatic therapy. Diuretics are used to reduce swelling. With symptoms of anemia, it is necessary to prescribe iron preparations, vitamins, etc.

AT final stages CRF patient is transferred to chronic hemodialysis (the process of artificial blood filtration). The procedure is performed 2-3 times a week. An alternative to hemodialysis is kidney transplantation. In the terminal stage of renal failure, irreversible changes develop internal organs, so the issue of transplantation is better to decide in advance. With good compatibility and a successful kidney transplant, the patient has a great chance of recovery and a full life.

Diet

A special diet for chronic renal failure will help reduce the burden on the kidneys and slow down the progression of the process. Besides, proper nutrition in case of renal insufficiency, it will significantly improve well-being.

The basic principles of the diet:

• limiting the intake of protein foods,
• high calorie,
• adequate content of fruits and vegetables,
• control of salt and fluid intake,
• unloading fruit and vegetable days 1-2 times a week.

In the initial stage of chronic renal failure, the amount of protein in food approaches the norm (about 1 g / kg of body weight), provided that there are 1-2 per week fasting days. In the later stages, the daily intake of protein should not exceed 20-30 g. At the same time, sufficient intake of essential amino acids is necessary (the daily rate is contained in two chicken eggs). High caloric content of food is achieved due to fats (mainly vegetable) and carbohydrates. It is believed that under such conditions, nitrogenous slags can be used for the synthesis of non-essential amino acids.

The amount of fluid needed is calculated by the formula: the volume of urine excreted per day plus 500-800 ml. In this case, all liquids (drinks, soups, fruits, vegetables) should be taken into account. In the absence of severe arterial hypertension and edema, while maintaining the water balance, the patient can receive 4-6 g of table salt per day. If drug treatment includes sodium preparations, then the amount of salt in food is accordingly reduced. When hypertension and edema are pronounced, salt in the daily menu is limited to 3-4 g or less. Long-term significant restriction of salt is undesirable, therefore, with a decrease in edema and a decrease in blood pressure, its amount can again be slightly increased.

Treatment with folk methods

When diagnosed with kidney failure, treatment with folk remedies may have good effect, especially in the early stages. For this purpose, many plants are used that have a diuretic effect. Most often, birch buds, lingonberry leaves, field horsetail, string, blackcurrant leaves, chamomile, kidney tea are used. Sometimes mint, corn stigmas, St. John's wort and other plants are used, as well as collections from them. Usually they are used in the form of infusions and decoctions.

Important: before starting treatment with one of the folk remedies, consult a doctor. For some plants there are contraindications. Traditional medicine methods are used only as an auxiliary treatment in combination with doctor's prescriptions.

No matter how different kidney diseases are initially, the symptoms of chronic kidney failure are always the same.

What diseases most often lead to kidney failure?

Pyelonephritis, if left untreated, can lead to chronic renal failure.

• Diabetes
• Hypertonic disease.
• Polycystic kidney disease.
• Systemic lupus erythematosus.
• Chronic pyelonephritis.
• Urolithiasis disease.
• Amyloidosis.

Symptoms of kidney failure in the latent stage

At the first stage kidney failure (otherwise - chronic kidney disease of the 1st degree), the clinic depends on the disease - whether it be swelling, hypertension or back pain. Often, for example, with polycystic or glomerulonephritis with isolated urinary syndrome, the person does not suspect about his problem at all.

• At this stage, there may be complaints of insomnia, fatigue, loss of appetite. Complaints are not too specific, and without a serious examination, they are unlikely to help make a diagnosis.
• But the appearance of more frequent and abundant urination, especially at night, is alarming - this may be a sign of a decrease in the ability of the kidney to concentrate urine.
• The death of some of the glomeruli causes the remaining ones to work with multiple overload, as a result of which the liquid is not absorbed in the tubules, and the density of urine approaches the density of blood plasma. Normally, morning urine is more concentrated, and if the specific gravity is less than 1018 during a repeated study in the general analysis of urine, this is a reason to take an analysis according to Zimnitsky. In this study, all urine is collected per day in three-hour portions, and if in none of them the density reaches 1018, then we can talk about the first signs of kidney failure. If in all portions this indicator is equal to 1010, then the violations have gone far: the density of urine is equal in density to blood plasma, the reabsorption of fluid has practically ceased.

Next stage (chronic kidney disease 2) the compensatory abilities of the kidneys are exhausted, they are not able to remove all the end products of protein and purine base metabolism, and a biochemical blood test reveals elevated level slags - urea, creatinine. It is the concentration of creatinine in normal clinical practice that determines the glomerular filtration rate index (GFR). A decrease in the glomerular filtration rate to 60-89 ml / min is renal failure mild degree. At this stage, there is still no anemia, no electrolyte shifts, no hypertension (if it is not a manifestation of the underlying disease), only general malaise, sometimes thirst, worries. However, already at this stage, with a targeted examination, a decrease in the level of vitamin D and an increase in parathyroid hormone can be detected, although osteoporosis is still far away. At this stage, the reverse development of symptoms is still possible.

Symptoms of renal failure in the azotamic stage

If efforts to treat the underlying disease and protect residual kidney function fail, then kidney failure continues to increase, and GFR drops to 30-59 ml/min. This is the third stage of CKD (chronic kidney disease), it is already irreversible. At this stage, symptoms appear that undoubtedly indicate a decrease in kidney function:

• Blood pressure rises due to a decrease in the synthesis of renin and renal prostaglandins in the kidney, headaches, pain in the heart area appear.
• The work of removing toxins, which is unusual for him, is partly taken over by the intestines, which is manifested by unstable stools, nausea, and a decrease in appetite. May lose weight, lose muscle mass.
• Anemia appears - the kidney does not produce enough erythropoietin.
• The level of calcium in the blood decreases as a result of a lack of active form vitamin D. There is muscle weakness, numbness of the hands and feet, as well as the area around the mouth. Can be mental disorders both depression and agitation.

In severe renal failure (CKD 4, GFR 15-29 ml/min)

• lipid deception disorders join hypertension, the level of triglycerides and cholesterol increases. At this stage, the risk of vascular and cerebral catastrophes is very high.
• The level of phosphorus in the blood rises, calcifications may appear - the deposition of phosphorus-calcium salts in the tissues. Osteoporosis develops, pain in the bones and joints is disturbing.
• In addition to toxins, the kidneys are responsible for the excretion of purine bases, as they accumulate, secondary gout develops, typical acute attacks of joint pain can develop.
• There is a tendency to increase the level of potassium, which, especially against the background of developing acidosis, can provoke disorders heart rate: extrasystole, atrial fibrillation. As the level of potassium rises, the heartbeat slows down, and "heart attack-like" changes may appear on the ECG.
• There is an unpleasant taste in the mouth, the smell of ammonia from the mouth. Under the influence of uremic toxins, the salivary glands enlarge, the face becomes puffy, as with mumps.

Symptoms of kidney failure in the terminal stage

Patients with end-stage chronic renal failure should receive replacement therapy.

CKD grade 5, uremia, GFR less than 15 ml/min. Actually, at this stage, the patient should receive substitution treatment - hemodialysis or peritoneal dialysis.

• The kidneys practically cease to produce urine, diuresis decreases up to anuria, edema appears and increases, pulmonary edema is especially dangerous.
• The skin is icteric-gray, often with traces of scratching (skin itching appears).
• Uremic toxins tend to bleed more easily, bruise easily, bleed gums, and bleed from the nose. Gastrointestinal bleeding is not uncommon - black stools, vomiting in the form of coffee grounds. This exacerbates the existing anemia.
• Against the background of electrolyte shifts, neurological changes occur: peripheral - up to paralysis, and central - anxiety-depressive or manic states.
• Hypertension is not curable pronounced violations heart rate and conduction, congestive heart failure is formed, and uremic pericarditis may develop.
• Against the background of acidosis, noisy arrhythmic breathing is noted, a decrease in immunity and congestion in the lungs can provoke pneumonia.
• Nausea, vomiting, liquid stool manifestations of uremic gastroenterocolitis.

Without hemodialysis, the life expectancy of such patients is calculated in weeks, if not days, so patients should come to the attention of a nephrologist much earlier.

Thus, the specific symptoms that allow a diagnosis of renal failure to develop develop quite late. Most effective treatment possibly at stages 1-2 of CKD, when there are practically no complaints. But minimal examinations - urine and blood tests - will give fairly complete information. Therefore, it is so important for patients at risk to be regularly examined, and not just to see a doctor.

Which doctor to contact

Chronic renal failure or chronic kidney disease is treated by a nephrologist. However, a therapist, pediatrician, family doctor can also suspect kidney damage and refer the patient for additional examination. Apart from laboratory research, ultrasound of the kidneys and plain radiography is performed.

The human urinary system is responsible for filtering and removing toxic substances and metabolic products from the female body. The kidneys are subjected to the greatest load, which continuously cleanse the blood of harmful chemical compounds.

The detoxification function of paired organs can fail when various pathologies. This condition is called renal failure in women, if left untreated, it threatens to develop severe complications.

Features of renal failure in women

Renal failure is a set of symptoms of a violation of the functional activity of the kidneys, which leads to a breakdown of all types of metabolism. AT this category includes the following types of metabolism:

• water;
• electrolyte;
• nitrous.

Most often, the disease is diagnosed in women and develops against the background of chronic pathologies of the urinary system. If kidney failure is not treated, then after a certain time the probability of death is high.

The predisposition of the female body to kidney disease is directly dependent on anatomical structure their urinary system.

The urethra in women is wider and shorter than in men. Pathogenic microorganisms can freely penetrate the bladder, form inflammatory foci there. Further, along the ascending pathways through the ureters, infectious agents rise to the structural renal elements.

Extensive damage to the parenchyma, calyces, pelvis lead to violations of the processes of filtration and excretion. Stagnation of urine provokes extensive intoxication of cells and tissues. Thus, endogenous and exogenous factors are involved in the formation of renal failure.

In women, kidney failure is diagnosed more often due to the short urethra.

Types and stages of renal failure in women

Symptoms of kidney failure in women depend on the type of pathology or the stage at which the disease is located. There are two types of kidney disorders: acute and chronic insufficiency.
The process of transition from one form to another can take a different time - from several months to 2-3 years. It all depends on general condition women's health, the ability of her body to resist the development of infection.

Acute renal failure occurs under the influence of exogenous or endogenous factors. The disease is characterized by sudden intoxication renal parenchyma, pelvis and calyces, in which they cannot perform the functions of filtering and excretion.

Metabolic products begin to accumulate in the blood:

1. Urea, its inorganic compounds.
2. sulfates, chlorides.
3. Pathogenic microorganisms.
4. Creatinine
5. sugar and nitrogen.

Changes in the composition of the blood require immediate correction with the help of detoxification therapy (hemodialysis), otherwise it may develop oxygen starvation brain cells.
Chronic renal failure is often diagnosed in women. The disease progresses rather slowly clinical picture not expressed clearly, so the person hesitates to visit the doctor.

Every day the number of actively functioning nephrons decreases, and toxins and toxins accumulate in the tissues. The kidneys connect nephrons to work that were not previously involved in the filtration processes, but they are gradually destroyed as well. The end stage of chronic renal failure is the shrinkage of the kidney or the complete loss of its ability to perform its functions.

The acute form of insufficiency is divided into stages of the course of the disease:

1. Prerenal. Pathology develops due to a decrease in renal blood flow. Insufficient blood flow provokes a decrease in the formation and excretion of urine.
2. Renal. The stage is associated with the deformation of the kidney cells. The blood enters in sufficient volume, but the bean-shaped organ cannot fully filter it.
3. Postrenal. The accumulation of urine occurs without disturbance, but its release does not occur due to blockage of the ureters or urinary canal.

Depending on the symptoms and the degree of destruction of cells and tissues of the kidneys, the following stages of chronic renal failure are distinguished:

• latent: electrolyte balance is disturbed, the concentration of protein breakdown products in the blood increases;
• compensated: the number of leukocytes in the urine increases, polyuria occurs;
• intermittent: the content of nitrogen metabolism products, creatinine, urea increases;
• terminal: the kidneys have practically lost their ability to filter the blood and remove toxins.

At this stage, the changes are irreversible. Erythrocytes in the blood are bound by toxic compounds and are unable to carry molecular oxygen to the brain cells. The processes of regulation of breathing are disturbed - pulmonary edema occurs, a person may die.

Causes of kidney failure in women

Acute renal failure most often develops when toxins are ingested. This happens when food poisoning stale food, mushrooms or pharmacological preparations. Women working in the chemical industry may be harmed in an emergency involving the release of environment chlorine, mercury or arsenic vapours.

The cause of acute or chronic pathology can be the following factors:

1. Malignant and benign neoplasms kidneys and adrenals.
2. Tuberculosis of the kidneys.
3. Extensive thermal damage to the skin.
4. The use of anticancer drugs.
5. Exposure to radioactive radiation.
6. Massive blood loss.
7. Chronic diseases of the urinary system: hemorrhagic cystitis, glomerulonephritis, pyelonephritis or incorrect tactics of their treatment.
8. Blood clotting disorders after surgical interventions.
9. Injuries or prolonged compression of the kidneys.
10. Congenital or acquired pathologies of structural renal elements.
11. Diseases of the endocrine system.

Women with chronic pathologies predisposed to kidney failure. This is due to the state of health and the amount of medication used. Drug-induced hepatitis, hepatitis B and C, ascites, cirrhosis often provoke damage to the kidney tissues. In some women, kidney failure occurred after a difficult pregnancy and complicated childbirth.

Pyelonephritis is a prerequisite for the appearance of renal failure

Symptoms of acute renal failure

The first stage of acute renal failure is characterized by symptoms of a condition that caused a violation of the functional activity of the kidneys. If the disease provoked penetration infectious agent, then the woman feels severe headaches, fever, chills, muscle pain. An hour later, malfunctions develop gastrointestinal tract: nausea, vomiting, diarrhea.

When a toxic substance or toxin enters the body, the skin turns yellow, signs of anemia, tremor of the upper and lower extremities appear. Signs of kidney failure

• growing rapidly:
• there is confusion, followed by a deep fainting;
• sweating increases, cold perspiration appears on the forehead;
• the pulse becomes thready;
• arterial hypertension appears, and then the pressure decreases to a minimum.

Infectious diseases of the urinary system (glomerulonephritis, pyelonephritis) are accompanied by painful sensations in the lumbar region, urination disorders, excretion of urine with blood impurities.

The second stage of acute renal failure is manifested by the following symptoms:

1. Urine ceases to be excreted or its volume is negligible.
2. The person loses consciousness and then falls into a coma.
3. Body weight increases due to the development of swelling of the subcutaneous tissue.
4. The brain and lungs swell.

If a health care delivered on time, then the probability favorable outcome great. First, a small amount concentrated urine, and then urine is formed in an increased volume. Thus, the urinary system gets rid of accumulated toxins, toxins, metabolic products. After a while, the kidneys begin to function actively.

In the case of improper therapy or its absence, a pronounced terminal stage of acute insufficiency develops. It is characterized by the following symptoms:

• copious sputum, foam;
• internal and subcutaneous hemorrhages;
• deep fainting;
• convulsions of the upper and lower extremities;
• disorders of the cardiovascular system.

At this stage of the disease, it is almost impossible to help a person. After a short time, death occurs.

Signs of chronic renal failure

Symptoms of chronic renal failure are absent at the initial stage of the disease, the woman's health is normal and practically does not differ from her usual state. As the deformation and destruction of nephrons, negative signs increase:

1. Dehydration develops due to a violation of urine output. Its formation is twice the norm, urination for the most part occurs in night period. With the aggravation of the pathology, the frequency of urination decreases significantly, the urine acquires a dark brown color and an unpleasant odor.
2. Fatigue and weakness increase, apathy and insomnia occur.
3. Work digestive tract upset, the woman is tormented by nausea, vomiting, flatulence, sour belching, diarrhea or constipation.
4. Limbs are constantly twitching, regular hand trembling develops.
5. Dryness and bitterness appear in the mouth.
6. Blood clotting decreases, extensive hemorrhages occur throughout the body.
7. Blood appears in feces and urine.

The body's resistance to infectious diseases decreases, there are frequent recurrences of acute respiratory infections, SARS, influenza. In women, menstruation stops completely. All chronic diseases are exacerbated, especially of the human endocrine system. Symptoms at the end stage of the pathology are similar to signs of acute renal failure and can cause death of a person without immediate detoxification therapy.

CT is used in diagnosing kidney failure in women

Diagnosis of kidney failure

When diagnosing acute renal failure, it is important to identify the cause of the disease. If the death of nephrons is caused by a pathogenic microorganism or poison, its nature must be determined for the correct administration of an antidote. A bacteriological study of urine is carried out to detect the pathogen, to determine the degree of its sensitivity to antibiotics.

For diagnosis, the patient is prescribed general blood and urine tests. In acute and chronic renal failure, a urine test shows:

• urine density is reduced or increased depending on the type of pathology;
• low content of protein metabolism products;
• red blood cells appear with injuries, neoplasms, bacterial infections;
• the concentration of leukocytes increases with exacerbation autoimmune pathologies, infections.

A general blood test helps to assess the level of negative changes in the body:

1. The concentration of leukocytes increases, which indicates the presence of infectious foci.
2. Developing Iron-deficiency anemia- the content of erythrocytes, platelets, hemoglobin decreases.

Biochemical analysis blood reveals the following changes in its composition:

• the level of calcium, phosphorus, magnesium, potassium changes;
• increases the content of the amino acid creatine;
• The pH of urine shifts to the acid side.

To assess the condition of the kidneys, bladder, urinary tract, the following are performed:

1. CT scan.
2. Dopplerography to assess blood flow.
3. Radiography is used for respiratory disorders and the detection of pathology that caused kidney failure.

To examine the bladder, the patient is prescribed chromocystoscopy. After the introduction contrast agent a thin endoscope with a built-in camera is inserted into the cavity.

If a neoplasm that caused renal failure is suspected, histological and cytological studies are performed, as well as a kidney biopsy. With a special needle, the doctor takes a small piece of kidney tissue for analysis. As a rule, a biopsy is performed when diagnosing a chronic pathology.

Hemodialysis is used to treat acute and chronic kidney failure in women

Treatment

At the first stage of therapy for acute renal failure, it is urgent to restore homeostasis and eliminate disturbances in the functioning of the kidneys. Carrying out detoxification therapy helps to cleanse the blood of toxins and toxins, to establish normal urine output.

For these purposes, the following procedures are used:

• hemodialysis;
• plasmapheresis;
• hemosorption.

Detoxification is accompanied by the introduction of drugs with a high content of sodium, potassium, calcium in order to restore the water and electrolyte balance in the body. Dopamine helps improve blood flow to the kidneys.

For better removal harmful products exchange, sparing diuretic drugs (Girothiazide, Trigrim, Diakarb) are used. Attached bacterial infection eliminated by course (10-14 days) antibiotics: cephalosporins, Amoxiclav, Clarithromycin.

Chronic renal failure requires long-term therapy. After eliminating the cause of the disease, the treatment is aimed at strengthening the woman's body and eliminating the health problems that have arisen:

1. With anemia, iron preparations are prescribed: Sorbifer, Fenyuls.
2. Gastrointestinal diseases are treated with antacids, probiotics, and a strict diet.
3. Puffiness is eliminated by mild herbal diuretics (half-fall, bear ears).

In the last stages of the disease, patients require constant hemodialysis in a hospital. If the kidney cannot be saved, then such blood purification becomes a lifelong necessity. An alternative would be a donor kidney transplant.

Content

Renal failure - symptoms of malfunctions in the secretory, excretory and filtration functions of the kidneys, a late stage or severe degree of the disease have a chronic symptom and lead to the destruction of the kidney tissue. The functioning of the kidneys is impaired due to a traumatic condition or due to inflammatory processes occurring in the body.

What is kidney failure

Renal failure is a disease caused by a malfunction of the kidneys. They stop forming and excreting urine, which leads to a failure in the regulation of the water-salt, osmotic state of the body, and then causes acidosis (violation of the PH level). Deficiency can be acute or chronic. Acute occurs abruptly, as a result of shock from an injury or intoxication. Chronic proceeds in several stages.

Causes

ROP occurs when external influence on the body. At timely treatment runs almost without severe consequences. Factors that provoke the disease:

• injury;
• burn;
• toxic effects of poisons or drugs;
• infection;
• acute kidney disease;
• violation of the patency of the upper urethra.

The acute stage can develop into a chronic one. Serious diseases of the internal organs and severe illness requiring constant medication:

• stones in the kidneys;
• cardiovascular disorders;
• diabetes;
• hypertension;
• hepatitis B, C;
• chronic glomerulonephritis;
• chronic pyelonephritis;
• cysts;
• anomaly of the urinary system;
• intoxication.

Classification

AKI varies in form, course, and severity. According to the course of the disease, it is divided into 4 phases, from the initial period to the stage of recovery. By severity, there are 1, 2 and 3 degrees, depending on the amount of creatinine in the blood. By the nature of the site of kidney damage, acute renal failure occurs:

• Prerenal acute. It is caused by a violation of the hemodynamics of the blood.
• Parenchymal (renal). Occurs due to toxic or ischemic damage to the kidneys, infection or inflammation.
• Obstructive (postrenal) - a consequence of obstruction of the urethra.

HPN proceeds in several stages. Depending on the degree of damage to the cells of the renal tissue, the stages of the disease are classified:

• latent stage. Main signs: dry mouth, fatigue, protein in the urine.
• compensatory stage. Increased daily urine output (up to 2.5 liters), with characteristic changes in composition, abdominal pain and urination. There are symptoms of intoxication.
• intermittent stage. Progression of impaired renal function, nausea, vomiting, lack of appetite, discoloration and condition of the skin, increased urea, creatinine in the blood.
• Terminal stage. Complete failure of the kidneys, death of kidney tissue. The electrolyte composition of the blood is disturbed, anuria occurs. Complications: pulmonary edema, heart disease, hormonal disbalance, worse blood clotting, weak immunity, disruption of the CNS.

Diagnostics

In the early stages of development, the symptoms of the disease are similar to the usual malaise. For a more accurate diagnosis, laboratory tests are used. How to identify kidney failure:

Method of laboratory research
General analysis urine	Presence of sediment. The level of protein and red blood cells indicates stones, infections, trauma, tumors. The level of leukocytes changes with infection and low immunity.
Bacteriological examination of urine	The causative agent of kidney infection is determined, incl. secondary. Appointed antibacterial drugs according to the reaction of the pathogen.
General blood analysis	increase in leukocytes and ESR level talk about infection. A decrease in red blood cells and white blood cells indicates anemia.
Blood chemistry	Assesses the degree of pathology. Measure: calcium; phosphorus; potassium; creatine; PH level.	The presence of chronic renal failure is determined by the level: urea; squirrel residual nitrogen; creatinine; cholesterol; hyperkalemia.
Ultrasound, CT, MRI	The internal structure of the kidneys helps to determine the degree of tissue damage, the bladder - to identify violations of the patency of the urethra.
dopplerography	Blood flow in the vessels of the kidneys.
X-rays of light	condition of the upper respiratory tract.
Chromocystoscopy - staining and examination of urine	In urgent situations
Kidney biopsy	Clarification of the diagnosis
	Identification of cardiac disorders.
Zimnitsky test: measuring the composition and volume of urine up to 8 times a day		The functions of the kidneys.

How does kidney failure manifest in humans?

Renal failure is manifested by impaired urination. The daily amount of excreted fluid decreases sharply up to anuria, nausea, swelling appear, the skin becomes dry and flabby with a yellow tint. Later, sweating increases as a result of the removal of toxins from the body. alternative way and sweat has a strong smell of urine.

First signs

In the early stages, the disease may present with abdominal pain. Symptoms are similar to poisoning the body or a simple viral infection. Common Syndromes:

• headache;
• nausea;
• vomit;
• dryness and bitterness in the mouth;
• diarrhea;
• convulsions;
• skin itching;
• abdominal pain;
• nosebleeds;
• swelling, bruising.

Acute

With acute renal failure in the early stages of clinical symptoms are not observed, because. the disease that provoked it is clearly manifested. Signs appear later: acute uremia occurs, anuria and polyuria (a sharp increase in urine volume). AKI is provoked by external damage to the kidneys, infections, toxins, side effects medicines.

Chronic

CRF is accompanied by the death of nephrons, cells of the kidney tissue. In violation of homeostasis and death significant amount of nephrons, efficiency decreases, dries the skin, and is tormented by thirst. The terminal stage leads to dystrophy due to a decrease in appetite, a change in the color and structure of the skin, muscle damage, the appearance of convulsions, skin itching, vomiting, diarrhea, and bloating. There is an odor of ammonia from the mouth and urine from the body. If left untreated, serious complications occur, incl. pulmonary edema, uremic coma.

Cardiorenal

CRF causes cardiovascular failure, leads to a decrease in blood flow in the heart, heart rhythm disturbances, and a decrease in the concentration of oxygen in the blood. Complications:

• arterial hypertension;
• lowering blood pressure;
• hypertrophy, diastolic and systolic dysfunction of the left ventricle;
• atherosclerosis;
• ischemia;
• chronic heart failure;
• arrhythmia;
• valvular disorders of the heart.

Hepatic-renal

CRF occurs when there is a change in blood circulation in the kidneys. Renal blood flow is disturbed, anemia develops renal arteries. The condition is aggravated by the use of alcohol, medication, local anesthesia. The disease progresses rapidly, urine output decreases sharply, the liver and kidneys fail, and toxic poisoning organism. Complications:

• damage to the digestive tract;
• pulmonary edema;
• osteodystrophy (violation of the structure of bone tissue);
• failure of other internal organs;
• encephalopathy.

heavy

The disease occurs with a significant death of the nephrons of the renal parenchyma - the building tissue of the kidneys. Nephron damage is an irreversible process, therefore late stage treated surgically, through the introduction of a catheter into the abdominal cavity to remove urine from the body. At the most severe forms artificial kidney implantation is required.

Symptoms in women

Women have special structure urinary system. The urethra in the female body is shorter and wider than in the male, which contributes to the unhindered penetration of infections into the bladder. The inflammatory process in the ureters rises to the kidneys. The ingress of toxins, poisons and drug waste is especially dangerous, as is hormonal disorders. Renal failure may present as a pathology after pregnancy or gynecological treatment, and may develop into chronic uremia.

Signs in men

The male urethra is narrow and elongated. Renal failure can occur with uremic pericarditis, blockage of the urinary canal, urolithiasis, inflammation of the genitourinary system. There is an inverse relationship - stones are formed in the bladder, the urethra becomes inflamed, prostate. All of the above is a consequence of kidney disease.

During pregnancy

Acute and chronic renal failure for a pregnant woman becomes a risk when carrying a fetus, which provokes miscarriages, fading of pregnancy, early birth and stillbirth. A complication during pregnancy is hypertension. The onset of the terminal stage during childbearing requires early delivery in order to save the life and health of the baby.

Video