Kidney pathologies are common in medical practice quite often. This is a large group of diseases that unites the defeat of kidney tissues. One such pathological process is renal nephrosis, which has many variations and a polysymptomatic clinical picture. Kidney nephrosis - what is it?
Nephrosis is called dystrophic processes in the renal parenchyma, accompanied by the regeneration of tubules and connective tissue structures of the kidney. As a result of such a disease, nephrotic syndrome, nephropathy and violations of the filtration function of tubules, oliguria develop. Another name for nephrosis is a toxic infectious kidney, which clearly reflects the specific nature of the disease associated with intoxication. Pathology develops in acute and chronic forms, which have many common manifestations.
Dystrophic nephrotic changes lead to thinning of the tubular tissue, which causes urinary excretion of blood proteins. A similar factor causes a decrease in the kidney volume and a violation of protein metabolism, which immediately affects the entire body. Nephroses are diagnosed more often in patients of childhood and adolescence, which experts explain by the weakness of the abdominal cavity of the growing organism, especially at 2-6 years of age.
The main causes of
Etiological factors in this pathology are sufficient, but experts identify a group of underlying causes, most often acting as a nephrosis provocateur:
- Intestinal obstruction;
- Genetically determined disorders of protein metabolism;
- Extensive burn injuries and traumatic complications;
- Infectious pathologies occurring in a chronic or severe with complications form;
- Systemic disorders such as rheumatism or amyloidosis;
- Blood transfusion of an incorrectly selected group, which caused a complication;
- Acute toxic poisoning;
- of Oncology;
- Long-lasting toe of compression underwear compressing the kidney area.
In women, renal nephrosis can develop against a background of aseptic necrosis during postpartum recovery. It is not necessary to exclude and hereditary factor, because the presence of nephrosis in parents increases the risk of its occurrence in the child. In a significant number of patients, poisoning with ethylene glycol vapors provoked nephrosis. These substances are present in the antifreeze liquid used in automotive cooling systems. There have been cases when the disease developed against the background of complications of bacterial origin characteristic of pathologies such as malaria, cholera, plague, etc.
Classification of
Renal nephrosis can occur in acute or chronic form, as mentioned above. And the lesion can affect both the right and left kidneys. Experts classify acute nephrotic forms as necrotic and posttransfusion. Chronic nephrosis usually occurs in the form of lipoid, amyloid and myoglobinuric kidney lesions.
Lipoid
Lipoid nephrosis is characterized by a rare occurrence and a slight change in renal structures. This form of the disease, as a rule, has a secondary character and develops against the backdrop of the already existing infection in the body, such as tuberculosis or syphilis. In addition, chronic intoxication of the body with toxic substances and heavy metal compounds can provoke lipid nephrosis.
The main factor in the development of such a nephrotic type is the sudden disruption of lipid and protein metabolism, which disrupts capillary permeability in the glomerular structures. The blood protein molecules penetrate through the capillary walls, causing their dystrophic changes. In addition, the mechanisms of autoimmune character promote the development of this nephrotic form.
Necrotic
Necronephrosis refers to acute renal lesions and is characterized by malfunctions in the nutrition and blood supply of the tubular structures, as a result of which necrotic epithelial tissue lesions develop. Against the backdrop of similar pathological processes, acute kidney failure is formed in patients, the volume of urine is significantly reduced, filtration processes are violated.
If the necessary therapeutic assistance is not available, in addition to dystrophic lesions, the tubule is exposed to toxic lesions. And if toxins act with increased aggressiveness, then the probability of development of shock renal pathology is great.
Amyloid
A similar type of nephrosis occurs against the background of primary or secondary amyloidosis. The primary type of pathology is caused by genetic protein-metabolic disorders, and secondary - by infectious lesions. When the amyloid is localized in the kidney structures, there is an active lesion of the glomerular system, which causes deviations in the filtration activity. As a result, the amyloid type of nephrosis is formed.
Posttransfusion
This is a specific type of necrotic nephrosis that develops as a result of infusion of a variety of biological fluids or drug solutions that cause a powerful release of histamine, serotonin, thromboxane, prostaglandin and other inflammatory mediators. In the blood can appear clots and clots, which serve as the basis for the formation of amyloids.
Most often, a similar form of nephrosis occurs against the background of a blood transfusion of an inappropriate group, which leads to the destruction of erythrocyte blood cells and the development of renal shock.
Myoglobinuric
This is an acute renal failure of alcoholic origin, which often leads to acute kidney failure. Myoglobinuria nephrosis is a characteristic disease for patients suffering from a combined heroin-alcohol dependence. Against the backdrop of chronic alcoholism and heroinism, membrane-cell structures are damaged, microcirculation of the kidneys and aerobic glycolysis are disturbed. This leads to an extreme degree of damage to the muscular tissues( rhabdomyolysis), and then myoglobinuria, when the pigment of myoglobin is present in the urine, staining it in a brownish-red color.
Myoglobin in urine indicates the breakdown of muscle tissue proteins. When myoglobin accumulates in the kidney tissues, it causes their dystrophic changes, i.e. myoglobinuric nephrosis.
Symptoms and signs
The clinical picture of nephrosis often has a weak degree of severity, therefore it is rather difficult to diagnose pathologies at early stages. Initially, patients may be worried about minor swelling of the legs and abdominal area. At later stages, puffiness becomes strongly pronounced, so it is difficult not to notice it.
Lipoid nephrosis is characterized by symptoms like:
- Lack of appetite;
- Fatigue;
- Increased weakness;
- Puffiness on the limbs and face;
- Increasing swelling, spreading to the genitals and lower back;
- of hydrothorax and ascites;
- Hypopolyvitaminosis;
- Tachycardic manifestations;
- Oliguria with high urine density.
Amyloid nephrotic lesion is accompanied by edema and fever, anemia and proteinuria, muscle pain and gastrointestinal lesions, changes in the skin surface and joint structures. The spleen and liver can increase, liver functions are impaired.
Posttransfusion nephrosis is characterized by a rapid onset. There are signs like:
- Breast, head and lumbar pain;
- Strong, literally shaking chills;
- Bronchospasm;
- Nausea;
- Redness, followed by blushing skin of the skin with a protruding sweat;
- Severe hyperthermia;
- Respiratory difficulties;
- Rapid reduction in blood pressure;
- Convulsive attack with involuntary urination or defecation.
Urine in post-transfusion nephros becomes reddish-brown. When the patient is removed from the shock state, oliguria and jaundice begin to develop. They progress, there is an increase in the liver and spleen.
Treatment of
In general, nephrosis therapy is based on such principles as:
- Elimination of a provoking etiologic factor;
- Elimination of puffiness;
- Restore protein balance.
Necrotic nephrosis develops against a background of toxic lesions, therefore, the elimination of the underlying cause is based on the removal of toxins from the body and the relief of renal shock. This type of nephrosis is not cure, so therapy is directed to stop necrotic processes. With the lipoid form of pathology, the basis of therapy is the elimination of an infectious focus, for which the patient is usually prescribed antibiotic therapy and this species is completely curable.
The most difficult from the therapeutic point of view is amyloid nephrosis, which requires complex treatment, including medications and diet therapy. The patient's diet is based on fruits and fresh vegetables with the mandatory exception of potassium-containing products and water loads. The patient is prescribed diuretic drugs( Novazurol, Lasik, Novourit), blood transfusions and the intake of albumins. With large protein losses, the diet is supplemented with meat and eggs, and preparations for protein recovery are prescribed.
If edema is not eliminated by physiotherapeutic and medicinal methods, then more invasive methods of treatment are resorted. Under the skin, special needles are placed in the fiber layer, through which excess liquid exits outwards. Sometimes drainage needles are left for several days.
If a complete renal failure system develops, then an operation is proposed that involves replacing the sick organ with a donor one. However, the survival rate of the transplanted kidneys, according to statistics, does not exceed 75%.
Forecasts
Unfortunately, renal disorders in nephroses are irreversible, which seriously complicates the prognosis of the disease. With adequate and timely therapeutic effect, the disease can be cured definitively. In chronic forms of nephroses, it is extremely important to undergo annual sanatorium treatment. But the amyloid type of nephrosis in terms of cure is characterized for the patient by unfavorable prognosis. Positive dynamics of treatment takes place only with timely diagnostic and therapeutic actions, but, unfortunately, they do not guarantee a final recovery.