Every person suffering from at least some chronic pathology should know about the first signs of death of kidney tissue, which is called renal necrosis.
Necrosis of the kidney
Necrosis of the kidneys is the process of necrosis of the cells of the kidney tissue. As a result of the research, it was found that for the necrosis of the kidney, the swelling of the cells and protein structures in them is characteristic, followed by destruction( lysis).
Necrotic changes in the kidneys can occur due to severe intoxication of any poisonous substances, as a result of the development of autoimmune processes in the human body. Quite often, the cause of the destruction of kidney cells is a decrease in blood flow in the organ itself. With a decrease in the degree of blood supply, ischemia and hypoxia of the kidney cell system develops, and then cell destruction.
Infringement of inflow of blood to a kidney can arise because of a thrombosis of renal vessels or obturation of urinary tracts by a stone or a neoplasm.
In children, this pathology occurs against a viral or bacterial disease as a complication of dehydration( with excessive vomiting or diarrhea).
Types
Necrosis of epithelial cells of convoluted tubules
Toxic substances affect the most sensitive parts of the kidneys - the epithelium of the tubular apparatus.
As toxic substances may act:
- Pesticides that are part of various poison agents or detergents;
- Heavy metal compounds, often mercury, lead and arsenic;
- Ethylene glycol is a representative of organic solvents.
A.- Non-nuclear cells;B. - Preserved nuclei in the cells of the Henle loop;Q. The vessels are filled with blood and dilated.
A possible cause of acute tubular necrosis may also be a trauma involving a strong squeezing of the organ, as a result of which the inflow of blood to the renal tubule is impaired.
This type of necrosis is manifested by acute or gradual urinary retention, initially blood appears in the urine, the frequency of urination decreases per day. Very often patients feel discomfort and sharp soreness in the lumbar region. The patient may be feverish. Such symptoms arise due to the development of a dangerous pathological condition with kidney dysfunction - kidney failure.
Cortical
Necrosis of the cortical substance of the kidneys( cortical) can often be found in newborns or in pregnant women.
Pathogenetic necrosis of the cortex is caused by increased intravascular coagulation of blood locally in the kidneys or totally( in the bloodstream of the entire body).Blood is folded intensively due to a decrease in the level of fibrinogen and an increase in the concentration of thromboplastin and thrombin. There is a blockage of blood-bearing( afferent) renal arterioles, which leads to a violation of blood supply and wrinkling of the kidney.
As a consequence of conducting a criminal abortion in inappropriate conditions, bacteria enter the bloodstream and release toxins. The sharp supply of such toxins in large quantities in the blood provokes the development of a shock state( endotoxic shock).
Quite often, necrotic changes in the cortical layer result in the deposition of calcinates.
Symptoms for this type of pathology can be diverse: there is urination with blood, the frequency of urination decreases until it is completely absent. There may be pain in the back( lower part), in the abdomen, vomiting and severe nausea, fever. If the process of intravascular coagulation is total, the symptoms of defeat of other organs are attached. On the skin there are hemorrhages.
Papillary
The main etiological factor in the development of necrotic changes in the cells of the papillae is a bacterial infection. Bacteria can enter the pelvis from the outside through the urinary tract, and can also be transferred to the kidney with blood( hematogenous pathway).When the pressure of urine in the pelvis increases, the bacteria spread to one or more papillae. As a result, lysis of cells develops, blood flow to the pyramids of the kidneys is disrupted.
Symptomatology is represented by a pronounced feverish condition, macrogematuria, pain syndrome, marked intoxication symptoms.
Caseous
Necrosis of kidney tissue of a caseous type usually develops on the site of growth and development of tuberculosis or syphilitic granulomas( sprouting).Often the cause of this pathology can serve as a disease, such as leprosy. Caseous areas resemble cheesy mass when examined. Under the microscope, the homogeneous nature of the kidney tissue is noted, broken cells and connective tissue fibers.
The diagnosis of tuberculosis and syphilis for initial clinical manifestations is rather complicated. There can be periods of a significant rise in body temperature, a long time to detect leukocytes and erythrocytes in the urine in large quantities.
Confirm the diagnosis can be in the implementation of laboratory and instrumental studies. The most informative method of diagnosis is a puncture biopsy of the kidney.
Focal
Focal necrosis of renal tissue is usually caused by bacterial flora( syphilis, tuberculosis, leprosy and some other diseases).Symptomatics is similar to that of the above forms of kidney necrosis.
Treatment of
The main principles of treating kidney necrosis are to eliminate the root cause of the pathological process. For this it is necessary to carry out a full clinical and laboratory examination.
Therapeutic measures depending on the etiology and pathogenetic mechanisms of the disease:
- Antibiotic therapy;
- Improvement of hemodynamics( anticoagulant therapy);
- Elimination of obstructive urinary tract syndrome( catheterization of the renal pelvis and nephrostomy formation is possible).
- Elimination of signs of renal failure and excretion of toxic substances( by hemodialysis);
- For the removal of the pain syndrome prescribe antispasmodics or non-narcotic / narcotic analgesics.
Surgical interventions are performed only in severe cases of the disease. If necrosis covers almost the entire area of the kidney, then its complete removal( nephrectomy) is performed.
If the cause of necrosis is the thrombosis of the vessel, then thrombectomy is widely used, angioplasty using a balloon.
Warning! In order to prevent necrosis of the kidney tissue, it is recommended to carefully treat your health, monitor the condition of the cardiovascular, endocrine, genito-urinary systems. And with the appearance of the slightest alarming symptoms, you should immediately consult a doctor!