Chronic renal failure – This is a serious condition of the body, the essence of which is the gradual cessation of the kidneys from performing their functions. It develops in various pathologies of the urinary system and is characterized by the gradual death of a large number of renal nephrons, and therefore, the kidneys stop working normally. Chronic renal failure can develop over the years and, if timely medical care is not provided, leads to the death of the patient, so the main goal of treating diseases of the urinary system is to prevent the development of chronic renal failure.

Why does chronic renal failure develop?

Any severe pathology of the kidneys or other structures of the urinary system, in the absence of adequate therapy, can lead to the development of such a serious condition as chronic renal failure. Most often, the symptom complex of chronic renal failure occurs against the background of a severe course of such diseases:

  • chronic glomerulo- and pyelonephritis;
  • glomerulosclerosis;
  • congenital and acquired disorders of renal tubular function;
  • bilateral anomalies in the structure of the kidneys and ureters;
  • vascular pathology;
  • diseases of the kidneys of metabolic origin;
  • obstructive urinary tract disease.

Course of chronic renal failure: stages of the disease

There are 4 stages during chronic renal failure:

  1. Latent chronic renal failure: the symptoms of the disease are mild. Glomerular filtration – up to 60 ml/minute. There is disaminuria, the appearance of protein in the urine can be observed periodically.
  2. Compensatory chronic renal failure is a period of adaptation of the organism to renal pathology. Glomerular filtration rate drops to 40 ml/minute, urine osmolarity decreases, and electrolyte disturbances may occur.
  3. In the stage of intermittent chronic renal failure, glomerular filtration does not exceed 25 ml / minute, disturbances in the water-electrolyte and acid-base state are more pronounced, periods of improvement and deterioration of the patient's condition alternate.
  4. The end stage of chronic renal failure is characterized by the development of non-reversible processes, and is divided into three periods:
  • in the first period, diuresis is more than 1 liter / day, clearance is reduced to 10 ml / minute, moderate acidosis occurs;
  • in period IIA, oligoanuria occurs, diuresis decreases to 300 ml / day, dizelektrolitemia, hyperazotemia and acidosis. The functions of the circulatory organs are impaired;
  • in period IIB, heart failure worsens, the patient's condition worsens significantly;
  • the third period is characterized by severe uremia, hyperazotemia, dizelektrolithemia and the development of decompensated acidosis. Heart failure at this stage is also decompensated. Dystrophic changes occur throughout the body.

Clinical course of chronic renal failure

 In accordance with the changes that occur with the kidneys during chronic renal failure, a characteristic clinical picture also develops. There are several degrees of chronic renal failure:

  1. In the first degree of chronic renal failure, the symptoms of the disease are virtually absent. There may be only such general symptoms as decreased performance, increased fatigue, and sometimes nocturia. With the help of instrumental research methods, a slight decrease in kidney function can be established.
  2. The second degree of chronic renal failure is manifested by symptoms of a clear impairment of kidney function: anorexia, frequent urination, thirst, nocturia and hypoisosthenuria. The general condition of the patient worsens, but the pathology of other organs and systems does not appear in this period.
  3. At grade 3A, both kidney function and homeostasis are severely disrupted. The symptoms of impaired renal function are accompanied by symptoms indicating a pathology of the circulatory system: anemia, arterial hypertension, papilledema and retinal hemorrhages occur, water and electrolyte imbalances appear.
  4. In stage 3B, chronic uremia syndrome develops: the functions of both the kidneys and other organs and systems are sharply impaired, the patient's condition is extremely serious, which is associated with the development of circulatory failure, external and internal edema. Infectious processes that develop during this period in the body are often the cause of death.

Treatment of patients with chronic renal failure

Treatment of chronic renal failure implies, first of all, the elimination of the underlying disease that provoked such a condition. Further therapy is carried out depending on the stage of chronic renal failure. Patients are prescribed a diet with limited salt intake, cardiac glycosides, vitamin preparations, anabolic steroids, and correction of water and electrolyte balance and acid-base status is carried out. In a severe course of the disease, extrarenal blood purification is necessary – hemodialysis. Such therapy can prolong the patient's life for years, but complete recovery in severe stages of chronic renal failure is possible only after a kidney transplant.

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