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Kidney failure

  Renal failure is the development of a variety of chronic kidney disease caused by the late part or all of renal function loss of a pathological state. Renal failure can be divided into acute renal failure and chronic renal failure, rapid progression of acute renal failure, usually due to insufficient renal blood supply (such as trauma or burns), kidney obstruction caused by a function of impaired or impaired Of the injury, causing acute renal failure. The main reason for chronic renal failure is a long-term kidney disease, with the time and disease, the function of the kidney gradually decreased, resulting in renal failure.

  Etiology

  Acute renal failure

  Usually due to insufficient renal blood flow (such as trauma or burns), the kidneys caused by a factor blocking the function of damage or damage caused by toxic substances, causing acute renal failure.

  2. Chronic renal failure

  Because of long-term kidney disease, with the time and disease, the function of the kidney gradually decreased, resulting in renal failure.

  classification

  Acute renal failure

  Rapid progression of acute renal failure, usually due to insufficient renal blood supply (such as trauma or burns), kidney obstruction due to some factors cause damage or damage by poison, causing acute renal failure.

  2. Chronic renal failure

  Chronic renal failure refers to a variety of renal disease caused by slow progressive renal damage and eventually lead to complete loss of uremia and renal function, causing a series of clinical symptoms and biochemical endocrine and other metabolic disorders of the clinical syndrome, from the primary disease Disease to the beginning of renal insufficiency, the interval can be several years to more than ten years.

  Clinical manifestations

  1. oliguria period

  The most critical stage of the disease, serious environmental disorders. Patients with oliguria (<400 ml / day) or anuria (<100 ml / day), low specific gravity urine (1.010 ~ 1.020), high urinary sodium, hematuria, proteinuria, tubular urine. Severe cases can occur in patients with water intoxication, hyperkalemia (often for this period cause of death), metabolic acidosis (can promote the occurrence of hyperkalemia) and azotemia (progressive increase may occur uremia) Endanger the lives of patients. This period lasts a few days to several weeks, the longer the prognosis is worse.

  2. polyuria period

  Oliguria gradually increased urine output, when the daily urine output more than 500 ml, that is, into the polyuria. Since then, urine daily doubled, the maximum daily urine output of 3000 to 6000 ml, or even 10,000 ml or more. In the polyuria initial, although increased urine output, but the kidney clearance rate is still low, the accumulation of metabolites in the body is still there. About 4 to 5 days later, serum urea nitrogen, creatinine and so on with urine volume increased gradually decreased, uremia symptoms also will be improved. Potassium, sodium, chlorine and other electrolytes from the urine can cause a large number of electrolyte imbalance or dehydration, should pay attention to the peak period of oliguria may be converted to hypokalemia. This period lasted 1 to 2 weeks.

  3. Recovery period

  Urine volume gradually returned to normal, 3 to 12 months of renal function gradually restored, most patients with renal function returned to normal levels, only a small number of patients to chronic renal failure.

  an examination

  1. Blood routine examination

  Significant anemia, normal cell anemia, white blood cell count normal or increased. Platelet reduction, cell settlement rate.

  2. Urine routine examination

  With the original disease varies. The common points are:

  (1) urine osmolality decreased low proportion, more than 1.018 in the following, fixed in between 1.010 ~ 1.012 serious, for urine concentration dilution test when nocturia is greater than the amount of urine, the urine specific gravity of more than 1.020, the highest and lowest Of the urine specific gravity is less than 0.008.

  (2) decreased urine output more than 1000 ml per day in the following.

  (3) quantitative increase in urinary protein due to the vast majority of glomerular damage has been, but decreased urinary protein.

  (4) urinary sediment examination can vary the number of red blood cells, white blood cells, epithelial cells and granular tube, wax-like tube type of the most meaningful.

  3. renal function tests

  The indicators suggest renal dysfunction.

  4. Blood biochemical examination

  Plasma albumin decreased, low serum calcium, phosphorus increased, serum potassium and serum sodium with the disease may be.

  5. Other inspections

  X-ray lithography and angiography, isotope renography, kidney scan, renal biopsy, etc., for the diagnosis of the cause of help.

  treatment

  1. Etiology treatment

  Treatment of renal failure caused by factors such as insufficient blood supply or blood loss, it will give patients added to lose body fluids and water; if there is infection for further treatment of infection.

  2. renal function

  Because the kidneys have lost function, so doctors will temporarily use dialysis treatment (commonly known as dialysis), to help rid the body of toxins and waste; acute renal failure patients without proper treatment or uncontrollable, the disease evolved from the acute Chronic renal failure, it may be due to uremia and life-long dialysis.

  Dialysis refers to the selective exclusion of certain substances in the blood by filtration. In other words, through the artificial way the patient in renal failure after accumulation of toxic waste in the body, water and salt exclusion, so that the patient's physical condition to return to health. Currently there are two forms of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis is a special machine to replace the function of the kidney. Peritoneal dialysis is to use the body's peritoneum as a filter to remove toxins from the body.

  3. Diet aspects

  Dietary control, for patients with renal failure, due to damage to renal function, food in the body after eating, the resulting toxins and waste, can not be excreted in vitro, so the diet must pay special attention to avoid causing physical burden .

  4. Renal transplantation therapy

  Some patients with end-stage renal failure require long-term dialysis treatment, in patients with their own conditions are appropriate, kidney transplantation (kidney transplant) can bring better quality of life for patients, but kidney transplant is a big project, although the current medical technology has been Very good, still need to do a lot of prior assessment, in order to improve the chances of success of kidney transplant.

  Kidney transplantation is the process of transplanting the kidney of an organ donor to a transplanted patient by surgery. Possible sources of kidney: family, spouse, close friend or brain death, and signed to agree to donate organs. Of course, the best matching kidneys usually come from siblings who are transplanted because their genes are most likely to match.

  Kidney transplantation is currently the best way to treat kidney failure, because transplanted to the patient's kidney can almost completely replace the depleted kidney function, so that patients live a normal life.

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