Kidney nephrosis - what is it?
Renal nephrosis is a disease that develops against the background of degenerative changes in the kidney tubules and is accompanied by a violation of protein metabolism. The causes of nephrosis (nephrotic syndrome) are varied. Nephrosis can occur as a result of damage to the kidneys themselves, or as a result of other diseases of the body. Accordingly, distinguish between primary and secondary nephrosis.
With kidney nephrosis, the kidney tubules, which are responsible for filtering urine, suffer. The permeability of the tubules increases, and blood proteins begin to leak through them, leading to their loss during urination. As a result, the body begins to suffer from a malfunction in metabolic processes.
Causes of renal nephrosis:
- Disorders of protein metabolism at the genetic level.
- Complications of infectious diseases that are chronic or severe.
- Systemic diseases: rheumatism, amyloidosis, sarcoidosis.
- Kidney disease: nephroptosis or glomerulonephritis.
Renal nephrosis is a disease that is not widespread. It is most common among children and adolescents, although it can develop at any age. The first signs of nephrosis most often appear at the age of 2 to 6 years. Girls suffer from the disease less often.
According to statistics, out of 7 million people, nephrosis is diagnosed in 50-60 children. The increase is from 20 to 25 new patients per year. Out of 100 thousand children under the age of sixteen, nephrosis is diagnosed in an average of 2 people.
- Classification of the disease
- The main symptoms of kidney nephrosis
- Renal nephrosis treatment
- Treatment prognosis
Classification of the disease
Renal nephrosis is usually classified according to the etiological factor, since depending on this, the symptoms of the disease will differ.
Lipoid nephrosis is extremely rare and is characterized by damage to the tubules of the kidney, which proceeds according to the dystrophic type. Lipoid nephrosis is a consequence of any disease of the body. So, tuberculosis, malaria, dysentery, syphilis, lymphogranulomatosis, and heavy metal poisoning can provoke dystrophic changes in the kidneys.
The capillaries of the renal glomeruli lose the ability to normal filtration due to a sharp disruption in lipid and protein metabolism.
Plasma proteins leak through the capillaries and accumulate on the epithelium of the renal tubules. This leads to the development of dystrophic changes in them. Most scientists believe that the cause of lipid nephrosis is autoimmune processes in the body.
Necrotizing nephrosis or necronephrosis
This type of nephrosis develops as an infectious-toxic kidney damage. In this case, a violation of their blood supply occurs, which leads to the death of the tissues lining the renal tubules. The patient begins to experience symptoms of acute renal failure, he develops anuria.
The blood circulation in the kidney is impaired, the reabsorption of water does not occur in full. As a result, toxic substances remain in the kidney tubules, the concentration of which is constantly increasing. This leads to a deterioration in the patient's condition. It will be all the more severe, the more aggressive the bacterial or chemical toxins that affect the tubular epithelium. Possible development of shock kidney syndrome.
Amyloid nephrosis or renal amyloidosis
Amyloidosis of the kidneys develops against the background of a chronic malfunction in protein metabolism and is characterized by the deposition of amyloid complexes in the tissues. Amyloid nephrosis is a consequence of amyloidosis.
In primary amyloidosis, the renal tubules suffer from genetic abnormalities in protein synthesis. With secondary amyloidosis, the kidneys lose the ability to function normally due to a malfunction in protein metabolism, which occurs against the background of such infections as: osteomyelitis, tuberculosis, syphilis, actinomycosis.
Infection leads to the fact that the synthesis of proteins is disrupted, and they begin to be produced with certain disorders. The immune system begins to attack these mutated proteins with antibodies. Proteins combine with antibodies to form amyloid. It begins to be deposited in various organs and tissues. With the accumulation of amyloid in the kidneys, the vessels of the glomeruli suffer, urine filtration is disturbed and nephrosis develops.
This type of nephrosis occurs due to the fact that a person has received a blood transfusion that is incompatible with his group. As a result, erythrocytes begin to collapse inside the vessels, acute renal failure develops, which can lead to shock.
Separately, nephrosis should be noted against the background of fever accompanying any infectious disease. In this case, the patient does not feel the symptoms of nephrosis, and it can only be determined by urine analysis. The amount of protein in it increases. As a rule, such nephrosis does not need specific therapy and goes away on its own when the human body copes with the infection.
The main symptoms of kidney nephrosis
Common symptoms of renal nephrosis are as follows:
- The presence of dystrophic changes in the tubules of organs;
- Increased permeability of blood vessels and tubular capillaries;
- Failure in metabolic processes against the background of increased removal of albumin from the body;
- A drop in the level of protein in the blood by 3.5-5.5% with a drop in the oncotic pressure of blood plasma;
- Since the oncotic pressure drops, the vessels cannot fully prevent the penetration of fluid into the tissues and edema forms in the patient;
- The volume of urine excreted decreases;
- The urine becomes dark in color.
It is the darkening of urine, and a decrease in its volume, are the early signs by which kidney nephrosis can be suspected.
Renal nephrosis treatment
Treatment of renal nephrosis is a complex task. Therapy should be based on the form of the disease.
Principles of necrosis treatment:
- Elimination of the cause of the disease.
- Getting rid of edema.
- Normalization of the amount of protein in plasma.
For therapy to be successful, it is necessary to get rid of the cause that led to the development of nephrosis. To get rid of lipid nephrosis, it is necessary to determine which infection triggered the development of the disease. Taking this factor into account, antibiotic therapy is selected.
For the treatment of necrotizing nephrosis, it is necessary to carry out detoxification therapy, as well as measures that will prevent the development of a shock state in the patient.
For the treatment of amyloid nephrosis, the patient is prescribed a special diet enriched with fruits, vegetables, vitamins and foods containing potassium. During the acute phase of the disease, the patient is given a blood transfusion, diuretics and albumin preparations are prescribed.
To reduce the swelling that accompanies any form of nephrosis, patients are advised to follow a diet that is reduced in salt and water. You should consume no more than 1-2 g of salt per day. In parallel, the patient is prescribed diuretics. It can be Salirgan, Novazurol, Novurit, Lasix.
To reduce swelling, you can use kidney tea, which has a pronounced diuretic effect. Patients with lipoid nephrosis are prescribed corticosteroids (Prednisolone) in combination with immunosuppressants (Imuran). Carrying out such therapy helps to normalize kidney function, reduce edema and achieve long-term remission.
Since all patients with renal nephrosis suffer from protein loss, restoration of protein levels is necessary. During an exacerbation of the disease, patients are prescribed blood transfusions, intravenous albumin and diuretics.
In addition, a high protein diet is recommended for all patients. The emphasis is on eggs and meat dishes. Calculation of the daily protein intake: 2-3 g / kg of body weight.
Patients with glomerulonephritis, in which a protein diet is prohibited, increase the calorie content of meals, introduce foods rich in fats and carbohydrates into the menu. The patient should consume no less protein per day than he loses in the urine.
Patients with any form of nephrosis are shown therapy, which is designed to reduce edema and bring the body back to normal.
Upon reaching remission, the patient is prescribed a diet, which is based on the following principles:
- Limiting salt and fluid intake.
- Increasing the content of protein products in the menu.
- Intake of vitamins from food.
If the disease has a chronic course, then the dietary regimen is not adhered to on an ongoing basis, but periodically.
The prognosis for recovery from nephrosis largely depends on the form of the disease. The earlier the treatment was started, the higher the chances of its successful completion. An unfavorable prognosis persists in amyloid nephrosis.
During an exacerbation of any form of nephrosis, a person is disabled. In chronic nephrosis, it is necessary to undergo spa treatment.
Independent treatment of renal nephrosis is impossible. Therapy should be carried out under medical supervision.
It is very important to correctly isolate the cause that triggered the development of nephrosis. The success of treatment is largely determined by how timely therapy was started and how accurately the patient follows the medical recommendations.
Author of the article: Lebedev Andrey Sergeevich | Urologist
Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.