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CHRONIC KIDNEY INSUFFICIENCY

- a syndrome that develops as a result of a gradual decrease in the number and changes in the function of the remaining nephrons, leading to impaired renal blood flow, glomerular filtration, tubular reabsorption and secretion, as well as kidney concentration ability and characterized by azotemia, impaired water and electrolyte balance, acid-base balance .



The main clinical manifestations

Usually, the greater the degree of renal failure, the more pronounced its clinical manifestations. In some cases, symptoms of damage to the cardiovascular system predominate, in others - nervous, digestive and hematopoietic. When the disease progressed in patients with signs of damage to the nervous system: weakness, drowsiness, apathy, fatigue. Gastrointestinal syndrome manifests itself in the form of nausea, vomiting, loss of appetite. In the future, patients, due to the delay of uremic toxins, appear itchy skin, subcutaneous hemorrhages, nasal and gastrointestinal bleeding; marked pain in the joints. Arterial hypertension leads to the development of severe retinopathy, reduced vision.



Classification

There are two stages of chronic renal failure:

I - conservative (glomerular filtration rate of 40 ml / min);

II - terminal (filtration about 15 ml / min).



Diagnostic criteria

Clinical - the appearance of drowsiness, apathy, nausea, vomiting, itching of the skin, nasal and gastric bleeding, pain in the joints, loss of vision, progression of hypertension.

Laboratory - when conducting a Zimnitsky sample, monotonous urine excretion of low relative density is noted, the level of creatinemia increases, the glomerular filtration rate decreases, hyperkalemia occurs.



Examples of diagnosis wording

one.
Idiopathic (primary) amyloidosis, terminal stage.

2. Chronic renal failure stage II with severe neurological, anemic-hemorrhagic and gastroenterological syndrome.

3. Chronic mixed mesangiocapillary glomerulonephritis, rapidly progressive course, acute phase. Chronic renal failure stage II with anemic-hemorrhagic and gastroenterological syndrome.



References: 1. Clinical Nephrology / Ed. E. I. Tareeva. M .: Medicine, 1983. 464 p. 2. Practical nephrology / Under the editorship of A. P. Peleschuk K .: Zdorov'ya, 1983. 344 p. 3. Tarerez EI. Fundamentals of Nephrology M .: Medicine, 1972. T. 1, 2
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CHRONIC KIDNEY INSUFFICIENCY

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