Nephrosclerosis or secondary contracted kidney - etiology, diagnosis, treatment

growth of connective tissue in the kidney parenchyma, leading to deformation, structural adjustment and compaction called nephrosclerosis.Nefrotsirroz - an extreme stage of development of renal scarring.Depending on the development mechanism of the disease can be identified:

  1. nephrosclerosis primary or primary contracted kidney, which develops as a result of circulatory disorders of the body.
  2. secondary or secondary contracted kidney, is developing as a result of untimely or inadequate treatment of chronic inflammatory diseases.

Causes of nephrosclerosis

Primary nephrosclerosis

occurs on the background:

  • atherosclerotic lesions
  • Thrombosis Thromboembolism
  • Hypertension arteriolosclerosis.

development of primary contracted kidney at a late stage of hypertension or atherosclerotic lesions is due to the fact that the circulatory failure leading to kidney tissue hypoxia, the development of atrophic and degenerative changes and sklerotizirovaniyu tissues.

Experts divide primary nephrosclerosis the following form:

  • Atherosclerotic
  • Involutory
  • Hypertensive

Unlike nephrosclerosis primary, secondary contracted kidney, the causes of which are based on the inflammatory process in the kidneys themselves, develops slowly.

include diseases Factors affecting sklerotizirovanie renal parenchyma,:

  • Chronic pyelitis and glomerulonephritis
  • formation of kidney stones
  • syphilis and tuberculosis with parenchymal renal
  • Systemic lupus erythematosus
  • renal amyloidosis
  • development of diabetesdiabetes
  • radiation effects - seen after a long time after exposure to radiation
  • injury and surgery on the kidneys
  • Nephropathy pregnant severe.

In addition to these forms is secondary nephrosclerosis, characterized by cystic transformation and expansion of the tubules.This form of the disease in oksalaturii, hyperparathyroidism and gout.

Development Mechanism

Nephrosclerosis disease develops in two stages:

  1. first is characterized by a painting, which is caused by the clinic disease that caused the process sclerotization renal tissue.
  2. At the second stage the clinical features of the causal disease is not already manifest.The process of gradually extended to the entire kidney, if the cause is nephrosclerosis pyelonephritis, kidney usually affected unequally.

Pathogenetically two forms of the disease can be identified:

  • Benign nephrosclerosis is characterized by slow development, if it affects the walls of the small arterioles and atrophy of nephrons separate groups.This is accompanied by the expansion of the interstitial connective tissue.
  • malignant form is characterized by fibrinoid necrosis of arterioles and capillary glomeruli, which is a cause of stromal edema, kidney tissue, hemorrhage and marked degenerative changes in the tubules.

Diagnosis and clinic

disease to diagnose nephrosclerosis need to pass the following studies:

  • general analysis of blood
  • Urinalysis - urine can detect proteins and blood cells, urine density is reduced,
  • Ultrasound - allows you to estimate the size ofand enforcement structure,
  • radionuclide - determines the rate and amount of tracer excretion from the kidneys,
  • X-ray - shows the deformation and vasoconstriction.

clinical picture depends on the extent of kidney tissue and is manifested by the following symptoms: the emergence of edema, stable high blood pressure in later stages of development can join heart disease, stroke, retinopathy.The outcome of renal scarring can become chronic renal failure and intoxication nitrogenous compounds.

This is important! If you have started to harass the cause swelling, which can not find out, or resistant hypertension, medication is not stopped, it is necessary to address to the nephrologist, early diagnosis and timely initiated therapy prevents the development of complications.

Principles of treatment and prophylaxis of contracted kidney

nephrosclerosis Complex therapy depends on the clinical manifestations of the disease and the patient's condition.If the disease is accompanied by the development of renal failure manifests clinically unstable hypertension, treatment would be to use a salt-free diet restriction and the use of protein products assignment antihypertensive agents.If

pronounced renal insufficiency pressure reduction means prescribed very carefully because, lowering blood pressure, can cause blood disorders and impair the functioning of the body.

Malignant nephrosclerosis form in which rapidly developing renal insufficiency, leads to the need for surgical intervention - embolization of renal vessels, nephrectomy (removal of the body), kidney transplantation, followed by chronic hemodialysis.

Most often nephrectomy performed open-access method, it is quite traumatic operation, which has a long postoperative period.With the development of modern technology it has become possible to remove the kidney through endoscopic technique of laparoscopic (through punctures in the abdominal cavity) or retroperitoneal (punctures made by the loin).These methods are less trauma and shorter post-operative period.

prevent the development of chronic kidney nephrosclerosis is the timely treatment of chronic inflammatory diseases of the kidneys and ongoing monitoring by a doctor in case of hypertension.

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