THE MAIN SYMPTOMS AND SYNDROMES IN KIDNEY DISEASES

Functions of the kidneys

• Removal of toxic waste products
• Removal of excess water and salts
• Blood pressure regulation
• Production of erythropoietin (epo)- stimulates red blood cell production from the bone marrow – deficiency of erythropoietin can cause anemia
• Help to keep calcium and phosphate in balance for healthy bones
• Maintain the blood in a neutral (non-acid) state

Signs, which point pathology of kidney are:

Main signs

• Pain in lumbar region,

• Urination disorders,

• Change of normal qualities of urine (quantity, color, specific gravity)

• Edema.

Secondary signs

• Chills,

• Headache,

• Dizziness,

• Visual disorders,

• Heart pain,

• Skin itching,

• Loss of appetite,

• Nausea,

• Vomiting ,

• Fever.

Pain in lumbar region

The pain is caused by:

Stretching of kidney capsule, spasm of ureters, inflammation of perirenal cellular tissue, infarction of kidneys and other factors

The intensity of the pain feelings can be different

– from dull, boring pain(at acute and exacerbation of chronic pyelonephritis) to sharp, very severe pain with irradiation towards and along ureters,in the groin, genitals, and front surface of thigh (renal colic which arises as a result of ureter corking with stone, at trauma of kidneys and kidney infarction).

Urination disorders

Oliguria - decreasing of urine excretion up to less than 500 ml per day.

Anuria -complete termination of urine excretion – it is a symptom of acute kidney insufficiency, mechanical obstacles of urine passage (stone, tumor).

Nocturia or nycturia (night diuresis is above day- urination is more common in the night than day); in normal kidney its is 1:2;

Dysuria – painful urination

Polyuria –increased volume of urine in chronic nephritis, cystitis.

Isosthenuria-in disorders of dilution and concentration function of kidneys, specific gravity is 1010-1011)

Edema

Often, edema is the one of the first signs of kidney pathology; it can suddenly develop as well as disappear. As a rule they are located on the face especially on eyelids (where the subcutaneous fat tissue is more loose).

Sometimes edema is equally distributed all over the body (anasarca). The edema has mild consistency; deep elevation of skin is present even with slight pressure on it. It can also spread to internal organs and cavities (profound edema) with accumulation of transsudate in serous cavities — pleural, abdominal and pericardial cavities.

Uric syndrome

• moderateproteinuria (from 100 mg up to3,5 g a day),

• red blood cells in the urine more than 1´10⁶/L per day (erythrocyturia),

• leukocyturia - more than 1´106/l per day),

• casts in urine,

• bacteriuria,

• dischargingof salts and their cristals with urine

• cells of renal and transitionalepithelium and other pathological elements both organized and non- organized renal sediments,

• The leading symptom in uric syndrome is proteinuria (albuminuria).

Nephrotic syndrome

• A massive leak of protein (albumin) into the urine (proteinuria) (more than 3,5 gr per day).

• A low blood level of albumin due to the large amounts lost in the urine (hypoproteinemia mostly because of hypoalbuminemia).

• An increased level of cholesterol in the blood (hyperlipidemia).

• Retention of fluid in the body causing swelling (edema).

•Hypercoagulation.

Renal arterial hypertension

This is symptomatic hypertension caused by pathology of kidneys or renal vessels.

Elevation of blood pressure is caused by 3 mechanisms:

· sodium and water retention,

· activation of pressor (angiotensin-renin)system,

· inhibition of depressory mechanisms.

Acute nephritic syndrome

It is characterized by the abrupt onset (days)of haematuria with red blood cells, casts ordysmorphic red blood cells appearing inthe urine, proteinuria, renal impairement(oliguria, uremia, raised urea and creatitine), hypertension due to water and salt retention, and edema (usually periodical).

Some diseases of the kidney include the following:

· Glomerulonephritis

· Pyelonephritis

· Nephrolithiasis (kidney stone)

· Nephritis

· Diabetic nephropathy

· Hydronephrosis

· Kidney tumors- Renal cell carcinoma, Wilms tumor

· Lupus nephritis

· Renal failure

· Polycystic kidney disease

· Renal dysplasia

· Renal agenesis

This is one of the lectures I had in Internal Medicine. Decided to share; I hope it helps you.