Drug-induced kidney damage. Drug-induced kidney damage (drug-induced nephropathy)

Drug-induced nephropathy is kidney damage caused by taking medications. Nephropathy may be combined with other manifestations medicinal disease or be its only manifestation.

Most common reason drug nephropathy - taking antibiotics regardless of its duration. Drug-induced nephropathy can develop when long-term use salicylates and preparations containing salts heavy metals. The development of the disease is facilitated by increased sensitivity of the body, previous kidney disease, impaired urodynamics, genetic predisposition, young or old age. Many medications affect the glomeruli and have a direct effect on the tubules.

Nephropathy is divided into groups depending on etiological factor and pathogenesis: glomerulonephritis (focal, acute and chronic diffuse, subacute); interstitial nephritis; nephrotic syndrome; tubulopathies; isolated hematuria; urinary diathesis, urolithiasis. Medicines can also cause acute renal failure.

Glomerulonephritis often develops with the use of azathioprine, codeine, novocaine, drugs of the penicillin group, rifampicin, sodium salicylate, heavy metal salts, sulfonamides, phenylin. Nephrotic syndrome can develop after administration of barbiturates, vancomycin, kanamycin, neomycin sulfate, drugs of the penicillin group, polymyxin, salicylates, heavy metal salts, streptomycin, sulfonamides, tetracycline. The cause of the development of interstitial nephritis can be acetylsalicylic acid, diuretics, nitrofurans, amidopyrine, polymyxin, rifampicin, sulfonamide drugs, isoniazid, phenacetin. Tubulopathies can occur under the influence of azathioprine, tetracycline, and heavy metal salts. Isolated hematuria develops due to the use of anticoagulants, isoniazid, para-aminosalicylate, sulfonamides, heavy metal salts, quinine, diuretic and cytostatic agents. Urinary diathesis and renal colic develop with the use of anticoagulants, sulfonamide drugs, thyroxine, and diacarb. Nephrocalcinosis can develop when amphotericin, thyroxine, and ethambutol are prescribed.

Symptoms of drug-induced nephropathy

The course of the disease is determined by the nosological form. Features of drug-induced nephritis include the relatively rare development of hypertension and hematuria.

The most common is analgesic nephropathy. It is characterized by thirst, polyuria, nocturia, renal colic, hypertension, leukocyturia, hyperuratemia, hematuria caused by papillary necrosis. X-ray reveals signs of pyelonephritis. The basis for diagnosing drug-induced nephropathy is the discovery of a connection between the disease and medication use. Laboratory, X-ray and radionuclide research methods have no diagnostic value. Characteristic, but inconsistent sign is the disappearance or reduction of changes after discontinuation of the drug.

Differential diagnosis is made with glomerulonephritis, pyelonephritis, and less commonly, amyloidosis.

Treatment of drug-induced nephropathy

Discontinuation of the drug that caused the development of the disease, prescribing a diet and symptomatic remedies. Considering the immune pathogenesis of most drug-induced nephropathy, the use of glucocorticoids is recommended. In order to prevent drug-induced kidney damage, motivated, adequate use of various drugs, especially with a history of allergic reactions and diseases, a systematic examination of the condition of the kidneys when using nephrotoxic drugs.

The outcome of the disease depends on the nosological form, timeliness of diagnosis and treatment. In general, the prognosis is favorable in acute forms and limited kidney damage.

Recent decades have been marked by a number of environmental disasters that inevitably worsen public health. These are generally recognized man-made problems, as well as uncontrolled use of medications, a wide range of which is offered by modern pharmaceutical industry. The growing tendency to self-medicate or on the “advice of friends” without taking into account general condition health can itself lead to the development of acute and chronic diseases. In this regard, the incidence of kidney damage (drug-induced nephropathy) is increasing (about 10 - 20 percent of all renal pathology).

What medications most often cause kidney damage? The leaders are painkillers and antipyretic drugs, in most cases combined, which include the so-called non-narcotic analgesics(NNA) - analgin, paracetamol, etc., as well as non-steroidal anti-inflammatory drugs (NSAIDs), such as indomethacin, diclofenac, etc. The next most common complications are diuretics, and more recently, dietary supplements and herbal remedies. The common perception of the harmlessness of herbal medicine has now led to a real threat to public health.

The kidneys are most vulnerable to any medicinal effects, since most drugs are mainly eliminated through them. The spectrum of renal pathology induced by drugs is extremely wide - from acute toxic reactions with the development of acute renal failure, sometimes even with complete loss of renal function, to chronic inflammatory renal processes. In the structure of chronic drug nephropathies, a special place is occupied by analgesic nephropathy - chronic kidney damage caused by long-term use of NNA and NSAIDs, which is associated with their high effectiveness against pain symptoms of various origins and availability. Clinical manifestations diseases consist of signs of damage to the urinary system. First of all, this is a progressive deterioration in the ability to concentrate urine, manifested by a decrease in its relative density, increased frequency of urination, predominant urination at night, the formation of urinary stones, disorder electrolyte balance, accompanied muscle weakness, phosphorus disturbance calcium metabolism with the development of skeletal pathology. Sometimes blood appears in the urine (hematuria), which can be a serious symptom of the development of necrosis (death) of part of the excretory tract or a malignant tumor urinary tract. Arterial hypertension occurs often, but not necessarily. The outcome of long-term drug-induced kidney damage is a decrease in their function, up to end-stage renal failure, at the stage at which this disease is usually diagnosed.

It is most dangerous to take these drugs if you are dehydrated (for example, with long-term use of diuretics), liver disease, heart failure, previous surgical interventions, as well as elderly patients prone to water-electrolyte disorders. Inducing factors for kidney damage can be heavy physical activity, alcohol consumption, and previous use of medications. In addition to analgesic nephropathy, patients with habitual analgesic consumption syndrome often have lesions of other organs and systems: the gastrointestinal tract, up to the development of hemorrhages with peptic ulcer stomach and duodenum, blood systems with a decrease in the number of erythrocytes and leukocytes, aggravation of the course of cardiovascular diseases. Particular attention should be paid to patients with hypertension accompanied by headache. A vicious circle arises: not knowing that the cause of the headache is increased blood pressure, the patient takes painkillers that can damage the kidneys and thereby increase arterial hypertension.

Alternative medicine products, which often enter the market without generally accepted licensing procedures and, therefore, with unknown effectiveness and safety, pose a great danger from the point of view of the development of adverse events, including life-threatening ones. There is a widespread belief among the population that products of plant origin are natural means and ancient methods traditional medicine, more powerful and safer than pharmacological preparations. In Belgium in 1991 - 1992. 9 cases of rapid development of end-stage renal failure in young women were reported as a result of treatment of obesity using certain types Chinese herbs in traditional clinics. Similar cases are known in France and Great Britain. It has been established that aristolochic acid, contained in some Chinese herbs, has a toxic effect on the kidneys. Along with toxic effect this substance has been shown in clinical and experimental studies to promote the development of malignant tumors of the urinary tract. If the total dose of aristolochic acid is large enough, kidney damage may progress even when the Chinese herbs are stopped. It should be noted that the nephrotoxicity of this substance was first described in Chinese medical literature in 1964 and confirmed in experimental studies.

In most countries, herbal preparations are not considered medicines. However, in a California study of 251 imported proprietary Asian Ayurvedic herbal product It was found that 32 percent of them contained undeclared pharmaceuticals and heavy metals (lead, mercury, cadmium, arsenic) in potentially toxic quantities, but the annotations stated that they contained only natural components.

Despite some evidence of potential health hazards, many dietary supplements continue to be widely available. They are often sold under different names and in the composition combination drugs, which makes it difficult for buyers to identify them in the finished product. In addition, 70 percent of patients do not inform doctors about the fact of using various means alternative medicine. High risk complications associated with the use of herbal remedies and biologically active additives together with medications.

Big problem modern society V present moment self-medication with readily available medicines, and especially the use of “miraculous” harmless means from herbs and from almost all diseases.”

Drug-induced kidney damage is very common in practice with long-term use of medications. After some therapeutic courses, pathologies arise in the body, characterized by kidney damage at the functional and organic level. According to statistics, it can be seen that over the past few years, drug-induced nephropathy has increased by 20%. It is worth noting that the negative effects of drugs are displayed both in acute chronic poisoning drugs and due to overdose. In some cases, malfunction is to blame immune system which shows negative reaction to antibiotics and anesthetics. In this article, we will look at all the features of kidney damage after taking medications.

Features and characteristics of drug-induced kidney damage

The peculiarity of pathologies due to drug-induced kidney damage is that the disease is considered as a change morphological form liver. Deformation occurs due to long-term use medicines. The disease is quite common occurrence, because today there is huge amount medications that can cause disorders in the functioning of the renal organs.

Important! According to studies, we can say that among the main side effects after medications are jaundice - in 2.5%, hepatitis - in 40% and renal failure acute form– in 25% of hospital patients.

If we take into account the subclinical nature of drug-induced damage to the renal organ, it should be noted that the frequency can be determined in in rare cases. Complications after taking medications have become much more common in practice. This fact is influenced by the fact that most drugs and medications are dispensed by pharmacists without a prescription. The patient cannot obtain extensive information about the features of the drug, so the risk of side effects increases. Thus, if you take 5 different types of pills at the same time, the likelihood of negative consequences by 4%, if 10 - then by 10%, and if you take about 30-60 drugs, then the risk increases by 60%.

Attention! It should be noted that half of all negative consequences after taking antibiotics are due to the incompetence or gross mistakes of doctors. According to statistics, death due to such situations occupies 5th position in the ranking. For this reason, take medications very carefully.

Causes of drug-induced kidney damage

Various drug-induced organ damage most often depends on large quantity factors. Among such accompanying circumstances of pathology, the following can be distinguished:

Age of the patient;
Females and males have different tolerances to certain drugs;
Features of tropholic status;
During pregnancy, a woman tolerates medications differently;
The dosage and duration of the therapeutic course of drugs can play a fatal role;
How do drugs interact with each other if you have been prescribed several of them?
Various enzyme inductions or their polymorphisms;
If a person has liver pathology, then medications should be taken very carefully;
If the patient has systemic or chronic diseases;
In case of impaired renal function.

Attention! Everyone knows the fact that the kidneys and liver play important role in the body, since they are the ones who biotransform drugs. That is, the first impact of the tablets falls on these organs.

Symptoms of drug-induced kidney damage

In general, the symptoms resemble ordinary human poisoning. The first signs can be replaced in the urinary secretions, where changes occur. Most cases of drug damage do not make themselves known to the person. Only if the dose of the drug is greatly exaggerated or complications arise. In such cases side effects may cause significant discomfort.

The lion's share of all toxic nephropathies is caused by drugs. In this case, a reaction of the body’s immune elements and chemical reagents is observed. The kidneys contain components of allergic zones, such as mast cells, interleukins and immunoglobulin. Thus, with drug-induced kidney damage, all these components enter directly into the lesion, which aggravates the situation. In general, the symptoms of pathologies resemble acute glomerulonephritis. Among the most obvious signs, it should be highlighted:

A person is tormented by general malaise and weakness;
The patient becomes irritable and may show aggression;
During this period, increased swelling of the entire body is observed;
The frequency and volume of urinary emission decreases, which in medicine is called oligoanuria;
In parallel with drug damage, arterial hypertension is very often observed, which can increase so much that a person suffers from convulsions and even stops heartbeats.

The toxic effects of sulfonamide substances, especially from streptocide and norsulfazole, are most often accompanied by attacks of fever, severe pain in the joint area, the skin and mucous membranes are affected, and hemorrhagic rashes occur. If you examine the capillaries on the kidneys, you can notice endothelial damage, in which the walls become ulcerated and vascular permeability increases.

Features of the treatment process

In most cases, the presence of toxic nephropathy leads to the formation of interstitial type nephritis, hemolytic-uremic syndrome and acute renal failure. In acute or chronic nephritis a person experiences the following symptoms:

Cutting or aching pain in the lumbar region;
Increase in blood pressure for a short period of time;
Often the patient suffers from pain in the joints, medically called arthralgia;
Observed various changes in urinary secretions.

When conducting general analysis urine can be detected increased amount ESR, symptoms of anemia and moderate leukocytosis. It is worth noting that when acute renal failure is achieved, the risk of death increases, which is why the disease is already dangerous. This is due to the fact that renal function may sharply decrease or disappear. In this case, the entire standard set appears clinical symptoms, that is, oligoanuria, retention of nitrogenous wastes in the body, impaired water and acid balance etc.

As you can see, the disease causes many unpleasant consequences. The good news is that any drug-induced injury can be treated, the main thing is to provide timely assistance. If treatment is not done in a timely manner, then it will only be possible to carry out detoxification or symptomatic therapy. Initially, the doctor determines the composition of the elements that led to the lesion, and taking this into account, prescribes necessary medications and methods for improving the human condition. Diuretics and alkaline agents are most often prescribed. So we got acquainted with the features of drug-induced kidney damage.

Effects of drinking alcohol on the kidneys

It is difficult to imagine a holiday without drinking alcohol; young people drink beer even on weekdays. It’s good when the body copes with the load that alcoholic drinks represent. However, if you at least sometimes feel discomfort in your back and suspect problems with your kidneys, it’s time to think about whether you need to give up alcohol. After all, sometimes experiments with strong drinks can cost lives.

How does alcohol affect the kidneys?

The kidneys are responsible for filtering and excreting toxic substances from the body, alcohol is precisely a poison, saturated with toxic components. The more alcohol you drink, the more toxins your kidneys have to process, but this process cannot be endless. Each organ needs to be given a break, and it is better not to overload it again. Regular drinking of alcohol is fraught with kidney failure, and the liver can also fail.

Patients who first encounter severe consequences for the kidneys after drinking strong drinks often ask: is it possible to replace alcohol with gentle alcohol, tinctures, or beer? Someone even voices the opinion of bloggers who claim that cognac can crush stones, so drinking it is allowed for medicinal purposes.

All this is real nonsense. Not a single competent and experienced nephrologist will confirm such information, much less recommend drinks with a degree as healing agent from diseases. If you do not trust the professional opinion of doctors, this is a question for psychotherapists - you will have to work with your own consciousness; most likely, you have not just a craving, but an alcohol addiction.

Read also: Why do your kidneys hurt in the morning?

What should you remember when drinking alcohol? Debunking myths:

Alcohol, and especially beer, which is drunk in liters, does not help with urolithiasis.
If stones are detected in the kidneys on an ultrasound, you should completely forget about beer - alcohol provokes the movement of echo suspensions and stones, and this can result in the patient getting a stone stuck in the ducts and causing death.
Beer does not dissolve stones.

Now about the composition of alcohol, which can be bought in a supermarket or ordered in the nearest pub. Today it is very difficult to find a high-quality alcoholic drink; mostly surrogates are put on sale that have nothing to do with a pure drink, which, by the way, is also not medicinal.

Therefore, when you drink a glass of beer, approach it consciously - responsibility for your health falls solely on your shoulders, right here and now.

Psychologists say that the bad habits common among Russians - smoking, drinking alcohol - are a unique form of sadomasochism. Everyone knows that smoking and drinking are harmful, alcohol decomposes the liver, blood pressure increases, kidneys fail, and work deteriorates. cardiovascular system, but at the same time they drink alcohol without restrictions.

If you cannot last without beer for at least a couple of weeks, and at the same time your back hurts, it breaks, your urine turns red, and urination is impaired, then it is urgently time to visit a nephrologist. Delaying treatment for the consequences of alcohol often causes the death of an alcohol-dependent person.

How to treat the effects of alcohol intake on the kidneys

You shouldn’t try to treat your kidneys on your own after drinking alcohol; only adequate treatment will help you avoid irreversible processes. The tissue of a diseased organ at the initial stage of the disease can still quickly recover; it just needs to be helped with medications and a diet that does not have an irritating effect.

But if the patient is going to continue to poison himself with strong drinks, the therapy will give a temporary effect, and soon the kidneys will refuse to work again. If the organ has already stopped filtering the blood from toxins and harmful impurities, nephrologists take emergency measures– they offer to undergo hemodialysis, which is a machine that replaces your kidney.

You have probably noticed that the kidneys make themselves felt after drinking beer, and this is not surprising - it is this type of alcohol, having a diuretic effect, that washes out useful and necessary substances.

How to completely restore your kidneys after alcohol

According to nephrologists, the kidneys are unique organs, which can independently restore their functions, the patient’s task is not to harm weakened cells and tissues and maintain them in a healthy way life. This requires complete failure from bad habit and taking medications:

Canephron N;
Nephroleptin;
Cyston.

Read also: Is a double kidney harmful to humans?

These preparations contain plants that have proven themselves to be effective in restoring kidneys. When recovering from an exacerbation, use vitamins and biological supplements:

Gentos Forte;
Urolite;
Therapikar;
Aquanorm;
Diurinate.

During treatment and after, you should adhere to a diet. The following dishes are excluded from the daily menu:

Salt.
Rich meat, fish and mushroom broths, give preference to vegetable ones. If you can't give up completely meat broth, cook the soup on secondary - pour the meat, peeled and fat, with purified water, and simmer over low heat after boiling for 3-5 minutes. During this time, all carcinogens will leave the meat. The water must be poured out and the meat thoroughly rinsed in boiled water. Pour water over the meat again and cook the soup, following the usual recipe, but do not season it with frying and spices.
Fatty dishes.
Fried foods.
Seasoned with mayonnaise and rich sour cream.
Chocolate in any form, confectionery, flour.
Hard cheeses. If you want to enjoy a cheese dessert, buy low-fat cottage cheese.
Marinades, smoked and pickled cucumbers, tomatoes, squash caviar.
Spicy dishes.
Cocoa, coffee, cappuccino, mineral water, which contains a large amount of sodium.

Prevention of kidney diseases

In order for the kidneys to remain healthy and perform their functions like clockwork, it is necessary to prevent the occurrence of diseases and not neglect the recommendations of leading nephrologists:

Drink clean water. Chlorinated, but boiled water from the tap is too hard, it contains a lot of impurities that settle in the kidneys and affect the formation of stones.
Do not get carried away with medicinal mineral water - you can only drink it in courses, as prescribed by a doctor.
Healthy kidneys and alcohol - this does not happen. You should also avoid coffee and carbonated drinks.
Celery and watermelon will help cleanse the kidneys. If an ultrasound reveals kidney stones, it is recommended to use a simple method: cut the watermelon rind into slices, dry well in the oven, grind to a powder consistency and boil in water for 5 minutes. After cooling, the infusion is taken 2 to 4 times a day, 1/2 cup.
Those who suffer from cystitis at least once a year need to support their kidneys and bladder, consuming a course of herbal diuretic teas that get rid of infections and bacteria.
Hypothermia is a common cause of kidney disease, so make sure that outer clothing covers your buttocks and that your feet are always warm and dry.
Indulge in permitted sports - run, dance, buy a pool membership, get involved in what you like, and enjoy the movement.

Review of medications for kidney treatment

If a person has certain kidney problems, then his medicine cabinet probably contains the necessary kidney medicine.

Basically, kidney diseases can be identified based on the characteristic appearance pain, which are localized in the lumbar region. Kidney disease can also be suspected when a person begins to feel certain pain during urination. Other signs that your kidneys need treatment are: general weakness patient, a significant increase in body temperature, a sharp decrease in performance. Cases of increased blood pressure are very common.

Urolithiasis

If a patient has kidney stones, you must know that the precursors to their occurrence are certain problems. Stones can form due to metabolic disorders, various inflammatory processes and a small amount of fluid consumed.

Very often, such an illness is accompanied by quite intense and very unpleasant sensations. Taking kidney medications at this time is the right decision. The necessary medications in such a situation are antispasmodics and diuretics. In this case, you can take No-shpu. Baralgin is perfect for treating kidneys with stones. This medicine must be administered slowly. Diuretic drugs that can help and quickly remove kidney stones include Furagin and Nolitsin. Stones can also pass out if the kidneys become inflamed.

Dissolving stones

If specialists have identified certain deposits in the patient’s kidneys, they will need to find out the true cause of their occurrence. In some situations, they can simply be dissolved, and most importantly, you do not need to take kidney pills. If such deposits consist entirely of uric acid salts, which are completely invisible in the image, then you can get rid of them very quickly. In this case, special citrate mixtures are suitable for treating kidneys. But if the stones are very massive and they are clearly visible in the picture, then they cannot be dissolved.

If during the research no deposits were found that are more than 0.5 cm in diameter, then sometimes experts recommend washing them. For this, doctors prescribe herbal kidney tablets such as Canephron N and Cyston. For this disease, some synthetic drugs can also be used. One of the most common is Allopurinol. This drug promotes the active dissolution of all existing deposits and has certain preventive effects. If your kidneys hurt, Blemaren tablets are perfect for treating them. To dissolve some formations that cannot be treated otherwise, medications such as Tiopronin and Penicillamine are excellent. These medications are very effective but have side effects. Based on this, most specialists reserve the prescription of these medications in case other drugs are not able to cope with the disease.

Renal colic

Any person has symptoms such as sharp pain, arising in the lumbar region, a strong increase in pressure, nausea, turning into vomiting, should prompt you to visit a doctor. An experienced specialist after carrying out all necessary research will be able to determine that this symptomatology arose as a result renal colic. It is strictly prohibited to independently diagnose such an illness, much less prescribe medications without consulting a doctor.

In hospital treatment, doctors most often prescribe tablets for the treatment of kidneys, antispasmodics such as No-shpa, Papaverine, Spasmolitin and Eufillin. In addition, they are usually combined with some painkillers. These medications include Tramadol, Analgin and some others. Treatment of this kind of disease should be carried out not only with the help of certain medications, but also with various thermal procedures, which include heating pads, sitz baths and sand bags. When taking sitz baths, the required water temperature should not exceed 39 °C.

Inflammatory processes

One of the most common kidney problems is pyelonephritis. This is what experts are used to calling the process of kidney inflammation. This disease must be treated exclusively in a hospital. In case of kidney inflammation, the patient should be constantly under the strict supervision of the attending physician. The main condition on the path to full recovery is taking plenty of fluids, as well as strict adherence to bed rest and timely use of antibiotics. An equally important factor in kidney inflammation is a special diet. From daily ration The patient must avoid eating spicy, fatty and salty foods.

For kidney inflammation, the treatment process will be quite long. The patient will be required to take all necessary medications. Antibacterial therapy can be prescribed for 6 weeks. Stop taking antibacterial drugs It will be possible only if the patient’s condition is completely normalized.

In the process of treating kidney inflammation, Penicillin is prescribed in most cases. If the patient’s microflora is stable, the specialist will begin to select one of the drugs (Tarvid, Erythromycin) or any other drugs that can cope with the process of kidney inflammation. To avoid bacterial resistance, each drug will need to be changed after 10-14 days. If you have kidney inflammation, you should definitely consult a specialist.

Special cases

There are cases in which taking antibiotics is completely undesirable. But this is not at all a reason to refuse treatment altogether. If the disease occurs in mild form, then medications such as Etazol, Biseptol, and others are perfect for treating the disease. For the kidneys, you can also take some antimicrobial drugs, such as Furazolin and Furagin. These medications have a more positive effect when combined with antibiotics.

IN certain situations You can easily use nalidixic acid preparations, which are prescribed as maintenance therapy at a time when the underlying disease has already been eliminated. Such medications include Negram and Nevigramon.

If the patient cannot tolerate taking antibiotics at all, then Salol and Urotropin are well suited for the treatment of kidney disease. But in some situations it is still necessary to resort to very surgical intervention.

Manifestations of glomerulonephritis

With this unpleasant disease, as glomerulonephritis, there is a deterioration in the general condition and well-being of the patient, a significant decrease in the amount of urine, which, moreover, in its color resembles meat slops, the occurrence of swelling and severe and sharp increase pressure. If the disease reaches a severe form, this can provoke the development of renal failure and even complete absence urine.

You cannot self-medicate with such a complex disease. When the patient is hospitalized, specialists prescribe Uregid, Clonidine, Raunatin and some other medications. If the pressure is low, then some can be used for treatment. antispasmodics, for example No-shpu or Papaverine. In order to relieve swelling in a patient, it is customary to take medications such as Lasix, Furosemide, and others.

Herbal remedies

One of the most common medicines based on various herbs is food additive, name - Nephroleptin. This drug contains various plant matter, which can have a positive effect on the entire renal function. These substances include:

propolis;
bird knotweed grass;
lingonberry leaves;
bearberry foliage;
color and marigold of licorice rhizome.

All of the above plants have been used for a long period of time in folk medicine in the treatment of the kidneys, as well as all urinary tracts. Previously, it was customary to take them in the form of all kinds of decoctions and medicinal teas. IN modern means In addition to medicinal components, there are auxiliary components: glucose, lactose, starch and many others.

Treatment with this drug is very effective. Nephroleptin is taken as an auxiliary medication and a general strengthening drug in the treatment of cystitis and pyelonephritis. With the help of this remedy, the patient's kidney functions are completely normalized. But do not forget about the contraindications of the drug. These pills should only be taken as prescribed by a specialist. The patient may have an intolerance or an allergic reaction to one of the components of the drug. Nephroleptin is not recommended for children and pregnant women.

The required course of taking this medication should last from 2 to 4 weeks. Recommendations regarding the use of the drug should only be given by a specialist.

Toxic nephropathies. Drug-induced kidney damage. Long-term use of medications leads to isolated or combined with other organ damage to the kidneys. According to the mechanism of action on renal tissue, drug nephritis, toxic kidney (nephrotoxic nephritis) and drug nephropathy are distinguished.

The pathogenesis of drug-induced nephritis is associated with immediate type I reactions (IRT-I) and immune damage to the renal tissue. Its development can be associated with taking any drug, as well as with the administration of vaccines and serums. Toxic and drug-induced nephropathies are based on morphofunctional disorders of the kidneys caused by the direct effect of chemical compounds, as well as drugs or their metabolites on renal tissue. The high intensity of renal blood flow, the multiple circulation of all blood, and with it drugs, through the kidneys create the most “favorable” conditions for damage to the filtration barrier of the glomeruli, interstitial cells of the medulla and the epithelium of the nephron tubular system. Antibiotics of the aminoglycoside group, especially neomycin, monomycin, kanamycin, streptomycin, have a direct and pronounced nephrotoxic effect; moderate damage is caused by amphotericin B, polymyxin and gentamicin. The nephrotoxic effect of tetracycline occurs if it accumulates in the body due to a decrease in the excretory function of the kidneys. Damage to the kidneys occurs with long-term use of non-steroidal anti-inflammatory drugs (acetylsalicylic acid, butadione), which contribute to the disruption of oxidative phosphorylation in the epithelium of the nephron tubular apparatus. Severe consequences in the form of microvascular spasm, renal capillary thrombosis and the development of acute renal failure occur during angiographic studies with the introduction of radiocontrast agents. With long-term use of diuretics and laxatives, the concentrating ability of the kidneys may be impaired due to dystrophy of the tubular epithelium.

The main signs of drug-induced nephropathies include hematuria (erythrocyturia), proteinuria, nephrotic syndrome. Oliguria may develop against the background of acute renal failure. Some nephropathy (phenacetin) can be asymptomatic for a long time. When the disease manifests itself, symptoms of chronic renal failure appear (polyuria, isohyposthenuria, decreased glomerular filtration rate, increased creatinine levels, anemia and arterial hypertension). Drug-induced nephropathies are observed during treatment with benzylpenicillin, sulfonamides, anti-tuberculosis drugs (tubazid), gold and nitrofuran drugs, mercury salts, iron compounds with dextrans, novocaine.

The development of toxic nephropathies is possible with exogenous intoxication with heavy metals (Cd, Pb), which directly cause necrosis of the renal parenchyma. There are cadmium and lead nephropathies. The detailed clinical picture of toxic nephropathies caused by heavy metals is associated with a decrease in glomerular filtration rate, the development of oliguria or anuria, proteinuria, arterial hypertension, aminoaciduria and glycosuria.

DiAbetic nephropathy (AN)- This general concept, which combines various types of kidney damage in diabetes mellitus, including glomerulosclerosis, urinary tract infection and papillary necrosis. Diabetic glomerulosclerosis (diabetic nephropathy) is a disease characterized by the appearance of specific degenerative changes in the glomerular vessels, leading to the development of proteinuria, edema and arterial hypertension. Diabetic nephropathy is the most common cause of death in most developed countries. About 25% of patients with type 1 diabetes suffer from DN 7-10 years after the diagnosis of the underlying disease. The main risk factors for diabetic nephropathy are uncontrolled levels of hyperglycemia and arterial hypertension, and hereditary predisposition. It has been established that DN develops due to mutations in the genes of enzymes associated with excess homocysteine in the blood. With DN, there is a thickening of the filtration barrier, hyalinosis of the afferent and efferent arterioles, sclerosis of the renal glomeruli with the subsequent spread of atrophic processes to the nephron tubules. The appearance of glomerular hyperfiltration indicates the development of renal failure. Nephrotic syndrome is a prognostically unfavorable sign of the course of nephropathy in patients with diabetes mellitus.

Congenital nephrotic syndrome(congenital nephrosis, familial nephrosis) is an autosomal recessive disease that manifests itself in the first three months of life and is fatal. Congenital nephrosis occurs in various ethnic groups, most often among Finns. The leading mechanism of the pathogenesis of familial nephrosis is the loss of the transmembrane protein nephrin as a result of gene mutations and non-selective leakage of the protein through the glomerular membrane. Massive proteinuria develops already by 35-38 weeks of gestation. Massive loss of protein leads to intrauterine growth retardation. Newborns develop edema, even ascites, and also sharply increase sensitivity to respiratory bacterial infection. In severe congenital nephrosis with protein deficiency, an imbalance of hemostatic factors occurs and thrombophilia develops, and the synthesis of thyroid hormones slows down (hypothyroidism). In the kidneys, sclerosis of the glomeruli occurs, interstitial fibrosis develops, tubular atrophy and loss of morphological differences between the cortical and medulla layers of the renal tissue. At the age of 3 to 8 years, the level of creatinine and urea in the blood of children gradually increases with the development of the final stages of chronic renal failure.

Nephropathies during pregnancy. As the fetus develops in the body of a pregnant woman, the functional load on the cardiovascular and endocrine systems, as well as on water-electrolyte metabolism, constantly increases. Changes in homeostasis at the organismal level lead to a natural morphofunctional restructuring of organs and tissues. Blood flow in the kidneys increases, the functional load on the nephrons increases, which leads to hypertrophy of the renal glomeruli, increased intensity of glomerular filtration and other changes. Physiological proteinuria is a reflection of the special functional state of the kidneys during pregnancy. Excretion of protein in urine per day during pregnancy increases almost 2 times. With a complicated course of pregnancy, in the second half (preeclampsia), swelling and dystrophic changes in the endothelium of the glomerular capillaries occur in the kidneys, and the lumen of the blood vessels sharply decreases. These pathological changes in the kidneys of pregnant women are known as "glomerular endotheliosis". With glomerular endotheliosis, protein loss from the body in the urine can reach 10 g per day. Nephrotic syndrome develops (swelling and other symptoms), and arterial hypertension appears. In rare cases, severe damage to the renal cortex or tubular necrosis is observed with the development of acute renal failure in pregnant women.

Congenital kidney anomalies. Modern technologies radiology diagnostics make it possible to detect abnormalities in the development of the kidneys in the fetus as early as the 20th week of gestation. Congenital anomalies remain the leading cause of end-stage kidney disease in children. A sign of improper formation of the urinary system is hydronephrosis. Hydronephrosis – persistent expansion of the cavities of the renal pelvis and calyces with pathological changes in the interstitial tissue and atrophy of the renal parenchyma, caused by impaired urine outflow. It is divided into bilateral and unilateral. Causes of bilateral hydronephrosis may include increased reflux of urine from the bladder into the ureters (reflux), an atonic bladder and an oversized ureter, and abnormal narrowing of the ureters (atresia). Unilateral hydronephrosis occurs when there is narrowing of the junction of the pelvis and ureter, as well as when duplex kidney or horseshoe kidney. This anomaly is known to be the most common renal anomaly in infants and is associated with hydronephrosis.

Symptoms of kidney nephropathy occur as a result of kidney failure. Nephropathy is in no way associated with primary disease kidney According to medical point vision, nephropathy is a disorder of kidney function.

Kidney nephropathy refers to all pathological processes occurring in these organs.

Causes of pathology

Any long pathological conditions organism, occurring in microcirculation disorders, can cause failure of the processes of filtration and removal of salts and other products of urinary metabolism.

Disturbances in the processes of filtration and removal of metabolic products with urine occur against the background of:

chronic inflammatory process, degenerative changes in body tissues, exposure toxic substances, tissue breakdown during tumor processes, hormonal disorders.

The immediate causes of impaired microcirculation in the renal tissues are:

long-term use of medications, intoxication of the body with heavy metals, household intoxication, metabolic disorders, radiation, abnormal kidney development, gout, kidney stones, diabetes mellitus.

The disease can develop for many reasons and therefore has various forms, namely:

toxic; dismetabolic; diabetic; hereditary; analgesic; endemic; gouty; metabolic; paraneoplastic.

Each of the forms leads to damage to the kidneys, enlargement and sprouting of their connective tissue.

Main symptoms of the disease

Symptoms of kidney nephropathy increase gradually. A person can long time suffer from this disease and do not know about its existence.

The first signs to look out for are:

excessive fatigue, constant feeling of weakness, constant pain in the lumbar region, dry mouth, nervousness, depression and stress, nausea, headaches, migraines.

Signs typical of nephropathy:

high blood pressure (usually rises during the working day to maximum levels and practically does not go down), excessive swelling (appears in morning time under the eyes and tends to move from top to bottom), the presence of protein in the urine (is the most important indicator in diagnosing the disease), the presence unpleasant odor from the mouth (resembles ammonia).

The first examination of the patient shows severe swelling of the fat layer and disturbances in heart rate, excessive sweating and disturbances in blood pressure.

If the patient has elevated temperature, there is pain when urinating. Sometimes they are accompanied by the discharge of pus and blood.

These signs indicate that pyelonephritis has joined the underlying disease.

Different types of pathology

Since the causes of renal dysfunction are very diverse, there are several types of this pathology.

Diabetic

Kidney nephropathy in this case develops against the background diabetes mellitus and is accompanied by bilateral organ damage.

The distinctive signs of diabetic nephropathy are the slow progression of the disease and the development of renal pathology. At the first stage, the symptoms of the disease are practically invisible. Its presence is indicated only by glomerular filtration.

At the second stage, the first signs appear, as evidenced by thickening of the capillary walls and expansion of the mesangium.

The third stage involves further spread of the pathological process, accompanied by an increase in pressure.

At the fourth stage, in addition to constant high blood pressure added, anemia and swelling. The appearance of protein is noted.

On last stage decreased kidney function is noted, which subsequently leads to chronic renal failure.

Toxic nephropathy

Appears as a result of the destructive effects of harmful poisons on the body.

There are the following types:

specific: occurring when salts of heavy metals enter the human body; nonspecific: occurs when poisons enter the bloodstream and have a toxic effect on the body.

The main signs of toxic nephropathy are sharp pain in the lumbar region, the appearance of bloody discharge in the urine and a decrease in urine level.

Hereditary form

Manifests itself at the gene and chromosomal levels. Different from previous forms long course a disease that can change to a sharp progression at any time. Features of the course of the disease are similar to the previous ones.
Metabolic nephropathy.

The cause is a metabolic disorder.

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Forms of manifestation of nephropathy

Depending on the origin, the disease has 2 forms:

Primary. It is a hereditary disease and is characterized by accelerated progression. The result of the primary form is rapid development renal failure and urolithiasis. Secondary. A disease directly related to kidney disease.

The main reasons are:

metabolic disorders; poor absorption of substances, or their excessive intake into the body; negative impact of incorrectly selected medications; disturbance of calcium metabolism in the body.

Signs of metabolic nephropathy:

metabolic disorders; stones or sand in the kidneys; inflammation of the genitourinary system; frequent urge to urinate; fatigue; discomfort and pain in the abdominal area; excessive presence of leukocytes and red blood cells in the urine.

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Objectives and methods of treatment

Treatment of kidney nephropathy is carried out in stages. Before prescribing drug therapy, the doctor recommends the following measures:

Change familiar image life. Drink plenty of fluids daily. Strict adherence to the diet.

In order for the treatment to bring positive result, the cause of the disease is necessary. And the sooner it is found, the more effective the process of treating nephropathy will be.

Treatment of patients with this diagnosis is carried out in a hospital after diagnostic and clinical studies.

The goal of treatment is to reduce blood pressure and get rid of swelling.

Treatment of nephropathy in pregnant women does not give the desired effect. Therefore, the attending physician observes the development of the disease and makes a decision on the method and timing of delivery.

Treatment of toxic nephropathy is aimed at freeing the patient from toxins. For this purpose, procedures such as gastric lavage, hemosorption, hemodialysis, etc. are carried out.

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Chronic form of pathology

The development of pathology is preceded by inflammatory processes that occur over a long period of time in the genitourinary system. The chronic form can develop against the background of myocarditis, endocarditis, tuberculosis, alcoholism, drug addiction, substance abuse, and taking analgesics in large quantities.

Hypertensive or diabetic nephropathy quickly turns into chronic form. In this process:

nephrons are lost, the glomeruli hypertrophy, and undergo interstitial fibrosis.

The kidneys fail and failure develops:

filtration stops or is disrupted, infection spreads inside the organ, pyelonephritis and cystitis develop, and stones form.

As the disease progresses, the blood becomes saturated with uremic toxins, which in turn begin to inhibit the bone marrow.

The kidneys begin to experience deficiency:

folic acid, vitamin B12, iron.

The patient shows signs of anemia.

Due to the fact that during illness the patient loses significant amount protein, the patient is prescribed an enhanced protein diet.

The purpose of the diet is to help the kidneys continue to function.

Due to the excretion of a large amount of protein along with urine, the main direction of the diet is to replenish the body with protein, and also remove excess liquid due to poor kidney function and swelling.

Nutrition for nephropathy is aimed at:

an increase in protein-rich foods in the diet; reduction in consumption fatty foods; saturating the body with lipolipids to improve metabolism and also reduce cholesterol in the urine.

To eliminate the symptoms of the disease, you must adhere to the following principles:

Saturation of your daily diet with protein-rich foods. Minimizing the consumption of fat-containing foods. Enriching the body with products that normalize metabolism in the body and lower blood cholesterol levels. If the patient's kidneys are seriously damaged, the intake of proteins into the body will have to be reduced. Minimizing consumption spicy dishes and spices. It is necessary to carry out 1-2 fasting days a week. Fluid restriction should not be allowed.

Main dishes that should be included in the diet:

salt-free bread products, dietary soups, lean meats, baked or steamed, all dairy products, lean fish, baked or steamed, buckwheat porridge, krupeniki.

potatoes, squash, zucchini, carrots, beets, pumpkin.

Among drinks, preference should be given to compotes prepared independently. Compotes made from strawberries, raspberries and lingonberries relieve inflammation best.

You can add leaves of these plants to it. Don't forget about herbal drinks. They also benefit the kidneys.

Products to say “No” to:

ice cream, chocolate, onion, garlic.

Diets for different types of nephropathy are different, so before you go on it, you should consult a specialist.

For example, a diet for diabetic nephropathy includes:

limited consumption of protein foods, moderate salt intake, complete avoidance of carbonated mineral waters and salty foods.

Food should be prepared without salt and only from natural products.

The patient's daily diet should include:

low-fat fish and meat, low-fat dairy products, starch-containing products.

The total calorie content should not exceed 2500 kcal.

With 100% compliance with the diet, the patient already in the first week experiences significant improvements health.

Treatment of kidney nephropathy with folk remedies

Of course, for kidney nephropathy, the doctor mainly prescribes treatment with various medications. But since ancient times there have been beautiful folk remedies for the treatment of kidney nephropathy, which also give good results.

Let us tell you in more detail several recipes for folk remedies for the treatment of this kidney problem, which perfectly relieve inflammation and regulate kidney function:

Collection No. 1. For this collection you will need: 30 g of St. John's wort, 25 g of coltsfoot, 25 g of yarrow flowers, 20 g of nettle. All these herbs are finely chopped and mixed well. Two or three tablespoons of the collection pour 14 liters hot water, put in a dark place to infuse. The cooled broth is divided into two equal parts and taken in two doses. Use it for at least 25 days. Collection No. 2. Take two teaspoons of flax seed, comfrey, bearberry leaves and gorse. Mix these herbs with blackberry leaves (1 part) and juniper berries (1 part). Pour 14 boiling water over it all, boil a little over low heat. We drink the prepared decoction several times a day for one month. Collection No. 3. We take one part of cornflower and birch buds, mix with two parts of bearberry and four parts of three-leaf watch. Pour one tablespoon of this mixture into 250 ml of hot water and boil for 12 minutes over low heat. We take the decoction 2-3 times a day. Collection No. 4. Lingonberries are excellent for helping with kidney nephropathy. Pass the berries through a meat grinder, add sugar 1:1 to the resulting puree. Pour the puree into jars, cover with parchment paper and refrigerate. Place 1 tablespoon of this puree in a mug and pour boiled water and drink it as a refreshing compote. Collection No. 5. Strawberry leaves and berries are excellent at fighting the inflammatory process. We take berries and strawberry leaves in the same amount, add 1 glass of water and boil for 10 minutes. Take the prepared decoction, 2 tablespoons three times a day. Collection No. 6. For such a collection you will need watermelon rinds. Take 2-3 watermelon rinds, cut into small pieces, pour 200 ml of boiling water, put in a dark place to brew. Take the prepared broth, 2 tablespoons three times a day.

But, remember that before using any folk recipe, you must first check with a specialist and obtain permission to use this or that collection. Because some of them may cause allergic reactions.

General opinion of patients about drug treatment of nephropathy and folk remedies

Some patients with kidney nephropathy speak negatively about drug treatment, since in modern world There have been cases when, due to medications, the disease only gained further momentum in its development.

Especially if you take medications without the advice of a doctor and large doses. In addition, almost all medicines now contain a lot of harmful chemicals that can cause allergic reactions. And therefore, many people advise using more traditional medicine, because they are more effective and beneficial. And use medications only strictly according to a doctor’s prescription and in the required dosage, not an ounce more.

However, folk remedies also have their disadvantages. Since now all people are trying to purchase some kind of herbal mixture for treatment kidney diseases cheaper, in markets where there is no license for the product, and the side effects of of this medicine and his safety. So it is best to purchase herbal kidney teas in pharmacies and use them exclusively as prescribed by your doctor, then they will give you 100% results.

Remember, you should not self-medicate nephropathy and other kidney diseases, because the kidneys are very sensitive to various medicines, be it medical drug or folk recipe. And to any of them there may be some kind of reaction, for example, from toxic poisoning and to kidney failure, and sometimes even to complete loss of kidney function and various chronic kidney diseases.

Consequences and complications of pathology

The most terrible complication nephropathy is kidney failure. That is, if such a pathology is not treated for a long time, the functioning of the kidneys may be completely impaired. But such a disease can also develop into various chronic diseases, for example, pyelonephritis and cystitis.

Very often, kidney nephropathy leaves behind dangerous consequences, life threatening person.

For example, these are:

anemia; cardiovascular problems; cardiac arrhythmia; high blood pressure; pulmonary edema; impaired renal function.

According to many doctors, all these pathologies and complications are currently gaining enormous momentum in development.

So, if you don’t seek help from a specialist in a timely manner and start correct treatment, then various pathological processes will start in the body, which will disrupt the functioning of all vital internal organs and systems. In addition, the physical and mental performance, a number of dangerous complications and even death will occur.

Methods for preventing this pathological condition

If you have been diagnosed with kidney nephropathy, then only highly qualified doctors can help you with treatment. And you, in turn, must only strictly follow all recommendations. First you need to identify and eliminate the real cause of this condition.

In this case, children need to undergo several tests to determine correct diagnosis and prevent the development of various congenital pathologies. For people with diabetes, frequent medical check-ups and necessary tests are recommended.

Here are the basic tips for a person suffering from nephropathy to improve their condition and prevent complications:

constantly monitor your blood pressure; eat right; eat more vegetables, fruits, do not eat fried, fatty, salty and a lot of sweets; observe the amount of fluid you drink; drink different vitamin complexes; do gymnastics daily.

If you fulfill all the requirements described above, you can not only stop the further development of the pathology, but also significantly improve the condition of the body.

Thus, preventive methods of nephropathy include strict maintenance of proper nutrition (in the case of metabolic nephropathy - dietary food), norms of fluid intake, as well as timely examination and treatment of diseases preceding nephropathy.

Kidney nephropathy - symptoms and treatment

This will help:

Such a complication of kidney diseases as kidney nephropathy is very dangerous for human life. The causes of the disease are different. This condition often results chronic pathologies internal organs. At first, the pathology develops asymptomatically and appears only after serious damage to the glomerular apparatus and renal parenchyma.

Primary and secondary causes

The origin of the disease can be primary or secondary. In some cases, hereditary nephropathies develop. Secondary include acute and chronic kidney dysfunction. Secondary nephropathies are caused by nephrosis, drug-induced vasculitis and tumors in the kidneys and in end result lead to serious disruptions in the functioning of the renal glomeruli. The primary form is provoked by the pathological development of any organ or the kidneys themselves during the prenatal period:

renal dystopia (incorrect location); irregular shape of the kidney; intrauterine structural disorder in the development of the kidney; anomaly of the renal glomeruli. Return to contents

Types and symptoms

Pathologies during organ development provoke disease.

In fact, nephropathy is a collective term for pathological processes that are characterized by damage to both kidneys. This includes renal tissue, tubules and blood vessels. The functioning of this organ is severely impaired. If treatment for kidney nephropathy is not started, serious consequences are possible.

Slow development of the disease implies hidden primary symptoms. Initial stages Usually they don't make themselves known.

After some time, the patient begins to complain of some symptoms: fatigue, painful manifestations in lumbar region, constant thirst. Appetite worsens and urination becomes more frequent. After a while, swelling appears and blood pressure rises. Depending on the cause and damage to the kidneys, nephropathies are divided into several types. Let's look at each of them in detail.

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Diabetic

The disease develops in diabetic patients and affects the arteries of the kidneys.

In nephropathy from diabetes, both kidneys are affected. The functional capacity of an organ decreases under constant negative influence progressive diabetes mellitus. One of the main features is the long development of pathology. Diabetes criteria predict symptoms of nephropathy. There are 4 degrees of the pathological process:

The first occurs with minimal manifestations, but upon examination an increase in the rate of glomerular filtration function is detected. Next comes the stage of the first pathological changes in the structure of the glomeruli. For the 3rd stage of development (prenephrotic), an increase in the level of microalbumin is characteristic. The subsequent nephrotic stage leads to a persistent increase in blood pressure, anemia and swelling. Return to contents

Metabolic

Metabolic nephropathy can be primary or secondary. With this pathology, metabolic functions are disrupted. Primary forms are considered hereditary, complications develop very quickly: chronic renal failure and urolithiasis. The secondary form occurs due to the influence of toxic substances and other diseases.

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Dysmetabolic

The disease is caused by a metabolic disorder.

This is also called urate nephropathy, caused by a disorder in general exchange substances. Additionally, it is accompanied by kidney damage due to salt deposits. Oxalic acid, oxalates and urates are predominantly deposited in the kidneys. Dysmetabolic nephropathy is divided into 2 types depending on the quality of salt deposits: oxalate and urate.

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During pregnancy

The main symptoms of this dangerous pathology during pregnancy are severe arterial hypertension and severe swelling of the body. Stage 1 nephropathy is almost always ignored during pregnancy. Typically, patients consult a doctor with complaints when stage 2 or 3 has occurred, which are characterized by more severe symptoms and the emerging risk of fetal loss.