First aid for acute renal failure. Clinic of acute renal failure

A group of disorders caused by dysfunction of the kidney(s) is called acute renal failure. This is a reversible process, which is characterized by a violation of the secretory, filtration, excretory functions, changes in water and electrolyte balance and high content in the blood products of nitrogen metabolism.

Basic forms, their causes

There are three main forms of acute kidney failure(table), helping to decide on taking measures to prevent similar complication and treatment of pathology:

Forms		Cause			The situation in which the pathology develops
prerenal		Manifested outside the kidneys (caused by impaired circulation)			heart failure; violation of the heart rhythm; accumulation of fluid in the heart; stool disorder; accumulation of fluid in the peritoneum; blood loss; burn; hypotension; blockage of blood vessels.
Renal		Kidney problem			destruction of cells by poisons; reception medicines; blood transfusion; injury; inflammatory process.
Postrenal		Impaired urine flow			blockage of the renal duct; the presence of a neoplasm.

Pathogenesis

Functional disorders of the kidneys lead to inflammatory processes in the organ.

Violation of the functionality of the renal corpuscles in the cortical layer of the organ, which are an important part of the glomerular structures, determines the pathogenesis of the disease. Destructive influence functional disorder operates in several directions. First of all, inhibition or complete suspension of the release of end products of nitrogen from the blood occurs. With the liquid part of the blood, they are carried throughout the body, getting into internal organs and vital systems. This leads to pollution, disrupted gas exchange in the body. The presence of oxygen in the body decreases carbon dioxide increases. The glomerular structures of the kidneys suffer from this situation, their partial or complete necrosis occurs. Restoration of the filtration function during the death of the renal corpuscles is practically excluded. In the future, the process is complicated by inflammation, which leads to poisoning of tissues and blood with poisons.

The main criteria for acute renal failure

RIFLE classification

In 2002, a rifle classification was developed and published in 2004, which allows to identify and diagnose acute injury kidneys. AT English letters the definition of the phases of development of renal failure is hidden:

• R - risk;
• I - damage;
• F - insufficiency;
• L - loss of functions;
• E - irreparable (terminal) degree of insufficiency.

Acute kidney injury is diagnosed when two conditions are combined:

• time criterion;
• functional criterion (weakening of organ functions, determined by the amount of urine excreted or the degree of creatinine in the blood).

RIFLE classification of the development of AKI
Class		filtration rate in the glomerulus			Diuresis
R risk		Increase in Ccr by 1.5 times or decrease in GFR by 25%			< 0,5 мл/кг на протяжении ≥ 6 ч.
I damage		2-fold increase in Ccr or decrease in GFR by 50%			< 0,5 мл/кг на протяжении ≥ 12 ч.
F failure		A 3-fold increase in Ccr or a 75% decrease in GFR			< 0,3 мл/кг на протяжении ≥ 24 ч. или анурия ≥ 12 ч.
L loss of function		AKI for ≥ 4 weeks
E irreparable insufficiency		AKI for ≥ 3 months
Ccr - creatinine level; GFR - glomerular filtration rate

AKIN classification

To improve diagnosis by improving the control of minor deviations in the concentration of creatinine in the blood, the classification was improved in 2007 by the AKIN group of specialists. Emphasis is placed on the end product of the creatine phosphate reaction, glomerular filtration rate (GFR) is excluded. Acute renal failure is characterized by the following criteria:

Symptoms and stages

The development of acute renal failure goes through 4 stages:

Acute failure during pregnancy

The disease in pregnant women is provoked inflammatory processes urinary system.

Acute kidney disease during pregnancy is a life-threatening complication. The danger lies in the fact that kidney damage always manifests itself quickly, in a few hours or days. Most often, the problem makes itself felt at the beginning of the third trimester, after childbirth. But there is a risk when acute renal failure develops when infectious diseases. The reasons for the development of pathology during pregnancy are as follows:

• increased burden on the kidneys due to more blood undergoing filtration;
• chronic inflammatory processes of the urinary system;
• exacerbation after an abortion or after childbirth;
• fetal death during pregnancy.

With timely attention to the signs of acute renal failure (back pain, decreased urination, thirst, and others), it is possible to restore the functionality of the organ and save the life of the mother and child.

If measures are not taken in time, the disease goes through all periods of acute renal failure, new signs are added (blood in the feces, limbs go numb) and there is a high probability of death for both the woman and the fetus. At acute course diseases future mom Be sure to consult not only a urologist, but also a gynecologist.

Complications and consequences

Acute kidney disease does not go smoothly, and significant pathological outcomes often occur:

Diagnosis of acute renal failure

If development is suspected acute insufficiency the doctor takes into account the history of the manifestation of symptoms and examination of the patient. Further clinical guidelines supported by the results of CFD and laboratory tests:

Diagnostic methods using mechanical devices allow you to examine the organ and assess the difficulties of the process (chronic or acute), determine the presence of blockage of the ducts:

• Ultrasound of the peritoneum;
• CT (computed tomography);
• X-ray of the peritoneum determines the presence of stones in the kidneys or ducts.

If the cause of the acute condition is blockage of the ducts, it may be necessary additional types research:

• MRI, which allows to assess the degree of change in the structure of the organ.
• Pyelography of the kidneys. Through catheterization of the ureter, contrast is introduced for a detailed anatomical study of the organs of the urinary system.
• Kidney scintigraphy. Rates functional state organ.

What treatment is needed?

The manifestation of symptoms indicating the development of an acute form of the disease indicates the need to deliver medical care to the patient as soon as possible. Until the doctor arrives, people nearby will need self-control to assess the situation and provide the necessary first aid.

Urgent care

The first step is to restore the volume of blood.

The necessary assistance in the first phase of the development of the disease will be of a more preventive nature, aimed at eliminating the causes that caused acute condition and elimination of violations that have occurred. To begin with, the patient is provided with bed rest, peace and warmth. To restore the movement of blood through the vessels, drip therapy is carried out using solutions of albumin, glucose, mannitol, plasma and others. After the resumption of blood volume, diuretics are used. Vascular spasms are stopped with novocaine mixtures.

Emergency care for acute renal failure during the development of the second phase is aimed at eliminating symptoms, since the situation is complicated by anuria or oliguria. Treatment of acute renal failure is focused on eliminating the consequences of poisoning the body. Warn and clear all conditions life threatening sick. Are used hypertonic solutions, vitamin preparations, anticonvulsants and antibiotics.

Acute renal failure is a syndrome caused by a critical decrease in the excretory function of the kidneys, most often due to ischemic or toxic damage renal parenchyma with retention in the blood of products normally excreted in the urine. Acute renal failure (ARF) is divided into prerenal, caused by disorders of the general circulation (shock various etiologies, profuse diarrhea, prolonged vomiting); renal, caused by damage to the renal parenchyma of various etiologies; and postrenal, caused by a violation of urination (obstruction and compression urinary tract).
Symptoms. The following phases of acute renal failure are distinguished: initial lasting up to 2 days (signs of the pathological process that caused acute renal failure dominate - shock, infection, sepsis, hemolysis, exo- and endointoxication, disseminated intravascular coagulation);
oligoanuric duration up to 2-3 weeks (symptoms of uremia: patients are lethargic, drowsy, lack of appetite, headache, nausea increases, a puffy face with yellowness, peripheral edema, petechiae and ecchymosis on the skin, "uremic tan" and "uremic powder", the smell of urea can be detected; usually hyperkalemia and hypermagnesemia focal lesions central nervous system sometimes develops delirium, renal eclampsia epileptic seizures, coma);
the phase of early polyuria (there is a decrease in the level of potassium ions sodium magnesium chlorine);
recovery phase of kidney function.
Diagnosis. Not always clear, should be differentiated from comas and others various violations central nervous system; it is necessary to identify its form when establishing the diagnosis of acute renal failure.
Complications: bronchitis, pneumonia, pleurisy, pericarditis, cardiac tamponade, hypertensive crisis, arrhythmias, respiratory and heart failure, pulmonary edema, delirium encephalopathy, aseptic peritonitis, disorders water-salt metabolism, different types hyperhydration and dehydration Hyperkalemia is characterized by the appearance on the ECG of AV blockade of the 1st degree, the widening of the QRS complex, the ST segment begins below the isoline, the shortening of the QT interval, the appearance of a pointed narrow G wave; for hypokalemia - QT prolongation, ST segment depression, flattening up to inversion of the G wave, the appearance of a U wave.
Typical for acidosis are Kussmaul respiration (with severe acidosis - Cheyne-Stokes), myoclonus, myoplegia, confusion. Alkalosis is characterized by rare shallow breathing, carpo-pedal spasm, chest constriction, tetanic convulsions and disorders of consciousness (stupor, coma).
With hypertonic overhydration, thirst, dry mucous membranes, anasarca, hypertension are observed (furosemide, 5% glucose solution are used), and with hypotonic overhydration - aversion to water, vomiting, headache, anxiety, mental disorders, focal neurological symptoms (renal eclampsia), coma respiratory disorders (introduction of physiological saline, if there is no oligoanuria, - 10 ml of Panangin IV). Isotonic dehydration is characterized by: weight loss, acrocyanosis, weakness, hypotension, hoarseness, patency disorders respiratory tract and esophagus (5% glucose solution, saline). With extracellular dehydration, the skin and mucous membranes are dry, there is little or no thirst, muscle weakness, headache, hypotension, vomiting, convulsions, coma are possible (hypertonic or isotonic sodium chloride solution, in their absence, 40% glucose solution can help for a short time). With cellular dehydration, weight loss occurs, the skin is moist, the facial features are sharpened, the eyes sink, there is a lack of saliva and lacrimal fluid, unquenchable thirst, apathy, muscle twitching, hallucinations, delirium, hypertension, respiratory disorders coma (5% glucose solution, 0.45% or physiological sodium chloride solution).
urgenthelp. Psycho-emotional peace, elimination causing factor(removal from shock, detoxification, etc.), to improve renal blood flow - 1-3 mcg / kg / min of dopamine. at peripheral edema- up to 300-500 mg of furosemide IV (with urinary tract patency). In renal eclampsia, up to 30 ml of 40% glucose is administered, up to 20-25 ml of 25% magnesium sulfate intravenously or intramuscularly.
Arterial hypertension corrected with sodium nitroprusside - up to 10 mcg / kg / min (50 mg / amp., 50 mg / 250 ml, 200 mcg / ml, 10 mcg / cap., Initial infusion rate 05 mcg / kg / min), or labetalol (100 mg / amp.) at 20-40 mg over a minute, can be repeated every 15 minutes until the onset of effect or a dose of 300 mg is reached. convulsive syndrome stopped by sibazon (diazepam) - 10-30 mg intravenously slowly over 5-10 minutes (10 mg / amp.). Hypertension can also be treated with diazoxide 75 mg for 10-30 s IV, if necessary, repeat every 5 minutes up to 300 mg, or hydralazine (20 mg / amp.) - 10-20 mg IV, repeat after 30 minutes ( i / m 10-50 mg), or phenigidine (nifedipine) up to 1 mg i / v. Phenigidine can be given sublingually up to 20 mg. In case of pulmonary edema systolic pressure above 160 mm Hg. Art. - up to 10 mcg / kg / min sodium nitroprusside or up to 50 mg pentamine IV slowly. If the pressure is low - up to 500 mg of furosemide, with anuria - bloodletting up to 300-400 ml, extremely careful administration of 03-05 ml of a 0.025% solution of strophanthin or 0.25-05 mg of digoxin IV.
In the treatment of arrhythmias, doses should be halved, the phase of acute renal failure (hyper- or hypokalemia) should be taken into account. With asystole or ventricular fibrillation, additional calcium preparations are used (2-4 mg / kg calcium chloride at 10-minute intervals) and sodium bicarbonate (2 ml of a 4.2% solution per 1 kg of body weight) or trisamine (1 ml/kg) IV.
Hospitalization: on a stretcher to the specialized department of the hospital for extracorporeal dialysis.

Acute renal failure is a symptomatic, potentially reversible complex that is caused by abrupt discontinuation of functionality organs. The occurrence of pathology is associated with a malfunction renal tubule, although there are much more factors provoking the disease.

Clinical manifestations of acute renal failure are associated with life-threatening conditions, during which functions are impaired important systems and organs. On the initial stage pathology symptoms are practically absent, and its development is characterized by swiftness. Therefore, acute renal failure requires emergency care. medical personnel. Prior to their arrival, measures are taken to fix and maintain work in the kidneys and other systems and organs.

Reasons for the development of acute renal failure

The kidneys, along with the liver, are engaged in cleaning the body, preventing it from penetrating into the body during intoxication. systemic circulation I will give. Thereby paired organ at healthy people water and chemical balance is maintained. They rid the body of excess water, dangerous toxins and drug residues. The participation of the kidneys is necessary for metabolism and the production of certain hormones. A decrease in the capabilities of an organ will lead to the loss of its functions. This will cause the inevitable death of the victim: the blood will be filled with toxic human waste.

All causes of acute renal failure, manifested by a violation of the functionality of the kidneys, are divided into 3 large groups:

1. Prerenal. Diseases caused by disorders of blood flow in a paired organ.
2. Renal. Damage to the structure of the kidneys: glomeruli and tubules.
3. Postrenal. Pathology related.

This happens for 3 reasons:

1. Blockage or blockage of the ureters;
2. The bladder is damaged, so the organ cannot "push out" urine;
3. The urethra was severely narrowed.

We list which diseases contribute to the development of acute renal failure.

The prerenal form of acute renal failure is caused by pathologies associated with a state of shock. He provokes a sharp decline volume of blood flow. Loss of water electrolyte balance cause gastrointestinal diseases, and accompanied by diarrhea. This category includes such malfunctions in the body:

• Work disruptions;
• failure;
• All types of burns;
• Septicemia.

Renal forms cause the following factors:

• Nephritis;
• Acute glomerulonephritis;
• Intoxication (poisons, drugs);
• Ischemia;
• Acute renal tubular injury.

Postrenal lesions are caused by blockage of the renal tubules by blood clots or protein particles. Their appearance is facilitated by such violations:

Symptoms and treatment depend on the course of the disease that caused ARF.

Symptomatic features

Severe course of these diseases at any time can lead to acute renal failure. Dangerous state goes through 4 stages of its development, each of which has a characteristic symptomatology.

• Initial phase

The specificity of this period is the bright manifestation of the background disease, the state of sepsis and. The duration of the phase is from 3 hours to 3 days. Begins intense violation blood supply to the kidneys. It is extremely important to provide emergency care for acute renal failure at this time. So you can stop the development of pathology.

• Oligoanuric phase

The period can last up to 3 weeks. His salient feature- the rapid development of oliguria (diuresis less than 300 ml / m2 per day) or anuria (lack of urine). Laboratory research will reveal the presence of proteins and red blood cells in the urine, an increased amount of sodium. The concentration capabilities of the kidneys are rapidly declining. Blood pressure is above normal. Biochemical analysis will show an increased concentration of urea, phosphate and creatinine.

Observed brightly severe symptoms intoxication:

• Weakness;
• Inhibited reaction;
• Vomit;
• Diarrhea;
• Drowsiness.

The development of the septic process is accompanied by chills and feverish state. General fixes anemia and extremely low level platelets against the background of pronounced leukocytosis.

Without necessary assistance there will be swelling of the brain and lungs.

• Polyuric phase

The stage is called recovery. Its duration can reach 3 months. There is a gradual persistent increase in urine production and excretion. Sometimes highlight biological fluid reaches 4 liters per day. Consequence rapid loss liquid becomes dehydrated, the concentration of potassium and sodium decreases.

• recovery phase

It lasts longer than all other stages - up to 2 years.

Systemic blood flow and kidney function are gradually restored. The causes that caused OPN are completely eliminated. This time is devoted rehabilitation therapy and spa treatment.

Diagnostic methods

Diagnosis of acute renal failure is carried out according to standard provisions. It begins in the doctor's office with an anamnesis. Doctors are interested in the following information:

• The presence or absence of chronic pathologies;
• Medications taken in the last month;
• Possibility of contact with poisons or toxins;
• Past pathologies within the last 2 months.

The patient is then asked clinical manifestations diseases:

• How pronounced is the decrease in the total amount of urine;
• Is there swelling;
• Does intoxication manifest itself;
• Characteristics of appetite, quality of sleep, general well-being;
• Are there signs of gastrointestinal disturbances?

Then the doctor palpates the kidneys, finds out the presence of edema and their severity, the condition of the skin and mucous membranes.

Based on the history and visual inspection the patient's doctor determines the necessary laboratory and instrumental studies.

• Blood - general and biochemical research;
• Urine - general analysis;
• Study of the acidity of the bloodstream and the concentration of electrolytes;
• Electrocardiogram;
• Indications blood pressure in dynamics;
• The specifics of diuresis;
• Diagnosis of the presence of C-reactive protein;
• Ultrasound of the kidneys;
• If there are suspicions of complications in the form, an x-ray examination is prescribed;
• According to the indications, a consultation is appointed narrow specialists, CT and MRI.

An important part diagnostic measures is to check the presence or absence of bladder biological fluid. This indicator is determined by catheterization. The same method allows you to find out the presence or absence of an obstruction in the ureter.

Specifics of emergency care

Acute renal failure requires emergency medical attention using large group medicines administered intravenously.

With acute renal failure, immediate hospitalization of the patient is needed. is dangerous only if the patient is in a state of shock. In this case, first aid is provided on the spot.

Each stage of the "ambulance" has its own characteristics.

initial stage

During this period, it is important to eliminate state of shock, restoration of BCC (volume of circulating blood). Since at this time there is also a violation heart rate are taking steps to restore it. Stabilize renal hemodynamics and microcirculation, water balance.

The therapy is carried out under conditions medical institution. It begins with the appointment of such drugs:

• Ringer's solution;
• Albumen;
• Sodium chloride and glucose;
• Mannitol.

After the bcc is restored, diuretic drugs are prescribed: Furosemide, Eufillin and others.

To restore the filtration capacity of the kidneys, forced diuresis is performed. To accelerate detoxification and recovery acid balance appoint intravenous administration sodium chloride and glucose or use Ringer's solution.

For prophylactic purposes, the introduction of subcutaneous "Heparin" is supposed, which will not allow thrombosis of the renal tubules.

Oligoanuric stage

A task urgent action in this period:

• Eliminate violations of water-salt metabolism;
• Eliminate azotemia;
• Stop ;
• Correct acid imbalances.

To achieve this goal, limit the intake of fluid taken by the patient. Prescribe the introduction of such medicines:

• Glucose with insulin - help potassium move into cells, working as a detoxifier;
• Salt-containing blood substitutes, sodium chloride solution - eliminate vomiting and diarrhea;
• Glycerin, sorbitol, ion-exchange resins rectally - relieve the growth of hyperhydration and hyperkalemia;
• "Kontrykal", "Gordoks", "Retabolil" - reduce the breakdown of proteins;
• "Lespenefril", Glutamic acid, "Arginine" - reduce azotemia.

Polyuric stage

At the recovery stage, the leading principle of therapy is to correct the water and electrolyte balance. Therefore, all restrictions related to drinking, salt intake and certain products food are removed. However, the entire stage takes place under the control of the patient's body weight, diuresis, blood pressure, respiration, heart function and body temperature.

At the stage of cure, the patient is shown a strict diet, symptomatic therapy and exception physical activity and stress.

The kidneys are one of the most important organs our body. These organs are part of the urinary system, they organize and carry out the purification of the body from metabolic products. The kidneys react very quickly to any disturbances in the activity of organs and systems, and when serious violations in the functioning of the cardiovascular system or in response to the entry of especially aggressive substances into the body, they can fail. As a result of such a pathological effect, acute renal failure may develop, the symptoms of which we will consider treatment, we will also clarify what emergency care is needed for a patient with such a diagnosis, we will consider how acute renal failure is diagnosed.

Acute renal failure refers to the rapid (developing within a few hours, days or weeks) cessation of kidney function, which is due to severe damage to most of the kidney tissues.

Symptoms of acute renal failure

At the first stage of development of acute liver failure only the initial action appears pathological factor(shock, sepsis, poisoning, etc.). The patient has symptoms of the underlying disease. There are also non-specific symptoms, represented by drowsiness, nausea, lack of appetite and weakness. initial stage acute liver failure can last from several hours or last for several days.

After pathological processes lead to a significant decrease daily diuresis- it is not more than five hundred milliliters. At the same time, urine is stained in dark color It contains quite a lot of protein.

In a patient, the amount of nitrogen in the blood increases (azotemia occurs), and the amount of potassium, phosphates and sodium in the blood also increases significantly. Metabolic acidosis develops, in other words, the acid-base balance organism.

The patient is concerned about diarrhea, severe nausea, turning into vomiting. There is an occurrence of overhydration, which leads to pulmonary edema, due to which patients suffer from shortness of breath and moist rales. Patients become lethargic, they develop excessive sleepiness and may even develop a coma. A significant decrease in immunity can lead to accession various infections.

Acute renal failure is accompanied by loss of appetite. The patient may experience muscle twitches, there is also a violation of the heart rhythm and an increase in blood pressure. Pathological processes may cause pain in the abdomen and enlargement of the liver.

The third stage of renal failure is accompanied by a significant increase in the volume of urine separated - its daily volume can reach two to five liters. At the same time, the body loses significant amount potassium, which is fraught with the development of hypotension, a decrease muscle tone and, in some cases, paresis skeletal muscle as well as cardiac arrhythmias.

Urine at this stage of the disease is characterized by low density, the amount of creatinine and urea in it decreases, but after a week, with favorable course disease, hyperathermia disappears and electrolyte balance is restored.

Energetic treatment with a favorable course of the disease allows you to restore kidney function within three months to six months.

How is acute renal failure detected, what kind of diagnosis is needed for this?

For staging correct diagnosis in acute renal failure, doctors assess the characteristic clinical picture. In addition, doctors determine the level of creatinine, urea, and potassium in the blood, and monitor the volume of urine separated. If necessary, ultrasound is performed, radionuclide and radiographic diagnostic methods are used.

Acute renal failure - emergency care

If acute liver failure is suspected, the patient is immediately hospitalized in the intensive care unit. If a vascular accident or injury occurs, the victims are usually immediately taken to the hospital, but, unfortunately, many believe that an ambulance health care in case of poisoning, it is not needed, which, if the kidneys are impaired, is fraught with serious problems.

Emergency care for acute liver failure involves the organization bed rest and warming the body of the victim. Needs to be eliminated as soon as possible causal factor- remove the patient from the state of hypovolemia and neutralize the shock. Doctors perform immediate inkjet introduction warm (38-40C) sterile saline solution "Trisol". Implemented intensive therapy sepsis, etc.

How is acute renal failure corrected, what is its effective treatment?

Therapy involves the exclusion of factors that provoked acute liver failure - they are canceled drugs, treated infectious diseases, take measures to remove the poison, etc.

Patients with this diagnosis are prescribed furosemide (diuretic) in the amount of 100-400 mg, it is administered intravenously. If the drug gives the desired effect, it is administered in an amount of 2-3 mg per kilogram of body weight intravenously in combination with mannitol ( osmotic diuretic) in the amount of 0.5-1 mg per kilogram of body weight. Mannitol is administered through a separate catheter.

Dopamine is administered - an agonist of dopamine receptors, which has hypertensive, cardiotonic and diuretic properties. This drug effectively improves renal blood flow and glomerular filtration, and also forces diuresis and activates the excretion of sodium ions. Dopamine is administered in a volume of 2-3mcg per kilogram of body weight per minute. If the medicine does not desired effect or if the increase in creatinine continues, its use is stopped after six to twelve hours.

Quite often, intravenous administration of heparin is practiced - 5-10 thousand units for the first injection, after drip it is injected into daily dosage no more than 40-60 units.

Patients with acute renal failure are indicated for infusion therapy glucose-salt solutions. Doctors also correct anemia by transfusing red blood cells. In addition, plasmapheresis is performed - the removed plasma is replaced with freshly frozen plasma, as well as with an albumin solution.

If necessary, doctors can carry out hemosorption - blood purification outside the body using a special apparatus. Hemodialysis or peritoneal dialysis can also be carried out, it is carried out with an increase in urea in the blood plasma to 24 mmol / l or more, as well as with uremic intoxication and an increase in potassium up to 7 mmol / l or more.

Patients are shown diet food with limited protein intake.

Proper Treatment allows to achieve kidney recovery in 90% of patients with uncomplicated acute renal failure.

Additional Information

In some cases, acute renal failure leads to the development chronic form this disease. With such a diagnosis, funds will benefit traditional medicine- bird cherry plant and shepherd's bag.

So you can prepare the fruits of bird cherry (a tablespoon of crushed). Brew them with one glass of boiling water and boil for twenty minutes. Strain the strained broth and drink cooled a quarter cup three times a day without reference to the time of the meal.

Also, in chronic renal failure, the shepherd's purse plant can be used. Brew three tablespoons of chopped vegetable raw materials with half a liter of boiling water. Insist in a thermos for three to four hours, then strain. Drink a ready-made infusion for the day - it is best to take it in half a glass immediately before a meal.

If you suspect the development of acute renal failure, you should immediately call an ambulance.

Acute renal failure is an organ pathology in which there is a sharp and rapid decline kidney function. The phenomenon is most often associated with organ ischemia, toxic damage, immune destruction and dysfunction of the tubules with a decrease in urine osmolarity. The pathology is aggravated by an instantly increasing level residual nitrogen, potassium, the development of uremia with increasing serum creatinine. reversible pathology has lightning-fast development and therefore urgent care is needed for acute renal failure. But how to provide the patient with the necessary auxiliary actions, we will tell about this.

Forms of kidney failure

Pathology is divided into several forms:

1. Prerenal, caused by all types of shock with a decrease in the speed and volume of blood circulation: bleeding, a decrease in the volume of water in the body with intense vomiting, diarrhea, burns and other phenomena;
2. Renal, detected on the soil acute glomerulonephritis, interstitial nephritis, toxicity with poisons, antibiotics, radiopaque preparations;
3. Postrenal, which is directly related to blockage of the tubules with urate, oxalate-type calculi, protein coagulants or blood clots.

The clinical picture looks like symptoms of the underlying disease that caused NDE: shock, chills, heat, vomiting, diarrhea. If there is a decrease in urine volume, drowsiness and lethargy, the diagnosis is confirmed.

Important! Acute PN is often complicated respiratory failure, gastrointestinal bleeding, arrhythmias and liver failure.

If OPN manifested itself, what should I do?

Emergency care is the only way to reverse the process of kidney destruction. The choice of therapy depends on the cause, form and intensity of the development of pathology. Patient in without fail must be hospitalized, assigned a strict regimen and introduced a diet of food, drink. In addition, it is necessary to monitor diuresis, blood pressure, respiratory rate, contraction of the heart muscle and temperature.

It is best to provide assistance in a hospital or intensive care unit through intensive care doctors, but this is not always possible. Therefore, if the patient is at home or at work, there are symptoms of acute renal failure, emergency care should be provided by those present. What should be done:

1. Put the patient horizontally, slightly to one side, slightly hanging his head so as not to impede the process of vomiting (if any);
2. Immediately call an ambulance team, explaining that there is a patient with acute renal failure;
3. Warm the patient outside with blankets, clothes;
4. Remove from a state of shock, hypovolemia by means of improvised means;
5. Measure blood pressure, with reduced blood pressure, give a drink that increases blood pressure: rosehip broth, strong tea with sugar and no alcohol;
6. Enter warm sterile saline solution intravenously;
7. To improve the circulation of blood flow in the kidneys, intravenously inject dopamine using the system: drops at a frequency of 5-10 units per minute, a solution of 0.05% in a 5% glucose solution;
8. Give the patient heparin intravenously at once from 5 to 10 thousand units, then daily 40-60 units;
9. Enter furosemide (Lasix) intravenously.

Infusion therapy is prescribed to restore the volume of blood flow, remove toxins and normalize the post-shock state of the patient. Shown gastric lavage, intestines for better removal toxic waste from the bloodstream. If sepsis has begun, it is carried out antibiotic therapy based on combined antibiotics, and the selection of drugs is made from the group of carbopenems. Catheterization is allowed to avoid stagnation of urine and the onset of necrosis.

Important! According to vital signs, surgical intervention is prescribed with opening the capsule of the kidney, draining or removing the organ.

Possible Complications

1. From the side respiratory system these are: pulmonary edema, pneumonia, pleurisy;
2. Cardiovascular system: heart rhythm failures, decreased conduction, insufficiency, tamponade;
3. Hyperhydration/dehydration;
4. Cerebral edema, encephalopathy;
5. Aseptic peritonitis.

Important! If first aid is not provided, it is possible fatal outcome. According to statistics, the mortality rate in the most severe cases reaches 70%. Acute renal failure is a pathology requiring emergency measures assistance, immediate diagnosis and application of the necessary therapy. You should not refuse hospitalization if "everything has already passed" - the disease must be treated, otherwise necrosis of the kidney tissue will begin and the organ will die.

slightest negative manifestations from the urinary system - this is an occasion to consult a doctor, undergo an examination and take the necessary measures for treatment. OPN is a reversible process, but only as long as the patient takes care of his health, otherwise, death is a matter of time, and not as long as many people think.