Wednesday, May 29, 2013

Renal Insufficiency

Renal Insufficiency is caused by many reasons. The renal glomeruli are damaged seriously, which leads to the disorder of electrolyte, acid-base balance. Renal insufficiency can be divided into acute renal insufficiency and chronic renal insufficiency. The prognosis is not good and threatens people’ s life.
The pathogenesis of renal insufficiency
Firstly, renal insufficiency can be caused by kidney disease such as acute kidney failure, chronic kidney failure, pyelonephritis, nephrotuberculosis, renal tubules degeneration caused by chemical toxicant and biological poisons, etc.
Secondly, renal insufficiency can also be caused by barrier in the whole blood circulation such as shock, heart failure, high blood pressure, etc.
Renal insufficiency can be divided into 4 stages.
The third stage is called compensation stage. Because kidney has a strong ability of compensation,symptoms will not occur. Even though some renal glomeruli are damaged, other remained renal glomeruli can still work and do more work to take place those which are damaged. The ability of secretion and electrolyte balance can also meet the need. So in clinic, there is no symptom. In renal function test, we can find out that some index can be in normal range and can be a little high.
In the second stage, we call it renal insufficiency stage. Many glomeruli are damaged in this stage, which account for 60% to 75%. Kidney has difficulties in discharging metabolism. Serum creatinine and BUN (blood urea nitrogen) will become slightly high. Patients can suffer from anemia, fatigue, decreased body weight, and can not concentrate well. All of them can be ignored easily. However, if patients loose water in the body, or suffer from infection, bleeding, etc, their symptoms will appear obviously.
In the third stage, it is called renal failure stage. The damage in the kidney has become rather serious, accounting for 75% to 95%. The inner environment can not maintain stable. In addition, patients will get tired easily and will feel fatigue, and can not concentrate, etc. Anemia is not serious as well. Urine at night becomes more. What’s more, serum creatinine increases. BUN increases as well. Patients can also be accompanied by acidosis. So this stage can also be called azotemia.
In the fourth stage, patients with renal insufficiency develop into advanced stage kidney disease or uremia stage. In this stage, damage of renal glomeruli spreads to 95%. Patients have serious clinical symptoms such as nausea, vomiting, little urine, edema, high blood pressure, serious edema and anemia, itch in skin, and so on.

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