Generality
Renal blockage, also known as acute renal failure, is a serious medical condition that is characterized by a sudden decline in the functional capacity of the kidneys.
The symptomatology is very broad and is a reflection of the functional incapacities of the kidneys.
If the treatment of renal block is immediate and appropriate to the causes, there is good hope of restoring kidney function.
Short revision of the kidneys
The urinary tract or excretory apparatus is the set of organs and anatomical structures responsible for the elimination of urine .
The main organs of the urinary tract are the kidneys .
Two in number, the kidneys reside in the abdominal cavity, on the sides of the last thoracic vertebrae and the first lumbar vertebrae; they are symmetrical and have a shape that is very reminiscent of a bean.
The most important functions of the kidneys are:
- Filter waste substances, harmful substances and foreign substances present in the blood and convert them into urine.
- Adjust the hydro-saline balance of blood.
- Adjust the acid-base balance of blood.
- Produce erythropoietin glycoprotein.
The anatomy of the kidneys is quite complex: the image below shows the main anatomical elements of a generic human kidney.
What is kidney failure?
The renal block is acute renal failure, that is the serious medical condition, which has as its object the kidneys and consists in the rapid and sudden decline of renal function.
In other words, the terms renal block and acute renal failure refer to the same circumstance, which sees the kidneys having lost their functional capabilities in a sudden and unexpected manner.
If treated promptly and adequately, the renal block has reversible effects . Its presence therefore does not exclude a recovery of renal function.
KIDNEY FAILURE: MEDICAL DEFINITION
With kidney failure, doctors intend a general inability on the part of the kidneys to properly perform their functions.
ANOTHER TYPE OF RENAL FAILURE: THE CHRONIC FORM
The condition of renal failure can also gradually emerge, due to a slow evolution mechanism.
When the loss of renal function occurs with the aforementioned modalities (slow and gradual evolution), the doctors speak of chronic renal failure .
Unlike renal failure, chronic renal failure is a pathological condition, the effects of which are irreversible and for which the treatments serve only to slow down its inexorable deterioration.
WHAT HAPPENS WHEN KIDNEYS WORK EVIL?
When the kidneys lose their abilities and work badly, they skip several mechanisms, including:
- The mechanism of disposal of waste substances present at the blood level. This involves the progressive accumulation of these substances and the consequent intoxication of the blood.
Two important parameters that describe the amount of waste substances accumulating in the blood are azotemia and creatininemia .
Azotemia is the concentration of non-protein nitrogen (or urea) in the blood; non-protein nitrogen is a waste product of protein metabolism.
Creatininemia, on the other hand, is the concentration of creatinine in the blood; creatinine is a waste product deriving from the metabolism of creatine in the muscles.
A high azotemia and, in the same way, an elevated creatininemia are indexes of a malfunction of the kidneys.
- The mechanism of regulation of the hydro-saline balance of blood. This has the effect of accumulating fluids (edema) in various parts of the body, for example in the legs or ankles.
- The mechanism of regulation of the acid-base balance of blood. From this derives an alteration of the blood levels of some electrolytes, such as phosphorus or potassium.
- The production mechanism of erythropoietin.
Causes
The causes of renal failure are very numerous and represent a very broad and complex topic. To make it easier to understand and study, doctors decided to divide them into three broad categories, each of which collects three different types of triggering conditions:
- Category 1: conditions that slow or block direct blood flow to the kidneys.
These conditions include:
- Myocardial infarction ;
- Heart diseases ;
- Liver failure ;
- Inadequate intake of aspirin, ibuprofen, naproxen and other similar drugs;
- Allergic reactions ;
- Severe burns ;
- Severe dehydration ;
- Severe bleeding ;
- Inadequate intake of hypotensive drugs.
- Category 2: conditions or events that cause direct damage to the kidneys.
These conditions include:
- The formation of blood clots in the arterial or venous blood vessels of the kidneys;
- The formation of cholesterol deposits in renal blood vessels;
- Glomerulonephritis ;
- The so - called hemolytic-uremic syndrome ;
- Infections of the kidneys;
- Systemic lupus erythematosus ;
- Intake of certain drugs, including chemotherapy and antibiotics, or other substances, such as contrast fluids and zoledronic acid;
- Multiple myeloma ;
- Scleroderma ;
- Thrombotic thrombocytopenic purpura ;
- Intoxications from alcohol, cocaine or heavy metals ;
- Vasculitis .
- Category 3: conditions that block the flow of urine inside the organs and structures of the excretory apparatus.
These conditions include:
- Bladder cancer ;
- The formation of blood clots in the urinary tract ;
- Uterine cervical cancer, in women;
- Colon cancer ;
- Benign prostatic hypertrophy, in humans;
- Kidney stones ;
- Prostate cancer, in humans;
- Damage to the nerve structures that control the bladder.
RENAL BLOCK RISK FACTORS
The subjects most at risk of renal failure are: the elderly, diabetics, people suffering from hypertension, heart patients, carriers of a kidney disease, individuals with liver disease, people with high levels of cholesterol in the blood and carriers of the so-called peripheral arterial disease.
Symptoms, signs and complications
The typical symptoms and signs of renal block are collected in the table below, which, to the left of the reader, shows the clinical manifestations and, to the right of the reader, the specific causes of these manifestations. In this way, the reader can realize why, in the presence of renal failure, there are certain ailments and problems.
| Event | Consequence of: |
Nausea Vomiting and diarrhea. They are often a reason for dehydration Frequent urination and light-colored urine, or, alternatively, reduced urination and dark urine Difficulty urinating Blood in the urine | High azotemia (hyperazotemia) |
Cramps and muscle spasms | Phosphorus accumulation in the blood (hyperphosphataemia) |
Cardiac rhythm abnormalities Muscular paralysis | Potassium accumulation in the blood (hyperkalemia) |
Edema in the lower limbs (water retention) Dyspnea and chest pain, following pleural effusion and / or pericardial effusion | Accumulation of fluids in tissues |
Sense of fatigue and weakness Drowsiness Memory problems and confusion Difficulty concentrating Dizziness | Lack of erythropoietin production and anemia arising |
Hypertension Loss of appetite Convulsions Persistent hiccups Easy bruising, due to a marked tendency to bleeding | Failure to carry out other renal mechanisms |
WHEN TO REFER TO THE DOCTOR?
The presence of the aforementioned manifestations must induce an individual to immediately contact his own doctor and consult with him about what to do.
Kidney failure is a medical condition that requires adequate and timely treatment. Otherwise, the patient's life is in serious danger.
COMPLICATIONS
Renal blockage is in itself a complication of other conditions or diseases.
Having said this, its further deterioration may correspond to: an aggravation of the edemas present; an aggravation of hyperkalemia with the appearance of serious cardiac arrhythmias, the need to undergo dialysis and, finally, death, especially in the absence of adequate or timely treatment.
Diagnosis
For a correct diagnosis of renal block and its triggering factors, the fundamental tests are: physical examination, medical history, blood tests, urinalysis and some diagnostic imaging tests.
In all those circumstances where doubts remain about the triggering causes, it is essential to use a renal biopsy .
OBJECTIVE AND ANAMNESIS EXAMINATION
Physical examination and medical history are two diagnostic evaluations that provide useful information about the symptoms and signs shown by the patient.
Furthermore, they allow the doctor to understand the health status of the person under examination and deduce the most probable causes of the symptoms in progress.
BLOOD ANALYSIS
Blood tests can be used to measure blood concentrations of urea - that is, azotemia - and creatinine concentrations - creatininemia.
Azotemia and creatininemia are two parameters that allow a significant assessment of an individual's renal function.
URINE ANALYSIS
Urinalysis provides information on the causes and characteristics of kidney failure in an individual.
DIAGNOSTICS FOR IMAGES
Among the possible diagnostic examinations for images useful for a correct diagnosis of renal blockage, it is worth mentioning: the ultrasound - which allows an evaluation of the anatomy and the size of the kidneys - and the abdominal CT - which provides three-dimensional images of the kidneys rich in details.
RENAL BIOPSY
Renal biopsy is a minimally invasive diagnostic test, which consists in collecting a sample of kidney cells (renal cells) and in its subsequent laboratory analysis.
Renal biopsy involves local anesthesia and the use of a long needle for aspiration of the renal cell sample.
Renal biopsy is the safest test to trace the triggers.
Therapy
The treatment of the renal block involves a therapy aimed at treating the causes ( causal therapy ), a therapy focused on improving the symptomatology and complications ( symptomatic therapy ), dialysis and the adoption of a lifestyle appropriate to the health conditions in to which the patient pays.
In general, renal failure requires hospitalization of the patient at least until normal kidney function is resumed.
Brief important note: the purpose of renal block treatments is to eliminate the cause of the aforementioned condition and restore normal renal function .
KIDNEY BLOCK: SYMPTOMATIC THERAPY
Generally, the symptomatic therapy that doctors adopt in the presence of renal blockade includes:
- The use of drugs against water retention (especially diuretics ).
- The administration of drugs that prevent the accumulation of potassium in the blood ( sodium polystyrene sulfonate and the like).
- The use of calcium infusions, to restore the normal concentration of calcium in the blood.
DIALYSIS
Briefly, dialysis is a treatment that artificially reproduces certain functions of the kidney, cleaning up the blood from excess waste products and water.
Figure: dialysis.
LIFESTYLE AND HOMEMADE REMEDIES
Generally, every patient with a renal failure receives accurate and accurate information from their treating physician on what type of diet to adopt.
For patients with kidney failure, sticking to the letter to a doctor's planned diet is a fundamental cornerstone of the therapeutic process.
The most common dietary recommendations include:
- Avoid too salty foods;
- Prefer foods with low potassium content;
- Limit ingestion of protein-rich foods;
- Limit foods that are high in phosphorus.
Prognosis
In the case of renal failure, the prognosis depends on the triggers, the timeliness of the diagnosis and treatments and, finally, on the general health conditions of the patient.
Prevention
Following a healthy lifestyle, taking care of even the least worrying of kidney problems and paying attention to the use of certain drugs are the main preventive measures against kidney failure.
