Nephrosclerosis of the kidneys - a sentence? Chronic pathology - kidney nephrosclerosis: what is it, the outcome of the disease and methods of its treatment Is it possible to cure kidney nephrosclerosis

This is a pathological condition caused by the death of nephrons, their replacement by connective tissue with an increase in renal failure. Manifested by polyuria, nocturia, hypertension, swelling, discomfort in the lower back, in the later stages - oliguria, hematuria, intoxication. It is diagnosed using laboratory tests, ultrasound, CT, MSCT of the kidneys, nephroscintigraphy, angiography of renal vessels, urography, biopsy. For treatment, etiopathogenetic therapy of the underlying disease, anticoagulants, antiplatelet agents, antianemic, detoxification, vitamin and mineral agents, replacement therapy, kidney allotransplantation are used.

General information

Nephrosclerosis is a secondary clinical and anatomical condition, manifested by compaction, wrinkling of the kidneys and a decrease in their functional viability due to the replacement of the parenchyma with fibers and interstitial substance of the connective tissue. The shriveled kidney was first described in 1914 by the German clinician F. Volgard and pathologist K.T. Farom.

Usually, nephrosclerosis complicates the course of urological and other somatic pathologies. In the twentieth century, glomerulonephritis was considered its leading cause, at the present time - arterial hypertension and diabetes mellitus (more than 60% of all diagnosed cases). The prevalence of nephrosclerosis in European countries is 0.06%. At the same time, 10-20% of patients need regular hemodialysis, and mortality from CRF reaches 22%.

Causes of nephrosclerosis

Shrinkage of the kidney is a polyetiological process that complicates various vascular disorders and urological diseases. Depending on the variant of nephrosclerosis, specialists in the field of urology and nephrology distinguish two groups of causes that cause primary or secondary replacement of the renal parenchyma with fibrous structural elements of connective tissue. The primary wrinkled kidney is formed against the background of damage to the renal vessels, caused by diseases such as:

Arterial hypertension. In patients with essential hypertension and symptomatic hypertensive conditions, renal vessels are persistently spasmodic and constricted, and the nutrition of the parenchyma is disrupted. The connective tissue thickening of the vascular wall or the death of arterioles, glomerular capillaries ends, respectively, with the formation of slowly progressive arteriosclerotic nephrosclerosis or malignant arteriolonecrotic glomerulosclerosis Farah.
Atherosclerosis of the renal arteries. The deposition of atherosclerotic plaques on the inner membrane makes the vascular wall less elastic, narrows the lumen of the vessels that feed the renal parenchyma. A decrease in tissue perfusion provokes destruction of nephrons and tissue hypoxia, which contributes to excessive formation of connective tissue. As a result, as a result of atherosclerosis, the cortical substance becomes thinner, the cells of the urinary tubules atrophy, which reduces the functional viability of the kidney.
Chronic venous plethora. Against the background of stagnation caused by nephroptosis, narrowing or chronic thrombosis of the renal veins, the parenchymal vessels expand paretically, the flow of oxygenated arterial blood decreases, and ischemia increases in the tissues. The situation is aggravated by the thickening of the vascular walls, which further disrupts tissue metabolism. Under conditions of hypoxia, partial cell death occurs, and nephrosclerosis occurs within 10-15 years.

In some patients, angiogenic destruction of the kidneys occurs acutely with partial or complete thromboembolism of the renal artery. A sharp violation of blood circulation causes a kidney infarction - a massive death of nephrons as a result of acute ischemia. Subsequently, the necrotic area is gradually replaced by connective tissue, and nephrosclerosis develops.

A secondarily wrinkled kidney is said in cases where the patient initially suffers from a urological disease, in which the renal parenchyma is destroyed under the influence of infectious agents, autoimmune complexes, mechanical factors (stretching, traumatizing with calculi), etc. The main causes of secondary (nephrogenic) nephrosclerosis are:

kidney disease. Sclerosis of the parenchyma can be the outcome of pyelonephritis, kidney tuberculosis, glomerulonephritis, urolithiasis, polycystosis. A separate group of causes of nephrosclerosis is secondary nephropathy, which complicates the course of other pathological processes - diabetes mellitus, systemic lupus erythematosus, malignant neoplasia, preeclampsia.
Diseases of the lower urinary tract. Nephrosclerosis can develop against the background of hydronephrosis, caused by obstructive stagnation of urine with sclerosis of the bladder neck, the formation of uretero-vaginal fistulas, and compression by tumors of the small pelvis. Atrophic processes are observed in 30-60% of patients suffering from vesicoureteral reflux.

Pathogenesis

Despite the variety of causes that cause nephrosclerosis, the mechanism of the development of the disease as a whole is common. Initially, under the influence of various damaging factors (hypoxia, inflammatory and dystrophic processes caused by pathogenic factors of microorganisms, autoimmune complexes, direct traumatic effects, etc.), destruction of the glomerular and tubular epithelium occurs with the exclusion of part of the nephrons from the general blood supply.

Since the kidney cells are not capable of regeneration, after phagocytosis of the destroyed cellular elements, nephrosclerosis begins - the damaged area is replaced by connective fibers, and the kidneys themselves become denser. In the remaining glomeruli, blood circulation and filtration increase, resulting in an increase in the volume of urine excreted and a decrease in its relative density. Against the background of blood flow disorders, the synthesis of renin, which regulates glomerular filtration, increases, which contributes to the occurrence or aggravation of arterial hypertension.

Due to the high compensatory capabilities of the renal tissue, clinical signs of renal failure appear only with severe nephrosclerosis with a loss of 70% of the nephrons of both kidneys or 85% of one. With the preservation of 5% of cells or less, functional failure of the organ occurs, requiring replacement therapy.

Symptoms of nephrosclerosis

The clinical picture of the disease at an early stage is characterized by an increase in the amount of daily urine (more than 2 liters), an increase in urination at night (more than 3 times per night), constant pulling pains in the lumbar region, and an increase in blood pressure. As nephrosclerosis progresses, edema appears: first on the face, then they spread evenly throughout the body. Puffiness is most pronounced in the morning.

At a late stage, the symptoms worsen: the volume of daily urine decreases to 0.5–0.8 liters, an admixture of blood may appear in the urine, the patient is worried about dry mouth, constant thirst. Common symptoms of intoxication arise and increase: headache, nausea and vomiting, weakness, muscle pain.

Complications

Serious violations of the filtration and reabsorption processes that occur during the destruction of more than 70-75% of the initial number of nephrons lead to the formation of chronic renal failure. Since the shriveled kidney stops synthesizing erythropoietin, which is necessary for the maturation of red blood cells in the bone marrow, iron deficiency anemia often develops. In patients with nephrosclerosis, the risk of nephrogenic arterial hypertension is increased due to excessive production of renin. If vitamin D metabolism is disturbed, osteoporosis occurs with increased bone fragility and a tendency to form pathological fractures.

Diagnostics

Patients with suspected nephrosclerosis are prescribed a comprehensive examination to determine the features of the morphological structure of the kidneys, identify signs of parenchyma atrophy, and assess the functional viability of the organ. The most informative laboratory and instrumental methods for diagnosing a wrinkled kidney are:

General urine analysis. For nephrosclerosis, a significant decrease in the relative density of urine (up to 1.005-1.015 g / l) is indicative. With an increase in signs of chronic renal failure, erythrocyturia (up to 2-3 erythrocytes in the field of view), cylindruria, proteinuria (up to 0.033 g / l) are possible.
General blood analysis. In patients with a wrinkled kidney, the content of hemoglobin and erythrocytes decreases, there is moderate thrombocytopenia, an increase in the duration of bleeding and blood clotting time. Slight leukocytosis often occurs.
Biochemistry of blood. Evaluation of functional viability by biochemical parameters reveals renal failure. With nephrosclerosis, the content of uric acid, creatinine, urea, magnesium, phosphorus, and sodium can be increased. Decreased levels of protein and potassium.
Sonography. The characteristic echographic signs of nephrosclerosis are a decrease in the size of the affected organ, thinning of the parenchyma, atrophy of the cortical layer, and its fuzzy differentiation with the medulla. Often, according to the ultrasound of the kidneys, nephrocalcinosis is detected.
X-ray methods. During survey and excretory urography, the size of the kidneys, the cortical layer are reduced, calcifications are determined in the parenchyma. Violation of the filling of the pyelocaliceal system with a contrast agent may indicate the development of chronic renal failure.
Angiography. On angiograms of the kidneys, the arteries are usually narrowed and deformed. In some patients, a small arterial pattern may be absent (symptom of "burnt tree"). The cortical substance is thinned. Roughness of the outer contour of the kidneys is typical.
Dynamic nephroscintigraphy. When wrinkled, the kidney accumulates and removes the nephrotropic radionuclide more slowly. The study is supplemented with static nephroscintigraphy, which reveals parenchymal defects by the uneven distribution of the radiopharmaceutical.
Tomography of the kidneys. On three-dimensional models and layered images obtained during CT, MSCT, thinning of the cortical layer and a decrease in the size of the organ are revealed. Signs of nephrosclerosis are narrowing and deformation of small arterial vessels.
Needle biopsy of the kidneys. Histological analysis of kidney biopsy shows a significant decrease in the number of nephrons, a large number of connective tissue fibers. During the study, the condition of arterioles and capillaries is assessed.

Differential diagnosis of nephrosclerosis is carried out with diabetes and diabetes insipidus, acute renal failure, rapidly progressive glomerulonephritis, hepatorenal syndrome, hypochloremic azotemia. If necessary, the patient, in addition to a nephrologist and a urologist, is consulted by a therapist, cardiologist, phthisiatrician, rheumatologist, endocrinologist, oncologist, oncohematologist.

Treatment of nephrosclerosis

Conservative therapy of the initial stages of kidney shrinkage is aimed at correcting the underlying disease that provoked the sclerotic process and increasing renal failure. Taking into account the pathology that caused nephrosclerosis, the patient is prescribed antibiotics, antihypertensive drugs, statins, glucocorticosteroids, antiglycemic, diuretic, non-steroidal anti-inflammatory and other etiopathogenetic agents. For the relief of disorders caused by functional renal failure, the following can be used:

Anticoagulants and antiplatelet agents. By influencing the rheological properties of blood, they improve blood flow in the renal arterioles, capillaries, and, due to the restoration of tissue perfusion, slow down nephrosclerosis. With caution are prescribed with an increase in chronic renal failure.
Vitamin and mineral complexes. To correct changes in the biochemical composition of the blood caused by impaired filtration, potassium, calcium, vitamin D, multivitamin formulations, and bisphosphonates are used. Their intake improves metabolism and prevents osteoporosis.
Antianemic agents. When anemia is detected, erythropoietin preparations are prescribed, which stimulate the formation of red blood cells, and iron, which is necessary for the synthesis of hemoglobin. Reducing hemic hypoxia allows you to slow down sclerotic processes in the tissues of the kidneys.
Detoxification therapy. To accelerate the excretion of toxic metabolites that accumulate in the body during nephrosclerosis, enterosorbents are used that bind metabolic products in the intestine. Artichoke-based herbal remedies may be prescribed to lower urea levels.

If the wrinkling of the kidney is combined with stage III-IV CRF, renal replacement therapy is indicated - peritoneal dialysis, hemodialysis, hemodiafiltration, hemofiltration. A radical treatment recommended for nephrosclerosis with a decrease in the number of viable nephrons to 5% or less is kidney transplantation after abdominal or laparoscopic nephrectomy.

Forecast and prevention

With timely detection of the disease, the prognosis is relatively favorable, the appointment of adequate therapy allows to achieve a long-term state of compensation for nephrosclerosis. Over time, the work of nephrons worsens, chronic renal failure develops: such patients need an organ transplant or regular hemodialysis.

For the prevention of nephrosclerosis, it is necessary to follow the recommendations of a specialist in the treatment of nephrological diseases (especially of an inflammatory nature), control the level of blood pressure, blood glucose, avoid hypothermia, do not abuse salt and meat food. An important role in preventing the development of a wrinkled kidney is played by regular visits to the family doctor for early detection and correction of somatic pathology.

A disease such as nephrosclerosis has long been ignored by doctors. Until the 19th century, there was no complete description of it. It began to be considered an independent disease only three decades later, when information about the etiology appeared. The disease was associated with damage to arterial vessels against the background of damage to their cholesterol. His prognosis is not always favorable. Many patients after a course of therapy have to deal with complications such as blindness, dysfunction of the ventricles of the heart. In order to maintain the viability of the body, in such cases, urgent blood purification is required by artificial means.

Anatomical note: kidney nephrosclerosis

If you suspect an illness, you should seek help from such a center or a local therapist. The latter, after studying the clinical picture, can give a referral to a narrow specialist.

Diagnosis of the disease begins with a study of the patient's complaints, his anamnesis and physical examination. During the consultation, the nephrologist can also palpate the abdominal cavity. These manipulations allow us to assume a preliminary diagnosis and outline further examination tactics.

At the next stage, the patient is assigned laboratory tests. For example, blood chemistry may indicate the following symptoms of kidney dysfunction:

increase in indicators;
reduction in the quantitative content of protein;
a decrease in potassium, and an increase in phosphorus and magnesium.

In the analysis of urine, protein and red blood cells are detected, but its density is significantly reduced. When examining a blood test, it turns out that the level of platelets and hemoglobin falls, and the quantitative content of leukocytes increases.

For a more accurate assessment of the work of the organs, they resort to instrumental methods for examining patients with a diagnosis of "nephrosclerosis". Ultrasound of the kidneys, for example, allows you to assess their size and the state of the cortical substance. Urography is mandatory. Angiography gives a complete picture of the state of the vessels in the affected organ.

Based on the results of the examination, the doctor confirms or refutes the preliminary diagnosis, gives recommendations for further treatment.

Use of drugs

Therapy of this disease is carried out in specialized nephrological centers. It boils down to eliminating the main provocateur factor. Attempts to restore lost kidney function without a first step are usually unsuccessful.

Treatment is always complex and long-term. Depending on the clinical picture and the general condition of the patient, the following medications may be required:

Anticoagulants ("Heparin") to prevent the formation of blood clots.
Medicines to lower blood pressure.
ACE inhibitors ("Diroton", "Berlipril") to expand the vessels of the kidneys.
Diuretics that remove excess fluid from the body.
Calcium antagonists that promote the expansion of arteries ("Falipamil").
Multivitamin complexes.

For other disorders caused by kidney dysfunction, drugs are selected individually.

Surgery

At the 3-4th stage of the pathological process, drug treatment is usually ineffective. In such cases, the patient is shown hemodialysis or transplantation. The essence of the first procedure is to cleanse the blood of toxic substances. For this, a special artificial kidney filter is used. The frequency of hemodialysis is determined by the patient's condition, the severity of the pathological process. The procedure must be accompanied by medical therapy.

Surgical treatment involves transplantation of a donor kidney. This is one of the few types of operations when an organ can be removed from both a living person and a corpse. During the recovery period, the patient is prescribed serious medical support and complete rest.

Nutrition Features

An excellent addition to the course of treatment is the observance of a fairly strict diet. Nutrition for kidney nephrosclerosis is selected by the doctor for each patient individually. The following principles are usually followed:

Limiting protein intake. At the same time, it cannot be completely abandoned. When choosing protein foods, preference should be given to poultry, fish and dairy products. It is important to completely exclude potatoes, cereals and bread from the diet.
The diet must necessarily include seafood, but they should not be abused due to the high phosphorus content.
Limiting salt intake. At any consultation, the nephrologist will say that at stages 1-2, up to 15 g of salt per day is allowed, and at the 3-4th, this amount is halved. It is impossible to completely refuse this spice, since the likelihood of dehydration increases.
Be sure to include potassium-rich foods in your diet. For example, bananas, dried apricots, raisins.
Nutrition should be as balanced as possible, contain the required amount of calories and vitamins.

Most patients are forced to adhere to such a diet for the rest of their lives.

Forecast

Kidney nephrosclerosis is a chronic disease. At the initial stages of its development, it is possible to maintain the functions of organs, but for this it is necessary to follow the doctor's recommendations and adhere to some restrictions. For example, for patients with such a diagnosis, it is important to minimize the consumption of salt, constantly monitor the levels of calcium and phosphorus in the blood. With each exacerbation of the pathology, it is necessary to seek medical help and each time undergo a course of therapy.

The “wrinkled kidney” identified at the 3-4th stage requires a slightly different approach. In this case, all restrictions are much stricter. It is no longer possible to restore lost organ tissues. Therefore, in such situations, therapy is reduced to ensuring the functionality of the remaining nephrons. Sometimes even this is not enough.

Renal nephrosclerosis is a pathological process characterized by the death of nephrons and the replacement of functional renal tissue (parenchyma) with connective tissue. It can be the result of various diseases of the kidneys or renal arteries and veins, as a result of which the normal blood supply to the organ is disturbed.

With the progression of the disease, due to a significant proliferation of connective tissue in the affected kidney, there is a dysfunction, characteristic structural and morphological changes. The kidneys decrease in size, become dense and wrinkled. Mostly nephrosclerosis develops as a complication of diabetes mellitus, hypertension, atherosclerosis, glomerulonephritis or pyelonephritis and gradually leads to chronic renal failure (CRF).

Types and causes of the disease

Depending on what mechanism underlies the onset of the disease, primary and secondary kidney nephrosclerosis is distinguished. As a result of certain pathological processes, the lack of nutrients and oxygen leads to atrophy or necrosis of the structural and functional units of the kidney (nephrons) located in the parenchyma of the organ. In place of the dead nephrons, connective tissue grows, as a result of which the kidney loses its ability to fully perform its functions.

Primary nephrosclerosis

Primary nephrosclerosis is caused by impaired blood supply to the renal parenchyma and is a consequence of pathological processes in the body that are not directly related to the kidneys. These include:

hypertonic disease;
vascular atherosclerosis;
age-related changes;
obstructed venous outflow of blood.

Hypertensive nephrosclerosis develops due to impaired blood supply caused by spasm and narrowing of the lumen of the vessels. There are two types of this disease:

arteriolosclerotic (benign) nephrosclerosis, characterized by the growth of connective tissue in the inner walls of the renal arteries, which leads to a decrease in their elasticity and causes atrophic changes in nephrons;
arteriolonecrotic (malignant) nephrosclerosis, characterized by necrosis of arterioles and glomeruli, hemorrhages in the walls of the urinary tubules and impaired protein metabolism in the epithelium of the convoluted tubules.

With arteriolosclerotic nephrosclerosis, the kidney has a fine-grained surface

With atherosclerosis, specific fatty plaques form on the inner walls of the arteries. They lead to a decrease in the diameter of the vessels, thickening of their walls and a decrease in elasticity, resulting in a decrease in blood flow and ischemia of the organs and tissues that receive nutrition through these arteries. Most often, atherosclerotic plaques are localized in the places where the renal artery enters the organ or in the area of its branches inside the kidney.

With atherosclerotic nephrosclerosis, the kidney acquires a large-tuberous wrinkled shape.

Age-related changes in blood vessels begin to develop in people after 40 years. They consist in thickening of the walls, loss of elasticity and narrowing of the lumen of the arteries due to deposits of calcium salts on their inner walls, proliferation of connective tissue, accumulation of smooth muscle cells. These processes lead to thinning of the cortical layer of the kidney and atrophy of the cells of the urinary tubules.

Important: After reaching the age of 70, the number of functioning nephrons in the kidney decreases by almost 40%.

With difficulty in the venous outflow of blood in the kidneys, congestion occurs that worsens the blood supply to the organ. The formation of connective tissue in this case is due to an increase in the synthesis of tropocollagen, a structural unit of collagen, as a result of hypoxia.

Secondary nephrosclerosis

Secondary nephrosclerosis is the result of the progression of kidney diseases of an inflammatory or dystrophic nature. Among them:

glomerulonephritis;
pyelonephritis;
nephrolithiasis;
kidney tuberculosis;
syphilis;
rheumatism;
systemic lupus erythematosus;
hyperparathyroidism;
diabetic nephropathy;
interstitial nephritis;
amyloidosis of the kidneys;
trauma and surgery on the kidneys;
exposure;
nephropathy in pregnancy.

Most often, the secondary form of the disease develops against the background of chronic glomerulonephritis. In this case, the affected kidneys have a fine-grained surface, as in the case of hypertensive nephrosclerosis.

Advice: Timely treatment and control of diseases, the complication of which can be secondary nephrosclerosis, helps to prevent the development of this severe pathology.

Symptoms and Diagnosis

In the early stages of nephrosclerosis, symptoms are mild. The first changes can only be detected by laboratory tests of urine and blood, reflecting kidney function. In the analysis of urine, the following deviations are observed:

increase in daily diuresis;
excretion of most of the urine at night;
the appearance of large amounts of protein;
detection of erythrocytes;
reduction in specific gravity.

In a biochemical and general blood test, it is noted:

increased levels of toxic products of protein metabolism;
decrease in total protein;
deviation from the norm of the concentration of potassium, magnesium, phosphorus, sodium;
lowering the level of hemoglobin and platelets;
increase in the concentration of leukocytes.

Patients with progressive kidney nephrosclerosis have:

high blood pressure, not reduced by drugs usually taken for hypertension;
weakness, headaches;
puffiness;
angina attacks;
heart failure and cardiac arrhythmias;
anemia;
blue skin of the extremities;
blurred vision, retinal detachment, inflammation of the optic nerve.

Recommendation: If you notice the above symptoms, you should seek help from a medical facility. The sooner an accurate diagnosis is established and treatment is started, the more likely it is to prevent the development of serious consequences.

Of the instrumental diagnostic methods for suspected kidney nephrosclerosis, the following are used:

ultrasound procedure;
radionuclide renography;
excretory urography;
computed tomography;
angiography of the renal vessels;
scintigraphy;
Doppler study of the vessels of the kidney.

Ultrasound of the kidneys reveals a change in the size of the organ, the thickness of the renal parenchyma, the degree of atrophy of the cortex

Treatment Methods

In kidney nephrosclerosis, treatment depends on the severity of the disease and the symptoms observed. The sooner it is started, the more likely it is to reduce the risk of onset or delay the development of CRF. The main task in the treatment of nephrosclerosis is to eliminate or control the underlying disease that provoked pathological changes in the kidney parenchyma. Otherwise, the applied methods of therapy for nephrosclerosis will be ineffective.

Medical treatment

Medicines are effective in the early stages of the disease. They are taken in a complex and long-term certain courses with short breaks. Depending on the clinical manifestations are prescribed:

antihypertensive drugs;
diuretics;
anabolic agents;
drugs that improve renal blood flow;
enterosorbents;
vitamins.

Important: With the progression of renal failure, antihypertensive drugs should be taken with great caution, as they can provoke an increase in azotemia and worsen renal blood flow.

Surgical treatment

Operative methods of treatment are used in the rapid course of the disease, progressive renal failure or malignant hypertensive nephrosclerosis. These include:

embolization of the renal arteries;
nephrectomy;
donor kidney transplant.

After nephrectomy or embolization of the renal arteries, the patient is shown regular hemodialysis to cleanse the blood of toxic metabolic products and restore electrolyte balance.

Features of nutrition in nephrosclerosis

Compliance with a special diet for kidney nephrosclerosis can reduce the load on the organ and reduce the amount of toxic products of protein metabolism formed. It is especially important at an early stage of chronic renal failure, which is detected when high levels of urea and creatinine in the blood are detected.

The principle of nutrition is to limit the intake of protein, salt and liquid. In addition, it is not recommended to eat foods rich in potassium (bananas, dates, prunes, etc.). Nutrition should be fractional, divided into 5-6 meals.

When compiling a diet, the stage of nephrosclerosis is necessarily taken into account. In the absence of signs of CKD, restriction of protein intake is minimal. Lean meats, fish, dairy products, eggs are recommended. In the case of chronic renal failure, the basis of the diet should be vegetables, fruits, cereals. With normal blood pressure and no edema, the amount of salt entering the body is not reduced. Fluid restriction is necessary in the later stages of nephrosclerosis.

Kidney nephrosclerosis

Every urologist knows the causes of kidney nephrosclerosis, what it is, the outcome of the disease and the signs of this pathology. Nephrosclerosis (shrunken kidney) is a disease that occurs in a chronic form and is characterized by the growth of coarse scar tissue. Mostly adults are affected. If not properly treated, this condition can be fatal.

Types and causes of the disease

Kidney nephrosclerosis is primary (it occurs as an independent pathology against the background of damage to the renal vessels) and secondary (it is a complication of other diseases). The following forms of this pathology are distinguished:

hypertonic;
atherosclerotic;
ischemic (develops as a result of blockage of the arteries that feed the kidneys);
diabetic;
hormonal (occurs during pregnancy and is a complication of toxicosis);
benign (characterized by slow progression);
malignant (characterized by the death of nephrons, capillaries and arterioles, which leads to atrophy of the organ).

The most commonly diagnosed diabetic and hypertensive nephrosclerosis. The reasons for the proliferation of connective tissue are:

Prolonged and persistent increase in blood pressure in the renal vessels (more than 139/89 mm Hg. Art.).
Frequent hypertensive crises.
Kidney infarction. This condition is characterized by tissue necrosis as a result of acute circulatory disorders.
Thrombosis of the renal arteries.
Thromboembolism (blockage of blood vessels by a detached blood clot).
Increased blood clotting.
antiphospholipid syndrome.
Blockage of arteries by plaque. This pathology often develops against the background of excessive consumption of fatty foods and simple carbohydrates, overeating, physical inactivity, smoking and dyslipidemia (changes in the lipid spectrum of the blood). With atherosclerosis, the lumen of the vessels decreases and the walls thicken. At the same time, elasticity decreases.
Congenital malformations of the kidneys.
Diabetes. It develops nephropathy. The reason is damage to the walls of blood vessels.
Toxicosis.
Chronic inflammatory diseases (pyelonephritis and glomerulonephritis).
The presence of kidney stones (nephrolithiasis).
Violation of the outflow of urine (hydronephrosis).
Stricture or compression of the ureter.
Tuberculosis.
Amyloidosis. With this pathology, an abnormal amyloid protein is formed, which is deposited in the tissues of the kidneys. In response, autoantibodies are produced that affect the nephrons and blood vessels.
Injuries.
Surgical interventions.
Exposure to ionizing radiation.
Systemic diseases (lupus erythematosus). With this pathology, circulating immune complexes are formed that attack their own tissues. There is damage to the renal tubules, an inflammatory reaction and tissue sclerosis.

Causes of kidney nephrosclerosis

Primary nephrosclerosis

Primary sclerosis of the kidney often occurs with a heart attack, atherosclerosis of the renal arteries, arterial hypertension and chronic plethora of the organ. Often this problem is faced by elderly people after 70 years. This is due to the natural aging process and the death of nephrons. In older people, there is thickening of the arteries, calcium deposition, and proliferation of connective tissue. The cortical layer of the kidneys becomes thinner, and the inner layer of the tubules atrophies. Symptoms of primary nephrosclerosis can be detected in a child.

Secondary nephrosclerosis

If hypertensive nephroangiosclerosis occurs primarily, then the secondary form is a complication of infectious and non-infectious pathology. It is necessary to consider what diabetic sclerosis is. Kidney damage is a late complication of type 1 and type 2 diabetes (occurs on average 15-20 years after the onset of the disease). Glomeruli are predominantly affected.

Forms of kidney nephrosclerosis

Symptoms and Diagnosis

If a person has atherosclerotic nephrosclerosis or another form of this pathology, then the following symptoms are possible:

Edema. They occur predominantly in the face, but may appear on the trunk. Edema is warm, mobile (going down) and paler than the surrounding skin.
Weakness.
Fast fatiguability.
Dyspepsia in the form of nausea and loss of appetite.
Skin itching.
Dryness and pallor of the skin.
Pain in the lumbar region.
Increase in blood pressure. It is manifested by headache, dizziness, impaired sensitivity and the presence of flies before the eyes.
Visual disturbances in the form of a veil before the eyes, loss of visual fields, decreased visual acuity and headache. With nephrosclerosis against the background of hypertension, swelling of the papilla or optic disc and retinal detachment often occur.
Bruising, bruising, bruising and bleeding. The reason is a decrease in the production of urokinase, which is responsible for blood clotting.
Signs of iron deficiency anemia in the form of weakness, dizziness, periodic fainting and shortness of breath.
Hematuria (an admixture of red blood cells in the urine).
Polyuria or oliguria. A decrease in urine volume is associated with the death of nephrons and a violation of blood filtration. With the death of more than 90% of kidney cells, anuria develops. With it, urine does not enter the bladder.
signs of azotemia. The reason is the accumulation of nitrogenous substances (creatinine and urea) in the blood. Thirst, palpitations, dyspepsia and drowsiness are observed. The extreme degree of this condition is uremia.
Pain behind the sternum.
Signs of cardiac asthma in the form of a feeling of lack of air, sweating, cyanosis of the skin, wheezing, shortness of breath and asthma attacks.
Intolerance to meat food.

In the early stages of the disease, there may be no complaints. The consequences (complications) of nephrosclerosis in children and adults are: chronic renal failure (the most common outcome of the disease), severe intoxication of the body and uremia. With the development of CRF (chronic renal failure) and the absence of proper treatment, the prognosis is unfavorable. Regular medication, blood purification and monitoring of laboratory parameters can prolong life.

Symptoms of kidney nephrosclerosis

Diagnosis requires:

Collection of anamnesis.
Palpation, percussion and auscultation.
Measurement of blood pressure.
General urine analysis. Detects proteinuria (protein admixture), erythrocyturia (blood admixture) and a decrease in its relative density.
General and biochemical blood tests. With this disease, hemoglobin, erythrocytes and platelets decrease. Leukocytosis is observed, creatinine, urea and uric acid increase. In the later stages, the concentration of trace elements increases.
ultrasound. Reveals a decrease in the size of the kidneys, salt deposits and atrophy of the cortical substance.
Test according to Zimnitsky.
excretory urography.
CT or MRI.
Angiography.
radioisotope scanning.
Dopplerography.
Renography (radiography).
Biopsy.

Treatment Methods

With renal sclerosis, treatment should be comprehensive. It includes:

Compliance with a salt-free diet. Patients should reduce protein intake, eat 5-6 times a day in small portions.
The use of medications (anticoagulants, antiplatelet agents, antihypertensive drugs, potassium and iron preparations, bisphosphonates, sorbents, Canephron or Cyston). With nephrosclerosis against the background of hypertension, ACE inhibitors (Perindopril, Kapoten, Enap), calcium channel blockers (Amlodipine, Verapamil) and beta-blockers (Egilok, Betalok, Concor) can be prescribed.
Micronutrient intake.
Purification of the blood by hemodialysis.

Treatment of kidney nephrosclerosis

In severe cases, a kidney transplant is required.

During a lifetime, every person at least once encounters diseases of the urinary system. For some, they pass almost without a trace, but people with a weakened immune system get complications in the form of wrinkling of the kidney, otherwise referred to as nephrosclerosis. If earlier it was thought that such a pathology occurs mainly in patients over sixty years old, now doctors say that the disease is increasingly manifested in children, adolescents and the working population. That is why it is so important to know what the early symptoms of pathology look like, as well as which doctor you need to contact for help.

Nephrosclerosis of the kidney: definition of the disease

Nephrosclerosis is a pathological process during which there is a violation of the structural and functional integrity of the human excretory system. Part of the kidney tissue, as a result of a lack of oxygen and nutrients, dies and is replaced by connective tissue, which cannot fully purify the blood. The affected organ shrinks and decreases in size.

During the pathological process, part of the renal substance dies and is replaced by connective tissue

Every year, about 30% of all patients with nephrosclerosis become disabled, and 7% die from developing acute or chronic kidney failure. At the same time, a little less than a third of all victims seek qualified help.

The kidneys are organs of the excretory system located in the retroperitoneal space. Their structural unit is the nephron - a set of tubules in which urine is filtered and nutrients are reabsorbed. The kidneys also have small cups that form pelvises, from which the ureter then exits. Under normal conditions, about 180-200 liters of liquid are filtered through them daily. If the kidney tissue is damaged and some area does not perform its functions, this negatively affects the general condition of the body.

Primary and secondary nephrosclerosis

Currently, it is customary to classify the disease according to the causes of its occurrence. If the disease develops in a person who has not previously been diagnosed with any other kidney disease, such a pathology is considered primary. Common causes of its development are thrombosis, compression of the vessels that feed the renal substance, malignant and benign formations. In secondary nephrosclerosis, the defeat of the pyelocaliceal system occurs against the background of pre-existing chronic inflammatory pathologies (pyelonephritis, glomerulonephritis, pyelitis, amyloidosis, stone formation).

Single sided and double sided

If only one organ is involved in the pathological process, then this is accompanied by much less pronounced clinical symptoms, since the human body copes with the processes of filtration and reabsorption of fluid for a long time by increasing the functions of the second kidney. Depending on the localization, left-sided or right-sided nephrosclerosis is isolated.

With the development of nephrosclerosis, on the one hand, a healthy kidney takes over all the functions

If both organs are involved in the pathological process, this type of disease is called symmetrical or bilateral. At the same time, the kidneys cannot cope with the load, and all symptomatic manifestations appear already in the second fourth week. This type of nephrosclerosis is recognized as the most unfavorable for the patient.

Bilateral renal nephrosclerosis is characterized by a more malignant course

Atherosclerotic shriveling of the kidney

When cholesterol metabolism is disturbed, plaques containing a large amount of fats form in the wall of blood vessels. They slow down the normal flow of blood through the arteries and veins, causing the kidneys to experience a serious lack of oxygen. This leads to the gradual death of some cells and the replacement of existing nephrons with a connective tissue substance that cannot perform the function of filtration and reabsorption. Atherosclerosis is a consequence of alcohol abuse, smoking and malnutrition.

Atherosclerotic nephrosclerosis occurs predominantly in older people.

A persistent increase in blood pressure greater than 140/90 millimeters of mercury is called hypertension. At the same time, against the background of such an ailment, a vascular spasm develops in a person - the necessary amount of arterial blood does not enter the kidneys and they die. Most often, with hypertensive nephrosclerosis, two organs are involved in the pathological process at once, which makes it an extremely unfavorable form. And also to the defeat of the urinary system, the phenomena of heart failure are added: shortness of breath, asthma attacks, arrhythmias and chest pain, swelling of the lower extremities and face.

Hypertensive nephrosclerosis is formed against the background of a constant increase in blood pressure

Diabetic shriveling of the kidney

In patients suffering from chronically elevated blood glucose levels, toxic compounds of this metabolite with proteins and other substances are regularly formed. They damage the smallest arteries, veins and capillaries, making the vessels more fragile and less elastic. As a result, a huge number of small blood clots are formed, which impede the blood supply to the renal substance. Malnutrition of one organ leads to the fact that the second takes on a dual function and also quickly fails. It is known for certain that all patients suffering from diabetes mellitus experience this form of nephrosclerosis between the ages of 45 and 70.

Diabetic nephrosclerosis occurs in patients who suffer from high glucose levels for a long time.

Malignant nephrosclerosis

This variant of the pathology is one of the varieties of hypertensive wrinkling of the kidney. Its peculiarity lies in its extremely rapid and rapid development: such patients often suffer from crises - acute attacks of rising blood pressure up to 220/110 millimeters of mercury. In this case, the centralization of blood circulation and the gastrointestinal tract, the urinary and endocrine systems are practically deprived of oxygen and nutrients, since they are all used to maintain the activity of the heart and brain. Malignant nephrosclerosis develops in the first thirty minutes after the onset of a hypertensive crisis. To restore kidney function, the patient must be hospitalized in the intensive care unit and connected to hemodialysis.

Currently, to get out of emergency situations, an artificial blood purification system is often used. A hemodialysis machine consists of a series of filter membranes that allow all the fluid circulating in the body to pass through. This allows the removal of toxins and saves time for doctors and the patient.

Hemodialysis lasts at least 4-8 hours

The main clinical symptoms of the development of the disease

Almost all forms of nephrosclerosis, except malignant, are slowly progressive diseases. In the first few months (in a separate case - even years), the disease may not have any symptomatic manifestations. Patients feel mild fatigue, headaches, increased fatigue and reduced resistance to physical exertion. This condition is perceived by most patients as a typical reaction of the body to stress and nervous strain.

A compressive headache is often the first sign of kidney disease.

A few months later, these symptoms are accompanied by a steady increase in blood pressure, dizziness, nausea and vomiting without connection with meals. Patients complain of night sleep disturbances, frequent awakenings and nightmares. In parallel with this, symptoms such as urinary retention, swelling of soft tissues, discoloration of urine, the appearance of blood, sand and other pathological impurities in it develop. About 30% of all patients note an increase in the volume of urine excreted, while the other 70% complain of a decrease in this indicator. No less important manifestations are changes in the neuropsychic status: patients become inhibited, lethargic and depressive, do not respond to external stimuli. This is an extremely unfavorable prognostic sign, as it indicates damage to the nervous system and the development of poisoning of the body with the breakdown products of proteins, fats and amino acids.

With nephrosclerosis, edema is formed on the upper half of the body.

The author of the article happened to participate in the treatment of a patient with a malignant form of nephrosclerosis. The man was admitted to the intensive care unit due to an acute hypertensive crisis and a pressure of 200/100 millimeters of mercury. At the same time, he developed a serious kidney lesion: urine practically did not stand out from the bladder, as a result of which the patient suffered from serious intoxication. Due to the involvement of the nervous system in the pathological process and damage to the cerebral cortex, the patient fell into a long coma. After sessions of infusion therapy and several hemodialysis procedures, it was possible to bring him out of this state.

Methods for diagnosing a wrinkled kidney

The first methods with which the search for the disease begins are the examination and questioning of the victim. The patient needs to tell in as much detail as possible about the illnesses (pyelonephritis, glomerulonephritis, amyloidosis, tumors), as well as to mention the presence of operations in the pelvic area. During the examination, the doctor assesses the condition of the skin and soft tissues. If, with prolonged pressure on fatty tissue, a hole remains on it, this indicates the development of edema. Immediately after the conversation with the doctor, the patient is assigned additional instrumental and laboratory tests. They allow you to assess the state of the urinary system, as well as to identify the cause that could provoke the development of nephrosclerosis.

In his practice, the author of the article often encountered the fact that patients use containers and containers for food, paints and chemicals for testing. Even with the most thorough treatment with antiseptic agents, there is a possibility that some of the protein-fat deposits will not be removed. They can contribute to the appearance of foreign impurities in the urine test, which will not allow a correct conclusion to be made, and the diagnosis will be significantly delayed. That is why doctors strongly recommend purchasing special disposable vacuum-packed containers in a pharmacy or supermarket that are designed to collect urine.

What methods of laboratory and instrumental diagnostics are used for nephrosclerosis:

A general urinalysis allows you to evaluate the physical properties of urine. Normally, it has a light yellow hue, high transparency, and also does not contain foreign impurities. With nephrosclerosis, there is a pronounced turbidity, which is due to the presence of a large amount of protein, salt leukocytes. A change in the shade of urine to a darker one indicates the development of an inflammatory process in the body.
The appearance of blood in the urine indicates the development of nephrosclerosis
Ultrasound diagnostics allows you to evaluate the structure of the pelvicalyceal system and determine the size of the kidney. With nephrosclerosis, the organ shrinks and becomes denser, and its structure changes. On ultrasound images, you can see the replacement of part of the functioning tissue with a connective substance, which causes such a deformation.
An ultrasound image shows a decrease in the size of the organ
Magnetic resonance imaging is one of the most expensive and effective research methods. If it is impossible to see the presence of some stones, tumors and foreign bodies on ultrasound, then MRI does an excellent job with this task. Thanks to the creation of a three-dimensional image on the computer screen, the entire human genitourinary system is visualized, which makes it possible to determine the level of damage.
The picture shows the presence of a foreign body in the left kidney, which causes nephrosclerosis

How is nephrosclerosis treated?

Shrinkage of the kidney is a rather serious disease that requires the immediate initiation of therapy. Without treatment, this pathology can lead to chronic urinary insufficiency in three to five years. All methods are divided into conservative (proper nutrition, the use of medications, folk remedies) and operational (surgical elimination of the problem of nephrosclerosis). Often the combination of these methods allows you to achieve optimal results in just a few weeks.

The most important principles of therapy for nephrosclerosis:

restoration of normal outflow of urine;
lowering blood pressure to normal values;
reduction of inflammatory edema of soft tissues;
replenishment of the body's need for proteins, fats and carbohydrates;
stabilization of water and electrolyte balance and acid-base balance.

Table: drug therapy for nephrosclerosis

Name of the drug group	Examples of active ingredients	The main effects of use
Antihypertensive agents	Catapressan; Guanfacine; Moxonidine; Hygronium; Benzohexonium; Pentamine; Reserpine; Labetalol.	Stabilize blood pressure, preventing its increase and the development of a crisis, reduce the load on the cardiovascular system
Anti-inflammatory drugs	Nimesulide; Askofen; Ketotifen; Nimesulide; Naproxen; Diclofenac; Ketorol; Ketorolac.	Reduce the severity of inflammation in the kidney tissue
Diuretics	Urea; Urea; Mannitol; Cyclopenthiazide; Triamterene; Amiloride; Eufillin.	Remove excess fluid from the body, preventing stagnation of urine in the pelvis
Detoxification therapy	physiological saline (sodium chloride); Disol; Acesol; Ringer's and Lugol's solution; Regidron.	Promotes the removal of toxic substances and reduces the manifestations of intoxication
Vitamin complexes and calcium preparations	Aevit; Calcium-D; Panangit; Asparkam; Duovit; Vitrum; Ostemag.	Replenish the body's need for the necessary micro and macro elements

Photo gallery: drugs for the treatment of shriveled kidney

Furosemide is a diuretic that removes excess fluid from the body.
Nise is an anti-inflammatory drug that reduces swelling of the kidney tissue.
Trisol removes toxins from the body
Complivit restores the body's need for vitamins

Surgical elimination of pathology

With the development of malignant nephrosclerosis and the addition of a bacterial infection, doctors decide to perform an operation. This condition directly threatens not only the health, but also the life of the patient, as it can lead to death. Contraindications for surgical intervention are:

general serious condition of the patient (coma, septic shock, myocardial infarction);
allergic reaction to anesthetic drugs;
terminal stage of HIV infection;
age over 90 years.

The operation takes two to five hours.

After introducing the patient into an artificial sleep, the doctors proceed to the operation. Soft tissues in the lumbar region are sequentially cut: skin, fatty tissue, muscle fibers. Next, surgeons find and study the condition of the kidney: it looks much smaller than a healthy organ. A clamp is applied to the place of origin of the neurovascular bundle and ureter to avoid the development of massive blood loss. Then doctors remove a section of the damaged kidney or the entire organ. At the end of the operation, a drainage system is installed in the wound to drain the pathological contents, and the patient is transferred to the intensive care unit, where he is under the supervision of doctors for a long time.

Traditional medicine as an aid

Various decoctions and infusions are widely used for the treatment of kidney diseases at the present time. Along with medications, they help relieve the symptoms of nephrosclerosis and alleviate the general condition of the patient. However, one should not completely abandon the means of the pharmaceutical industry: only the medicines prescribed by the doctor will help eliminate the cause that provoked the development of the pathology.

Before you start taking any new infusion or decoction, you need to check for allergic reactions. To do this, be sure to drink a small amount of liquid. With the appearance of a rash, itching, burning, choking and coughing, immediately abandon this remedy.

Put one hundred grams of chokeberry in a saucepan with 500 milliliters of non-carbonated water. Cook over low heat for half an hour, stirring constantly. After cooling, drink half a glass before each meal. Chokeberry is a berry that has a hypotensive effect. Therefore, before starting its use, it is necessary to measure blood pressure. It is worth using this remedy only in the presence of persistent hypertension: an overdose can provoke collapse and a state of shock.
Pour 30 grams of lingonberry leaf, three tablespoons of chopped chamomile and mint into a thermos with a volume of at least two liters. Fill with boiling water and leave for a day. Throughout the next day, drink one glass every few hours. This mixture of herbs and plants helps remove excess fluid from the body and helps reduce inflammation. It is recommended to use this method no more than three times a week for a course of four months.
Boil two teaspoons of dried calendula flowers in a glass of boiling water, covered with a saucer. Once the liquid has cooled, drink it in small sips before any meal. Calendula has a pronounced antiseptic activity, and also reduces the likelihood of purulent-septic complications. The course of treatment consists of twenty procedures with an interval of several days.

Photo gallery: traditional medicine for the treatment of a shriveled kidney

Chokeberry lowers blood pressure
Chamomile relieves soft tissue inflammation
Calendula has an antiseptic effect

Video: treatment of kidney ailments with natural remedies

To restore the necessary balance of proteins, fats, carbohydrates and vitamin and mineral elements, patients with a wrinkled kidney are prescribed a special diet. It allows you to reduce the load on the cardiovascular and urinary system and contributes to the normalization of blood pressure. Basic principles of proper nutrition for patients with nephrosclerosis:

reduction of salt volumes to 5 grams per day;
the number of meals - at least 6 times a day (breakfast, lunch, dinner, snack);
the ratio of proteins, fats and carbohydrates should be 1:1:4.

Doctors recommend adding more berries to the usual diet. The most useful are cherries, cranberries and lingonberries, as they have an antiseptic and mild diuretic effect, and also contain a large amount of vitamin C.

What foods are useful for people with nephrosclerosis:

fresh vegetables and fruits (in the form of salads, mashed potatoes, cuts);
milk, cheese, cottage cheese, yoghurts without additives, snowball, kefir, bifidok;
lean meat (turkey, chicken, beef) and fish (pink salmon, hake, pollock, perch);
cereals (buckwheat, oatmeal, rice, oatmeal, millet);
hard pasta;
nuts;
legumes and peas (beans, chickpeas, lentils).

Photo gallery: healthy food

Fresh vegetables and fruits are the best source of vitamins
Curd contains a lot of calcium
Eating meat restores the need for protein

Predictions and possible complications of nephrosclerosis

Like any other pathology that damages internal organs, kidney shrinkage has a negative impact not only on the urinary system, but on the entire human body. With a timely start of a course of drug therapy, doctors manage to reduce the risk of developing pathological complications to a minimum. It is known that the success of recovery largely depends on factors such as the age of the patient, his behavior and attitude to treatment, the presence of chronic diseases (alimentary obesity, diabetes mellitus, hypertension, gout).

As you know, lifestyle also has a significant impact on the development of many complications of nephrosclerosis. In his practice, the author of the article treated one patient who had suffered from pyelonephritis for many years. She refused to follow a diet and take medications, which regularly led to a deterioration in her condition. A few days after the exacerbation of chronic pyelonephritis, the woman was hospitalized in the intensive care unit, where she was diagnosed with kidney failure against the background of nephrosclerosis. The affected organ had to be completely surgically removed, and the patient is now required to attend hemodialysis for life. And also she was assigned the second group of disability. The development of this situation could have been avoided if the patient had corrected her habits in a timely manner and regularly took the medications prescribed by the doctor. That is why doctors strongly recommend that you constantly go for examinations and not start chronic diseases.

What complications and unpleasant consequences can lead to nephrosclerosis:

increased risk of developing malignant and benign neoplasms;
the formation of stable arterial hypertension and periodic crises;
the addition of bacterial microflora and the occurrence of an abscess, furuncle and phlegmon;
violation of urine output and water-electrolyte balance, which is manifested by convulsions and arrhythmia;
infectious-toxic shock and collaptoid conditions;
cerebral edema;
thrombosis and thromboembolism of large vascular trunks;
urolithiasis disease;
uremic coma and poisoning with decay products of substances.

Features of the manifestation, symptoms and treatment of the disease in children

The body of a child is very different from the body of an adult. Due to the insufficient development of adaptation mechanisms to environmental factors, babies are much more sensitive to the formation of inflammatory diseases of the genitourinary system. Even pyelonephritis transferred at an early age can cause nephrosclerosis. Children react much more sharply to pathological processes occurring in the body: they are characterized by an increase in body temperature up to 39 degrees, chills, sweating, loss of consciousness due to sudden pressure surges.

Based on my own experience, the author of the article can say that the most unpleasant prognostic sign is the presence of a convulsive syndrome. At the same time, the tone of the muscles of the body increases in the baby, it is spastically bent, and the limbs are deformed. Such a pathology indicates the development in the child of an excess content of potassium in the body. This chemical element is responsible for the contraction of the muscles of various organs, including regulating the activity of the heart. Its increased content can provoke arrhythmia, which is often observed in children with nephrosclerosis.

During an attack of seizures, the baby takes an unnatural position

All babies with suspected development of such a pathology are subject to mandatory hospitalization. Therapy in the department of nephrology is carried out according to the same principles as in adults, however, dosages and drugs are replaced with more gentle ones, it is permissible to use various decoctions and herbal infusions. After discharge from the hospital, the child must follow a diet, limit the intake of salt, sweets and fast food, as they slow down the metabolic processes in the human body.

The body of a baby has a much greater potential for regeneration than the body of an adult. That is why patients under the age of 18 who have been diagnosed with this disease can almost completely recover with a well-chosen course of medical procedures.

What drugs are used to treat nephrosclerosis in children:

antihypertensive agents: Veroshpiron, Labetalol, Verapamil, Diltiazem, Chlorpromazine;
anti-inflammatory and antipyretic: Ibuklin, Ibuprofen, Nurofen, Paracetamol, MIG;
diuretics: Spironolactone, Urakton, Phonurite, Diakarb, Hypothiazid.

Photo gallery: medicines for the treatment of a wrinkled kidney in children

Verapamil stabilizes blood pressure
Hypothiazide - a diuretic that removes excess fluid from the body
Ibuprofen is an NSAID that reduces inflammation

The manifestation of the disease and its treatment in the elderly

The occurrence of nephrosclerosis in people over 60 years of age is directly related to the development of chronic diseases such as atherosclerosis, hypertension and diabetes mellitus. At the same time, kidney shrinkage develops gradually, remaining almost invisible against the background of other health problems. People who have been suffering from nephrosclerosis for a long time may not even be aware of it. Patients over 60 often complain of nocturnal awakenings due to constant urge to go to the toilet, prolonged headaches and discoloration of urine, but do not associate this with possible kidney damage. Body temperature rarely rises to 27 degrees, but older people often suffer from drops in blood pressure (more than 60 millimeters of mercury during the day).

Quite often, nephrosclerotic kidney damage is detected in patients during a planned general urine test or during an ultrasound examination.

In the treatment of wrinkling of urine in persons over 60 years of age, there are certain aspects that must be taken into account when prescribing and selecting medications. First of all, it is imperative to find out what drugs the patient is currently taking, and whether it is possible to allow their combination with each other. In addition to the main therapy, the following groups of drugs are prescribed:

Anticoagulants prevent the formation of blood clots and thickening of the blood, which is often found in older patients. The most famous drugs are: Heparin, Fraxiparin, Clexane, Enoxaparin sodium, Lepirudin, Refludan, Neodicumarin, Sinkumar.
Antiplatelet agents also normalize blood flow and reduce the likelihood of emboli formation. These include: Aspirin, Thrombo ACC, Dazoxyben, Ridogrel, Prostacycline, Dipyridamole, Curantil, Anturan, Persanthin, Ticlid, Plavix.
Phytotherapy: preparations based on various plants and herbs are less aggressive, but highly effective. They help relieve spasm and inflammation from the soft tissue area, and also stimulate urine output and reduce swelling. The most famous are: Cyston, Kanefron-N, Fitolizin, Afala, Urolesan, Flavia, Trinephron.

Photo gallery: drugs for the treatment of nephrosclerosis in the elderly

Clexane is an anticoagulant drug that thins the blood.
Clopidogrel reduces the likelihood of a blood clot
Cyston - a herbal preparation that helps to normalize urination

Nephrosclerosis belongs to the group of extremely dangerous pathologies, untimely diagnosis and treatment of which can lead to the development of many unpleasant complications. That is why all doctors strongly recommend not to engage in therapy at home, but to immediately seek medical help. This can avoid the negative consequences of nephrosclerosis. And also special attention should be paid to the prevention of diseases of the urinary tract: pyelonephritis, glomerulonephritis and pyelitis are among the most common causes of the disease. Regular check-ups with the doctor and taking the necessary urine and blood tests will help to avoid these infections.

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