kidney atrophy
Introduction
Introduction to renal atrophy Renal atrophy refers to a pathological anatomical phenomenon in which the nephron is lost or the blood supply to the kidney is insufficient for various reasons, resulting in a decrease in kidney volume and a decrease in physiological function. It is common in the end stage of various acute and chronic kidney diseases, renal artery stenosis, and kidney development. Bad diseases and other diseases. The most common causes of renal atrophy are various congenital or acquired renal parenchymal diseases, secondary kidney disease, chronic pyelonephritis, aristolochic acid nephropathy, etc., resulting in a decrease in kidney volume and a decrease in function. In addition, the more common causes are renal artery stenosis, urinary tract obstruction that has not been relieved for a long time, renal artery thrombosis and embolism, reflux nephropathy, and renal tuberculosis. The key to treatment is to find the cause of kidney atrophy and analyze the cause. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: anemia, uremia
Cause
Cause of renal atrophy
General reason
Kidney atrophy usually shows left kidney atrophy, right kidney atrophy and kidney atrophy. In general, the causes of kidney atrophy are as follows:
First, we need to consider congenital renal hypoplasia after renal atrophy, followed by end-stage renal disease, namely kidney failure, uremia or some acute conditions. Such as: acute glomerular disease, diabetic nephrosis, renal transplant rejection, chronic glomerulonephritis, renal cortical necrosis, Alport syndrome, acute tubular necrosis, hypertensive nephrosclerosis.
Bilateral kidney or one side of the kidney is mostly the cause of chronic pyelonephritis, which is a common cause of renal atrophy.
In general, chronic kidney disease develops into renal insufficiency, especially in renal failure and uremia, when serum creatinine and urea nitrogen are elevated, kidney damage is severe, kidney essence is damaged, and the kidneys are reduced. Therefore, patients with renal atrophy must be highly valued. Kidney disease is highly concealed. If the glomerular filtration rate is less than 50%, the clinical symptoms will be correspondingly caused by severe kidney damage. After the diagnosis of kidney atrophy, we must actively find the cause in order to check the condition.
other reasons
There are two reasons for renal atrophy: renal tuberculosis (single unilateral kidney shrinkage, with contralateral hydronephrosis or compensatory increase), renal artery stenosis, and congenital hypoplasia.
Conclusion
In general, renal atrophy is associated with prolonged kidney disease, which is caused by kidney diseases, especially glomerular damage, which causes the entire kidney to shrink. Renal atrophy and changes in renal function are complementary. When the patient has renal atrophy, renal insufficiency and renal failure - uremia are already present. In this way, patients with renal atrophy are expected to pay attention to the disease, and a systemic examination should be performed as soon as possible to rule out the possibility of renal failure, so as not to delay the disease.
Prevention
Kidney atrophy prevention
1. Limit the intake of protein. You can eat milk and meat in an appropriate amount. They contain more essential amino acids to supply the body.
2, fat should consider eating foods with a single unsaturated fatty acid, such as vegetable oil. Limit the intake of water and salt so as not to increase the burden on the kidneys and cause edema.
3. Avoid eating foods that contain too much potassium, such as bananas, dried fruits, beef, pork, sardines, bean paste, lettuce, and wheat.
4, eat more dark green vegetables.
Strictly speaking, kidney atrophy is a disease that is difficult to treat. If it is caused by other diseases, in the case of very little damage to the kidney function, the treatment of the primary disease can be controlled and alleviated.
Complication
Renal atrophy complications Complications anemia uremia
Can cause nausea and vomiting, fatigue, anemia and so on.
Symptom
Renal atrophy symptoms common symptoms low back pain with kidney area snoring pain hematuria legs edema low back pain weak backache nausea and vomiting
Patients with renal atrophy may have nausea and vomiting, fatigue, anemia, etc. Continue to worsen will cause uremia. Renal atrophy in patients with renal atrophy can also cause swelling of the face and legs, symptoms of itchy skin, and may also be accompanied by swelling of the feet, and some patients may have a bad back pain, not long-term sedentary. Kidney atrophy is caused by long-term kidney problems, caused by overwork, kidney atrophy, swelling of the legs and feet, and blood pressure will increase with the severity of the disease. The body will gradually lose weight.
Patients with renal atrophy may also have hematuria. Hematuria refers to an abnormal increase in red blood cell excretion in the urine, which is a sign that the urinary system may have serious diseases. Centrifugal sedimentation of urine per high power field of view 3 red blood cells, or non-centrifugal urine more than 1 or 1 hour urinary red blood cell count of more than 100,000, or 12 hours of urine sediment count of more than 500,000, all showed an abnormal increase in red blood cells in the urine, It is called hematuria. Lighter only found red blood cells under the microscope, called microscopic hematuria; heavy appearance is washed water or contains blood clots, called gross hematuria. Usually 1mL of blood per liter of urine is visible to the naked eye, urine is red or washed water.
Understand the symptoms of kidney atrophy, in the case of some abnormalities, we should go to the hospital for kidney B-mode ultrasound to understand whether the kidney has kidney atrophy, which is of great significance for the treatment of the kidney.
Examine
Renal atrophy
Although the size of the kidney is not directly found, the cause of the kidney disease can not be directly found, but the nature of the disease can be initially understood, the doctor's attention can be brought, or the acute and chronic diseases can be identified to provide a basis for reasonable treatment. There are several ways to check the size of the kidney. The most convenient and convenient B-mode ultrasound examination is economical and should be used as a routine item for physical examination. B-mode ultrasound examination of renal atrophy, kidney size methods include the long diameter of the kidney pole and the thickness of the renal parenchyma. The long diameter of the kidney varies according to nationality, height, and age. The left kidney is slightly longer than the right kidney, and the male is slightly larger than the female. According to the survey of the Chinese population, the length of the adult kidney is about 10~12cm and the width is 5~6cm. The kidney volume of the elderly is reduced with the increase of age. The survey considers that the elderly kidney has a long diameter of 9.2~11.8cm and <9.2cm is the kidney. Zoom out, >11.8cm for the increase. The thickness of kidney parenchyma in adults is about 1.5~2cm, and there is no significant difference in the elderly. <1.5cm is reduced, and >2.0cm is thickened. According to the survey, acute and chronic renal failure were identified by measuring the long diameter of the kidney and the thickness of the renal parenchyma. The coincidence rate was 92.6%. Suffering from chronic kidney disease, regular check of kidney size can help monitor the progression of the disease.
Diagnosis
Diagnosis and differentiation of renal atrophy
Standard for judging kidney atrophy
The normal kidney size (long axis) is 11 to 13.5 cm (average 12.2 cm) and the right side is 10.8 to 13 cm (average 11.9 cm), which is equivalent to the sum of the adjacent three lumbar vertebral bodies including their intervertebral space. The width is one-half of the length. It is generally believed that the difference in length between the two kidneys is 1.5 cm, and the right kidney is less than 10% less than the left kidney, which has no positive significance [2]. The renal shadow was slightly reduced (<10 to 9 cm), moderately reduced (9 to 8 cm), and severely reduced (<8 cm).
Clinical features of unilateral renal atrophy
1. The compensatory increase of the contralateral kidney is not common, but the renal blood flow is mostly enhanced.
2, unilateral renal atrophy itself does not cause high blood pressure, such as congenital renal dysplasia, renal self-cutting, renal tuberculosis, chronic pyelonephritis without hypertension, but renal artery stenosis due to activation of renin-angiotensin-alcophenol Systematic and elevated plasma renin levels [4], causing hypertension is common.
3, renal artery stenosis with limbs dorsal artery pulsation weakened or disappeared is not common.
4, renal artery stenosis after DSA expansion, atrophic renal blood flow increased significantly, the kidney increased significantly, showing that some of the atrophic kidneys are reversible.
5, the renal artery is severely stenotic, and the blood flow is not detected, but the kidneys maintain a good blood supply through the collateral circulation, and the diseased kidney is not severely atrophied.
6. On the isotope kidney map, the development of the diseased kidney is delayed, the excretion is slowed down, and the abnormal discharge function appears first. Renal blood flow is significantly reduced or disappeared.
