Acute renal insufficiency: Acute renal insufficiency is characterized by a reduction in the amount of urine and a more than 50% increase in the substance creatinine (metabolic product of the muscle) in the blood.
These are the typical symptoms
High blood pressure Water retentions/edema Headaches Fatigue and reduced performance Muscle twitching Itching Loss of appetite and nausea Bone softening Anemia
- High blood pressure
- Water retention/oedema
- Headaches
- Fatigue and reduced performance
- Muscle Twitching
- Itching
- Loss of appetite and nausea
- Bone softening
- Anemia
Itching – also called pruritus among physicians – occurs in the context of uremia. Uraemia describes the increasing poisoning of the body with substances that actually have to be excreted via the kidneys. Uraemia, which only occurs in advanced renal insufficiency, leads to a variety of symptoms.
One of these is itching, which affects many patients. It is not yet known why itching occurs as part of uremia. In chronic renal insufficiency, unpleasant bad breath occurs later in the course of the disease.
This is an intense smell of urine. This odor is primarily released via the exhaled air. In addition, the urine odor is also released via the sweat production of the skin.
In medicine, this typical body odor is called Foetor uraemicus. The kidney not only has an important function in the detoxification of the body and the water balance. It also produces hormones – including erythropoietin or EPO for short.
This is also used as a doping agent in sports. Erythropoietin stimulates blood formation in the bone marrow. In renal failure, the production of erythropoietin is reduced, so that blood formation in the bone marrow is no longer stimulated sufficiently.
This leads to anemia, also known as anaemia. For this reason, erythropoietin is given as part of the therapy when anemia occurs. The sensory disturbances, which are among the late symptoms, are called polyneuropathy.
The sensory disturbances occur primarily on the legs. They can manifest themselves in different ways. There can be paraesthesia, numbness, limited sensation of heat and cold and other sensory disorders.
Polyneuropathy occurs because in the late course of renal insufficiency the whole body suffers from the accumulation of toxins that would have to be excreted through the kidneys. The nerves are affected. There are many other diseases that cause numbness in the legs.
A widespread disease is diabetes mellitus, which often occurs together with renal insufficiency. The kidney influences the bone metabolism. It is in the kidney that vitamin D is activated.
Together with two other substances, vitamin D regulates the breakdown and formation of bones. The vitamin D has the task of promoting the mineralization of the bone. A lack of vitamin D therefore leads to softening of the bones.
Additionally the Vitamin D ensures that the substances for the structure of bones, i.e. phosphate and calcium, are provided, by promoting the admission of calcium in the intestine and of calcium and phosphate in the kidney. Thus a vitamin D deficiency also leads to a deficiency of phosphate and calcium. In medicine, the negative consequences in bone metabolism caused by chronic renal insufficiency are also known as renal osteopathy.
Edemas are water retention in the tissue. They occur in the context of renal insufficiency due to insufficient water excretion and the resulting accumulation of water in the body. Edema occurs mainly in the legs and is initially noticeable as heavy and thick legs in the evening.
As the body’s water retention increases, the edema becomes more pronounced and is distributed throughout the body. In severe cases, edema also occurs in the face. Headaches occur in the context of uremia, i.e. the accumulation of toxins in the body due to limited kidney function.
In addition to the headaches, visual disturbances can also occur. Headaches are often accompanied by other general symptoms such as fatigue and reduced performance. In the final stage of renal insufficiency, the symptoms become more severe and dizziness and drowsiness develop.
The water, which can no longer be excreted, collects in the lungs, among other things. This is known as pulmonary edema.In chronic kidney disease, the water does not collect directly in the lungs, but in the tissue between the alveoli and airways of the lungs. This becomes thicker and thus narrows the airways.
The pulmonary edema leads to an increase in breathing rate and coughing. The more water accumulates in the lungs, the more severe the breathing problems become. Proper seizures only occur in the final stage of chronic renal insufficiency.
Late symptoms, however, include muscle twitches. Restless leg syndrome, which describes restless legs, especially when falling asleep, can also occur. Muscle cramps can also occur during dialysis.
In the advanced stage of renal insufficiency, the various toxins accumulated in the body can lead to inflammation of the pericardium, known as pericarditis. Pericarditis causes stabbing pain behind the breastbone. In the context of renal insufficiency, however, cardiac arrhythmia can also occur.
The excitation of the heart reacts sensitively to changes in the potassium concentration. Renal insufficiency causes changes in the water and electrolyte balance, which can lead to excessive potassium concentrations. This can then trigger cardiac arrhythmia.
Therefore, regular checks of the electrolyte values are very important in therapy. The blood pressure setting in the body is influenced by many factors. The kidney itself can have a regulating effect on blood pressure by releasing hormones.
The release of hormones depends on the pressure and the salt concentration in the small renal arteries. In the event of a loss of function, this regulation no longer functions and high blood pressure results. This is fatal, as high blood pressure itself has a negative effect on kidney function. This creates a vicious circle. Therefore, a good blood pressure setting is essential in the therapy of chronic renal insufficiency.
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