The main signs of kidney disease include swelling, changes in color and clarity of urine, the appearance of blood clots in it, pulling, pain symptoms in the lumbar region. Also, pyelonephritis and similar diseases of the urinary system can be accompanied by an increase in temperature and blood pressure. Any of the above factors is the reason for contacting a doctor.
What are the symptoms of kidney disease
There are signs, the appearance of which is characteristic of a disease. Such symptoms are called symptoms. With kidney disease, the symptoms can be varied, and not always the patient can refer them to the pathology of the kidneys. Some kidney diseases, sometimes even very serious, are asymptomatic. What if you are concerned about something and when you need to see a doctor?
Most commonly, the symptoms of kidney disease are manifested by the symptoms listed below:
- pain in the lumbar region;
- increased blood pressure;
- violation of color and transparency of urine.
Important are the emergence of general weakness and malaise, the occurrence of dyspnoea and nausea, a decline in performance. But this is not a characteristic symptom of kidney disease - these complaints are so nonspecific that their development can only lead to the idea of a disease without knowing which organ is affected.
The first symptoms of kidney disease: swelling of the legs and under the eyes( with photo)
Puffiness is one of the main symptoms of kidney disease, although very often patients say that they excrete more liquid in the urine than they drink. At the same time, they do not have edema, and the body weight does not increase. Of course, this is a delusion. Before determining the kidney disease, you need to consider the rates of intake and loss of fluid.
In physiological conditions, there is a balance between the flow of fluid into the body and its release, which determines the approximate equality of these two components. Approximately the volumes of daily intake and consumption of liquid are as follows.
Approximately 300 ml of water is formed in the body every day when oxidizing carbohydrates, proteins, fats. A person consumes about 1100-1400 ml of liquid a day in the form of liquid food and drink, 800-1000 ml - in the form of solid food, but this figure can vary significantly depending on physiological, climatic, emotional and social factors.
When compiling a balance of fluid intake in the patient's body, the volume of fluid during infusions must be taken into account by the physician:
- Kidneys release about 1500 ml of urine daily( normuria).Every hour an adult releases an average of 40-80 ml of urine. The volume, concentration and composition of urine vary considerably depending on fluid intake and non-adrenal loss.
- Under oliguria( decrease in the amount of urine) is meant a decrease in the volume of daily urine( in the absence of obstructions to urination!) To 400 ml or less.
- With anuria( cessation of urine output in renal failure), the urine output( i.e., urine flow into the bladder) is less than 100 ml per day.
- Polyuria is understood as an excessive amount of 24-hour urine, which under physiological conditions should not exceed 3000 ml. Polyuria, as a rule, is explained by excessive consumption of liquid by the body, also arises from the medicinal mobilization of endogenous water reserves( diuretic therapy).
When analyzing the body's water balance, extrarenal( extra-cellular) fluid losses must also be taken into account, which are subdivided into: natural( through the skin, lungs, gastrointestinal tract) and artificial( via fistula, extensive wound surface, drainage systems).
That's why all attempts to increase the volume of diuresis strictly to the volume of fluid intake for a long time always fail. Some patients say that they drink a lot, but rarely and rarely urinate. The number of such complaints is catastrophically increasing in the summer. This is due to large extrarenal fluid loss, because sweating, sometimes imperceptible at first glance, is significantly enhanced at high ambient temperatures. It is impossible to accuse a patient of the fact that he does not know the elementary law of conservation of mass of matter, since even doctors with extensive experience often forget about this. And sometimes such patients get to the nephrologist, who for a few minutes dispels vague doubts about the health of the kidneys addressed.
With a variety of diseases, the liquid can be distributed into the intercellular space, which can lead to the formation of swelling of the subcutaneous fat. These swelling are most often formed on the lower limbs, namely on the feet. With the increase in the phenomena of hyperhydration( excess fluid in the body), swelling is intensified. With kidney disease, edema spreads on the lower leg, thighs, trunk, upper limbs, face, neck. This distribution of fluid occurs if the patient spends most of the daytime on his legs.
See photos of leg edema in kidney diseases and puffiness of other parts of the body with hyperhydration:
If the patient's bed regimen, the distribution of fluid can occur in such a way that first swelling appears on the upper limbs, face, trunk. This explains the appearance of swelling of the face in the morning hours and the build-up of edema of the lower extremities in the afternoon.
The peculiarity of edema in kidney diseases caused by hyperhydration is their symmetry( if the right lower extremity flows, then the left one swells).However, this allows some patients to have different degrees of edema, for example, on the right and left lower extremities, which can be positional( for example, a long position lying on its side).
Not always with hyperhydration, swelling is detected, in the adult body, up to 2-3, and sometimes 5 liters of fluid can be delayed without appearance visible to the eye and palpable( when palpating) swelling. This is the so-called hidden swelling. The fluid may also linger in the cavity( pleural, peritoneal, pericardial cavities, testicular membranes).
Sometimes, with kidney disease, there are swelling under the eyes( "bags" under the eyes).What only people do not to get rid of them! This and expensive beauty salons, and diuretics, and resorts, and senseless walking around the doctors. Why meaningless? The thing is that swelling under the eyes in most cases is not a pathology.
As seen in the photo, edema under the eyes with kidney disease is different from edema caused by genetic factors:
The swelling in this case does not affect other parts of the body. When examining the doctor for signs of pathology is not detected, and he spreads his hands, and we are disappointed in one doctor and go to another. A small puffiness under the eyes is due to increased hydrophilicity( the ability to absorb and retain liquid) of the subcutaneous fat in this area. This ability is inherited. Pay attention to the faces of your parents, and you will understand everything. Therefore, the only effective way to combat "bags" under the eyes is plastic surgery in the center of aesthetic surgery. If your face suits you, then on this fight with swelling under the eyes ends.
Characteristic symptom in kidney disease: back pain
What other symptoms are characteristic of kidney disease and how do they manifest? A common symptom is pain. This is one of the first symptoms of kidney disease, and it indicates the localization of pathology in these organs.
But low back pain also occurs with : spine and peripheral nervous system pathology( osteochondrosis, ankylosing spondylosis, spine trauma, herniated disc), intestinal diseases( colitis), pancreas( pancreatitis, tumors), female genitalia( myoma of uterus, adnexitis, malignant tumors of the uterus, appendages, endometritis), flatulence( swelling of the intestine), aortic aneurysm( sack-like enlargement), and other pathological conditions.
Back pain in kidney disease occurs with: pyelonephritis, stricture of the ureter, compression of the luminary and calyxes with an additional renal artery, nephroptosis( kidney depression), renal artery thrombosis or vein, urolithiasis, kidney tumor, polycystosis, less often glomerulonephritis anda number of other diseases.
If there is pain in the lumbar region, if it is chronic and worries not the first day, and if it is acute and intense, sometimes unbearable( renal colic), you need to seek medical help.
What are the mechanisms of the onset of pain as a symptom of kidney disease and how are they manifested? First of all, this is an increase in pressure in the lumen of the urinary tract due to the appearance of an obstruction to the outflow of urine. In this case, there is an increase in the pressure of urine on the walls of the pelvis, cups, ureter, where pain receptors are located, signaling to the central nervous system.
The second cause of pain in kidney disease is the extension of the kidney capsule, in which there are also pain receptors. Stretching occurs with inflammatory edema of the kidney( glomerulonephritis, interstitial nephritis), as well as overflow of the kidney with blood( with renal vein thrombosis).
In the event that the pathological process is localized in the ureter, pain occurs along the ureter, that is, by a conditional skew-line line. If the bladder is sick - the pain is localized in the suprapubic region. In diseases of the urethra, pain occurs in the groin. In men with prostatic diseases, pain occurs in the groin and rectum.
How to determine the kidney disease by the pain symptoms and the strength of their manifestation?
Pain sensations vary in intensity: from discomfort and heaviness in the lumbar region to intense paroxysmal pain( renal colic).With renal colic, the patient can not find a place, there is a psychomotor agitation, the patient groans.
As for the analysis and color of urine, to identify a chronic kidney disease
Each of us saw his urine repeatedly and could appreciate its color and transparency. How many vivid impressions arises from the kind of muddy urine, the urine is the color of blood! Most of us, seeing reddening of the urine or the fallout of a heavy sediment, turns to the doctor. But a whole series of serious kidney diseases does not change the color of urine, and microscopic and biochemical research is required to detect these changes.
How to determine the kidney disease in urine and in what cases does its color change indicate the onset of the disease?
Normally, urine can change its color - from colorless( "urine as water") or straw-yellow to dark yellow( "color of beer").Yellow pigment is given by pigments - urochromes, which are formed in the body and excreted in the urine. If the concentration of urochromes is high, then the color of urine is saturated-yellow, if low, then colorless or light-yellow. As it is not difficult to guess, when the volume of urine is increased, the concentration of urochromes decreases, they are diluted, as it were, with a large amount of urine, and it becomes lighter( this happens normally after a plentiful drink, and also during the cold season when the fluid loss with skin is reduced and the fluid consumedis released in large quantities in the urine, by the way, for the same reason in the winter season the volume of urine we have - diuresis - is higher than in summer.
When the volume of urine decreases, on the contrary, the concentration of urochromes increases, and urine is colored more intensively. Therefore, in most cases, if your urine is often yellow or rich yellow, consider whether you consume a lot of fluids. And if urine is often transparent - is it necessary to limit the intake of fluid.
But if everything was so simple. Some diseases lead to the appearance of dark yellow urine. These include jaundice caused by hepatitis( inflammation of the liver), liver cirrhosis( irreversible restructuring of the liver microstructure with the formation of fibrosis).Colorless urine may be an early symptom of such kidney disease as chronic kidney failure. And then this is due to the low concentration of urine in the kidneys. Colorless urine with kidney disease occurs if the disease is accompanied by the development of thirst and copious fluid intake( polydipsia), and hence polyuria.
These include: diabetes mellitus, diabetes insipidus( with this disease, the amount of fluid consumed per day can increase to 10-15 liters!), Etc.
There is no doubt that urine should not be normal red or pink and certainly should not contain blood clots. If you have a blush in your urine, then this is an occasion for urgent medical attention. In some cases, urine may blush due to the intake of certain drugs and chemicals and not be related to kidney damage. This condition is called pseudo-hematuria. In this case, after drug cancellation, the color of urine is normalized and no consequences for the organism arise.
Causes of blood in the urine as a symptom of kidney disease
It is logical to assume that if there is a pseudogematuria, that is, hematuria( in translation from the Greek - "bloody urine").Reddening of urine is associated with the appearance in it of a large number of red blood cells - erythrocytes. To detect kidney disease with blood in the urine, the doctor always assigns a large list of examinations, since the search for truth occurs among a large number of possible causes of its development.
The main causes of this symptom of kidney disease are: glomerulonephritis, malformation of the urinary tract, kidney stone, kidney, ureter, prostate, bladder or urethra, renal infarction. Women should not forget that during the menstrual period, the collection of urine for analysis is not carried out. In extreme cases, when urgently needed, to collect urine, you need to use a urinary catheter or collect urine after a hygienic swab is inserted into the vagina and hygienic treatment of the external genitalia is performed.
Urine is cloudy most often due to the crystallization of salts, the concentration of which in it for one reason or another rises. Often cloudy urine is a symptom of kidney disease, pyelonephritis, when a large amount of mucus and pus are secreted in the urine.
Detection of pus in the urine with a microscopy consisting of white blood cells( white blood cells performing a protective function) is always a sign of pathology. Most often, leukocytes are detected in acute and chronic microbial inflammatory diseases of the urinary system. In the event that urine for analysis for the presence of kidney disease is collected in violation of the rules, some of the leukocytes and bacteria from the vulva in women and from the prepuce bag in men can get into it, distorting the result of the analysis. Therefore, it is very important to strictly follow the rules for collecting urine.
High temperature in kidney disease and how to knock it down
High temperature in kidney disease is a non-mandatory symptom. Normally, the basal body temperature does not exceed 37 ° C and ranges from 35.8 to 37.0 ° C, averaging 36.1 ° C.Basal is the temperature measured in a person under the arm( axillary) or orally( in the mouth) in the morning after awakening from sleep in the supine position, while the ambient temperature should be 21-28 ° C.During the day, the temperature gradually rises, reaching a maximum between 18 and 22 hours( rises to 37.2-37.3 ° C), and then slowly decreases, reaching a minimum between 2 and 4 hours. Thus, the evening temperature of 37-37.3 ° C can not be considered pathologically elevated.
In addition to axillary and oral, rectal thermometry( measurement of temperature in the rectum) is used, however the rectal temperature is usually 0.5-1.0 ° C higher. Physiological elevation of body temperature can also accompany high temperature of the environment, intense physical activity. A fever is the increase in the basal body temperature above 37 ° C or body temperature, measured in the evening hours above 37.3 ° C.
Fever is noted for a number of diseases, which are so many that we will only list the main groups of these diseases.
The occurrence of fever is the reason for contacting a doctor. Remember that uncontrolled intake of all kinds of antipyretic drugs often only distances you from the timely application for medical help. If the doctor did not see a fever symptom of a terrible disease and with the diagnosis of ARVI sent you home, in this case he will recommend the necessary treatment, including antipyretic drugs. Despite the seeming safety for the body of antipyretic agents, they all have side effects that can, with a certain probability, manifest themselves. Puzzling is the use to reduce body temperature in patients with kidney disease analgin and dimedrol.
High temperature in diseases of the kidneys or any other disease is an adaptive reaction of the body, developed during the process of phylogenesis. The fever contributes to the disruption of reproduction of microorganisms, enhances metabolic and reparative processes in the body, stimulates the immune system. It is believed that the temperature to 38.5 ° C is generally not recommended to be reduced. This also repents the high temperature in diseases of the kidneys, including pyelonephritis.
But there are always exceptions: children;diseases accompanied by the development of convulsive syndrome;poor tolerance of high fever( vomiting, severe nausea, the appearance of psychomotor agitation or inhibition, seizures in the fever that occurred earlier).
Than it is possible to bring down a temperature at diseases of kidneys and in other cases? To reduce the temperature doctor should recommend paracetamol( 1-2 tab.) And ibuprofen( 1-2 tab.).
Kidney disease and hypertension: nephrogenic arterial hypertension
Kidney disease and high blood pressure - the phenomena are often interrelated. According to statistics, about 45-60% of patients with kidney disease have a pressure that is far from normal.
By arterial hypertension is understood as a persistent long-term increase in blood pressure above 140/90 mm Hg. Arterial hypertension can be an independent genetic disease, and then it is called hypertensive disease, or primary arterial hypertension. It is also possible to develop arterial hypertension due to chronic kidney disease. In this case, arterial hypertension in kidney disease is called secondary, or symptomatic, or nephrogenic.
What signs make it possible to suspect nephrogenic arterial hypertension? First of all, a prerequisite is the presence of chronic kidney disease. Nephrogenic arterial hypertension develops against the background of the existing kidney disease. Often with kidney disease, blood pressure is disrupted.
In addition to these simple signs, there are a lot of symptoms that confirm the nephrogenic nature of high blood pressure in kidney disease, diagnosed by the doctor in a detailed study.