The reason that a large proportion of cases of chronic kidney disease (glomerulonephritis or pyelonephritis) correct diagnosis is made late, only when it is expressed in chronic renal insufficiency. A careful examination of the patient, repeatedly carried out test samples of urine sediment, and crops to identify the flora in the urine and its resistance to chemotherapeutic agents and antibiotics, and check the level of urea serum creatinine, serum electrolytes – sodium, potassium, chloride, calcium, phosphorus, if necessary – a more complex instrumental studies (X-ray, isotope and morphological), the precise clinical assessment and nature of kidney disease and their functional state – must precede treatment. Inadequate and incomplete research in kidney disease, late introduction of correct mode of treatment and can cause severe consequences of acute and chronic glomerulonephritis and pyelonephritis. Acute renal failure aetiology and pathogenesis. Acute renal failure shows a sudden sharp decrease in urine output of less than 300 ml.
The most common causes of kidney failure are: impaired blood flow to the kidneys (cardiovascular failure, massive hemorrhage, sepsis), toxic effects (heavy metals, drugs, etc.), a massive cytolysis (intravascular hemolysis by transfusion of blood gruppovonesovmestimoy, myoglobinuria with severe trauma, massive burns), severe violations of water-electrolyte balance, renal tubular damage, blockage of the urinary tract (nephrolithiasis, changes in the prostate gland neoplasms), etc. Often, acute renal failure occurs in the hard place of internal medicine – the so-called extrarenal azotemia and hepato-renal syndrome. In the initial stages of acute renal failure, especially in cases of violation of the dynamics and dizelektrolitemiey properly conducted intensive treatment can lead to complete recovery of renal function. The clinical picture. Oliguric phase can last from 2-3 to 20-30 days with a gradual increase in serum Blood levels of creatinine, calcium and hydrogen cations. Evolving clinical picture of uremia. The next phase – poliuricheskaya. Gradually increasing the amount of urine, which can reach 5-10 liters per day.