Toxic kidney symptoms. Treatment Options and First Symptoms of Toxic Nephropathy

12.04.2020

The kidneys are one of the most important elements of the "cleansing" of the human body. This is a perfect natural filter, the functionality of which includes blood purification. In the case of the appearance of endogenous and exogenous nephrotoxins, the condition of the body is complicated, which is often accompanied by renal failure.

Symptoms of Toxic Nephropathy

When a toxic kidney begins to suffer, the level of organ damage for the most part will be determined by the type of substances entering the body, their number and method of exposure. Here, the urinary system is given their participation until the disease appears - if chronic kidney diseases were present, nephropathy can develop from any manifestations to the level of maximum severity.

The clinical picture is very similar to acute glomerulonephritis. First of all, standard symptoms of toxic nephropathy will begin to occur: general malaise, apathy, in some cases, the temperature may rise.

After a while, the patient will begin to notice how his legs swell, and his face begins to take a puffy shape. In parallel with this, the composition of urine begins to change - the number of protein increases, blood appears (red blood cells).

Processes and causes

The kidneys are a paired organ of small size in the form of beans. This organ performs the following functions in the human body:

regulates water balance;
participates in the control and support of blood pressure;
participates in the process of creating blood cells;
displays exchange products.

In each of the kidneys there is about one million units of filtration, which are called nephrons, which, in turn, contain glomeruli. They are semi-permeable, which allows metabolic products that dissolve in the blood to make an unhindered passage through the membrane. Thus, metabolic products that have been filtered, leave the body naturally with urine.

When toxic damage to substances begins, most Nephrons take on the load, this after some time leads to the fact that they simply can not cope with their basic functions.

Nephron - a structural unit of the kidneys that performs the "work" of the body

The list of damaging substances looks like this:

poor quality alcohol;
heavy metals;
organic solvents;
pesticides;
medicines (in case of overdose, the use of low-quality or expired drugs, the wrong route of administration).

In case of malnutrition, the risk of developing ischemia increases. This is fraught with the fact that prolonged acute ischemia can lead, in particular, to necrosis. This is exacerbated by serious problems with the functionality of the kidneys, as a result of which toxic environment and substances begin to accumulate in them, which it is no longer possible to naturally remove.

What treatment should be used?

The most important action that should be performed in the treatment of this type of poisoning is the neutralization of the toxic effect and the emergency removal of its factors from the body. Medical support in this case will be required instantly.

First aid in such situations looks like this:

rinse the stomach (especially for children) - if toxins begin to get into the blood due to the use of food containing poison or many drugs;
take a strong poisonous sorbent - in cases of chemical intoxication or poisoning by industrial waste;
take activated charcoal - to help remove toxins that enter the bloodstream;
use a special device "artificial kidney" - for especially difficult cases.

Toxic nephropathy poses a great danger to human life. Pathology in the work of the kidneys is enhanced by toxic liver damage (hepatorenal syndrome). Thus, when a nephrotic lesion is detected, the first thing a person needs to do is to seek help from a specialist, and as soon as possible.

The most commonly used treatment options for this disease are the use of an “artificial kidney” and detoxification through the use of activated carbon. Using these methods, you can urgently cleanse the body of all poisons.

Hemodialysis will cleanse the blood of toxic and toxic substances, metabolites

Preventative measures

Prevention of the disease includes:

introduction of continuous technological processes;
the use of hermetic equipment;
improvement of automatic and remote processes;
close monitoring of the use of personal protective equipment by employees;
it is also important to carry out preliminary and periodic medical examinations of employees.

If all the necessary requirements are met, the probability of a favorable outcome is quite high. Forecasts in this case are positive, the probability of a complete recovery is very high.

Pathology of the kidneys, damage to the glomerular apparatus and kidney tissue, provoked by the introduction of nephrotoxic substances into the body (code according to ICD-10 - N14.4) or their accumulation.

The severity of the course of the disease is distinguished:

mild - minor symptoms, changes in laboratory parameters of blood and urine;
medium - a decrease in diuresis, an increase in uremia and symptoms;
severe - decreased glomerular filtration, the development of edema, the possibility of complications of renal failure.

A number of diseases and factors can lead to nephropathy, for example, diabetes mellitus, and it can also be of an infectious toxic origin.

Causes and pathogenesis

Kidney damage can occur due to the pathogenic effect of toxic substances themselves, their decomposition products on their tissues, and also against the background of the development of an autoimmune reaction.

Most often, the disease is caused by such substances:

Heavy metals, their salts;
Ethylene glycol;
Oxalic, acetic acid;
Pesticides, herbicides;
Arsenic;
Solvents;
Copper sulfate;
Poisons of animals, insects;
Mushroom toxins;
Nitrogen-containing compounds;
Volatile ethers;
Poor alcohol.

Often, toxic nephropathy is recorded in people employed in hazardous industries, where work is associated with poisons, chemicals, rubber, polymers. All substances can enter the body through the respiratory system, as well as through the blood, through the skin (with bites).

After exposure to the kidneys of toxins and metabolites, parenchyma cell edema is observed, as well as impaired renal glomeruli, which causes interruptions in cellular respiration and precipitation of protein fractions. If hemotoxic poisons act on the body, they simultaneously destroy red blood cells, as a result of which hemoglobin clogs the structural units of the kidneys - nephrons.

The severity of organ damage will largely depend on the type of substance received in the body, on its quantity, on the method of ingestion. The health of the urinary system plays a certain role before the onset of pathology - in the presence of chronic kidney diseases, nephropathy can develop even from small doses of toxic substances.

The clinical picture resembles that of acute glomerulonephritis. At first, general symptoms appear - weakness, weakness, lethargy, and temperature may rise. Further, a person notes swelling of the legs, puffiness of the face. Urine composition indicators are changing - the amount of protein is growing in it, blood appears (red blood cells).

Other common signs of pathology:

Increased blood pressure up to very high numbers.
Decreased urine output, frequency of urination (sometimes complete anuria).
Low back pain due to swelling of the kidneys.
Cramps.
Heart rate reduction.
Arrhythmia.
Wheezing in the lungs.

Depending on the type of toxic substance, specific symptoms may join the clinical signs described above. For example, if a person has been poisoned with an excessive amount of sulfonamides, then with toxic nephropathy he has pains in the joints, hemorrhages on the skin and mucous membranes, and a fever.

In terms of severity, the disease is differentiated in this way:

The first is a moderate increase in protein, hemoglobin and red blood cells, mild symptoms.
The second - diuresis decreases, the amount of urea, potassium, creatinine in the blood increases significantly, the symptoms increase.
The third - due to renal edema and a sharp decrease in glomerular filtration rates, the development of acute renal failure, a deadly complication, is possible.

In the progression of renal failure with toxic nephropathy, several stages are also distinguished:

Initial (up to 3 days). The actual poisoning of the body with nephrotoxic agents occurs.
Oligoanuric (1-2 weeks). Due to fluid retention, urine flow is reduced, which leads to an overload of the heart and the development of edema, shortness of breath, wheezing in the lungs. Cerebral edema is also possible at this stage. There is death from asphyxiation with pulmonary edema, from cardiac arrest, DIC. Often secondary vasculitis, anemia, and thrombocytopenia join.
Stage of polyuria (up to several months and years). This stage occurs with a favorable course of the disease. Diuresis is increasing, which can also lead to dehydration.
Recovery. All urine and kidney function return to normal, but not all patients can recover completely.

The main causes and course of toxic nephropathy

As in case of poisoning by mushrooms, alcohol substitutes or poisons, and when the body breaks down its own tissues, the main problem for the kidneys is the negative effect of toxins on the internal renal structures. It is a total violation of the kidneys that leads to life-threatening complications.

In most cases, toxic nephropathy develops after a certain group of chemical compounds enters the body, they include:

Lead, mercury;
Nitrogen-containing compounds - ammonia, aniline, nitrobenzene;
Halogenated derivatives - carbon tetrachloride;
Glycols - diethylene glycol, antifreeze;
Esters - ethyl acrylate, dioxane.

Alkalis, acids, insecticides in high concentrations that enter the body can lead to the development of the disease. Pathology is most often detected in people whose specialties are directly related to working with the listed chemicals. Less toxic kidney damage occurs when poisoning with highly toxic mushrooms, low-quality foods, high doses of alcohol.

Kidneys are a paired organ, similar in shape to beans, which performs such functions:

regulate the balance of fluid in the body;
control and maintain proper blood pressure;
participate in the process of blood cell formation;
remove metabolic products from the body.

Each of the kidneys consists of many nephrons - these are special particles of filtration. Each of the nephrons consists of a glomerulus of small blood vessels, they are semi-impermeable, therefore metabolic products pass through them, like through a membrane. Well-filtered metabolic products are excreted in urine.

If toxic substances enter the body, then the whole burden falls on the nephrons, which begin to cope poorly with their function. The clinical picture directly depends on what toxic substance has penetrated the body.

The causes of toxic nephropathy include the following factors:

poisoning with low-quality alcohol-containing drinks;
heavy metal poisoning;
ingestion of various solvents;
pesticide intoxication;
overdose medicines, as well as treatment with expired or substandard medicines.

If the nutrition of the kidneys is insufficient, then ischemia may develop, which is considered a reversible condition. If ischemia is not treated for a long time, then necrosis occurs, which is already an irreversible pathology. This condition is characterized by a complete impairment of renal function, due to which toxic substances accumulate in the body, and they are not completely eliminated naturally.

Toxic nephropathy requires urgent treatment, otherwise life-threatening complications may occur.

There are a lot of toxic substances that can harm the kidneys. Some of them enter the body in the process of life, while others arise due to injuries or diseases. Toxic nephropathy may appear during treatment with drugs or in the provision of emergency medical care. The main factors causing toxic nephropathy include:

eating poisonous mushrooms;
poisoning with chemicals, heavy metals (mercury, copper, cadmium);
exposure to radiation (uranium salts);
ingestion of organic poisons (acetic acid, carbon tetrachloride);
poisoning with alcohol substitutes;
prolonged use of drugs that contribute to the poisoning of the body (antibiotics, antimicrobials);
blood transfusion incompatible by group or Rh factor;
severe injuries or burns when massive destruction of tissues occurs with the ingress of decay products into the blood;
the penetration of microbes, leading to infection and septic state.

As in case of poisoning by mushrooms, alcohol substitutes or poisons, and when the body breaks down its own tissues, the main problem for the kidneys is the negative effect of toxins on the internal renal structures. It is a total violation of the kidneys that leads to life-threatening complications.

Toxic nephropathy can be classified depending on the causes of its occurrence. So, the following types of pathology are distinguished:

Nephropathy is specific toxic. It develops under the influence of direct ingestion of poisons and toxins. This can be alcohol, various chemicals and metals (arsenic, mercury, lead, cadmium, synthetic rubber, oxalic or acetic acid, etc.). Also, a specific form of toxic kidney damage can develop as a result of poisoning by poisonous fungi or a bite of poisonous animals / insects.

Nonspecific nephropathy. It develops as a result of the penetration into the body of toxic substances that do not have a direct toxic effect on the kidneys, but at the same time stimulate organ failure. Here, the causes of pathology can be a sharp drop in blood pressure, interruptions in electrolyte balanceviolation of the general blood flow in the kidneys and the body as a whole, or uncompensated acidosis.
Mediated toxic nephropathy. In this case, toxic substances and poisons are independently produced in the human body in the presence of such renal pathologies as blockage of the kidney nephrons by hemoglobin, proliferation of muscle tissue in the kidneys and compression of the same renal nephrons by it, and excessive production of amino acids liver failure. Also, causes of renal toxic insufficiency can be sepsis (blood poisoning), a long process of squeezing muscle tissue as a result of trauma and, as a result, a large amount of protein that enters the bloodstream.

In addition, the causes of toxic damage to both kidneys can be such reasons:

Human radiation exposure;
Taking medications of the non-steroidal anti-inflammatory group, sulfonamides or aminoglycosides for a long time and without proper medical supervision.

Nephropathy begins with the effects of poisons on a person or autoimmune reactions of his body. The course of the disease is due to the ingestion of the toxin, its type and quantity. At risk are people who have constant contact with toxins. But poisoning is possible at the household level. In children, the development of toxic nephropathy is due to the presence of congenital pathologies or factors that affect the kidneys during pregnancy. Among the melancholy substances that can cause this pathology, the following are distinguished:

mercury, lead and other heavy metals;
mushroom poison;
poisons of animals and insects;
nitrogen compounds: ammonia, nitrobenzene;
various solvents;
inorganic fertilizers;
various acids;
alcoholic surrogates;

The kidneys are a paired organ of small size bean-shaped. Kidney function:

regulation of water balance in the body;
participation in the control and maintenance of blood pressure;
participation in the formation of blood cells;
removal of metabolic products.

Each kidney consists of more than 1,000,000 filtration units - nephrons. Each nephron contains glomeruli of small blood vessels (glomeruli). Being semipermeable, they allow metabolic products dissolved in the blood to pass through the membrane. Filtered metabolic products are excreted in the urine.

Upon receipt of toxic substances, a significant burden falls on the nephrons, which cease to cope with their tasks. The development of the clinical picture largely depends on the nature of the damaging substance. But common is a malfunction.

Damaging substances include:

low-quality alcohol;
heavy metals;
organic solvents;
pesticides;
medicines (in case of overdose, the use of low-quality or expired drugs, violation of the route of their administration).

With insufficient nutrition of the kidney, ischemia develops (reversible condition), and prolonged ischemia leads to an irreversible consequence - necrosis. This leads to a complete loss of kidney function, the consequence of which is the accumulation of toxic substances in the body and the inability to remove them naturally.

Nephropathy can develop under the influence of such substances:

Chemicals - oxalic acid, acetic acid, copper sulfate, nitrogen-containing toxins, polymers, synthetic rubber, mercuric chloride, antifreeze, dichloroethane, ethacrylate.
Of alcohol.
Heavy metals - mercury, lead, arsenic, cadmium.
Poisonous mushrooms and animal poisons.
High doses of drugs - sulfonamides, aminoglycosides, non-steroidal anti-inflammatory drugs.
Ionizing radiation.

Etiology

the presence of metabolic disorders (diabetes, gout, etc.);
poisoning the human body with heavy metals;
prolonged use of certain pharmaceuticals, such as anti-inflammatory, analgesics and anticonvulsants;
bearing a child;
the effect of radiation on the human body;
the presence of extrarenal neoplasms of a benign and malignant nature;
industrial and domestic intoxication;
abnormalities in the development of the kidneys and urinary tract, etc.

Clinical picture

The manifestations of toxic nephropathy and the severity of the course can be different. Often, symptoms of acute glomerulonephritis or renal failure come first. The general series of symptoms appears as follows:

arterial hypertension (increased pressure);
oliguria up to anuria;
puffiness of the face;
pain in the lumbar region;
stagnation;
cramps
proteinuria;
hematuria.

Also, depending on the type of toxic substance, specific symptoms may join.

A terrible complication is renal failure - a symptom complex that is caused by impaired renal function due to various reasons. It is characterized by anuria and a delay in the blood of nitrogenous products. Further, if timely assistance is not provided, a uremic coma develops against the background of lethargy, weakness, intense headaches, and skin itching.

Kinds

One of the most common types of illness is dysmetabolic nephropathy. It is divided into several subspecies:

oxalate-calcium neuropathy. More common is dysmetabolic nephropathy in children;
oxalate. The first signs of the disease appear at any age (even in newborns). If untreated, there is a high risk of developing urolithiasis;
phosphate. The main cause of progression is chronic infection. genitourinary system;
urate. There are both primary and secondary;
metabolic nephropathy involving cystine.

Also in medicine, the following varieties of nephropathy are distinguished:

diabetic nephropathy;
nephropathy of pregnant women;
toxic nephropathy;
gouty nephropathy;
myeloma nephropathy;
Iga nephropathy.

Diabetic form

Diabetic nephropathy is characterized by the simultaneous damage of both kidneys, which leads to disruption of their functioning. The main cause of the disease is diabetes. Diabetic nephropathy progresses slowly in the background diabetes mellitus. Symptoms appear gradually. Clinicians distinguish 5 stages of diabetic nephropathy:

asymptomatic. There are no symptoms. Identify the presence of pathology is possible only through analysis;
initial structural changes. Blood circulation in the kidneys increases, as does glomerular filtration;
prenephrotic. The concentration of microalbumin increases to 300 mg / day, but there is no pronounced proteinuria. Blood circulation and glomerular filtration is normal. Some patients may have a slight increase in blood pressure;
nephrotic. Blood pressure is constantly increased. Protein appears in urine. Filtration, as well as blood circulation, is reduced. In humans, there is an increase in ESR and cholesterol. Edema appears;
uremic. The filtration function of the kidneys is significantly reduced, which causes the accumulation of urea and creatinine in the blood. Protein levels are further reduced, which is why swelling increases. Blood pressure can rise to critical levels. In almost all clinical cases, this stage of diabetic nephropathy gradually turns into renal failure.

Nephropathy of pregnant women

Nephropathy of pregnant women is one of the most dangerous complications during gestation. The reasons for the progression of this condition are not fully understood. At risk are young girls, as well as those who regularly drink alcohol and smoke cigarettes.

Nephropathy of pregnant women is more often diagnosed in the second half of pregnancy. The patient's blood pressure rises to high numbers, swelling and proteinuria appear. If an adequate treatment of nephropathy of pregnant women is not timely carried out, then a miscarriage is likely. Doctors observe women with such a diagnosis in stationary conditionsto constantly monitor their condition.

It is also worth noting that nephropathy of pregnant women is not a rare pathological condition. Recently, cases of disease progression have become much more frequent.

Toxic form

Toxic nephropathy progresses after poisoning the body with various toxic substances. The first symptom is pain at the site of the projection of the kidneys. Further, the clinical picture of toxic nephropathy is supplemented by such signs:

swelling;
oliguria;
anuria
blood in urine;
protein in urine and nitrogenous bases.

It is important to treat toxic nephropathy as soon as possible, since acute renal failure can develop against its background.

Gouty shape

The basis for the progression of gouty nephropathy is the accelerated formation of uric acid when it is slowly excreted from the body. As a result, the substance gradually accumulates in the bloodstream and urate forms in the kidneys. If gouty nephropathy continues to progress, this will lead to deformation of the kidney tissue. Excretory and filtering abilities will significantly decrease.

Myeloma

The main manifestations of myeloma nephropathy are severe proteinuria and the gradual development of renal failure. It is worth noting that with this form, all the signs indicating nephropathy are absent. But at the same time, dysproteinemia and hyperproteinemia are observed. Also, patients with such a diagnosis are often diagnosed with nephronecrosis.

Iga nephropathy

A feature of Iga nephropathy is macro- or microhematuria in combination with proteinuria. As a rule, the disease begins to progress a few days after the acute illness of the upper respiratory airways.

Also, with Iga nephropathy, hyperthermia, arterial hypertension, nephritic syndrome, pain in the lumbar region, dysuric phenomena are observed. Iga nephropathy is also characterized by a relapsing course.

More rarely diagnosed:

hereditary nephropathy;
family;
paraneoplastic;
tubulointerstitial;
analgesic;
endemic;
hypertonic;
membranous;
reflux;
contrast induced;
medicinal.

Symptoms and stages of the disease

Toxic kidney damage can be classified in degrees depending on the severity of the patient's condition. So, there are such stages of pathology:

Mild poisoning. In this case, the patient in the urine will be detected protein, red blood cells and increased urine density.
The average degree of pathology. To the existing symptoms will be added a decrease in the total daily volume of urine, as well as an increase in potassium, creatine and other metabolites in the patient's body.
In severe stages of poisoning the patient develops acute renal failure, which can lead the patient to a coma.

The symptomatology of the pathology is due to the amount of toxin ingested, the stage of development of toxicosis and general condition urinary system of the patient. In the presence of chronic kidney, liver, or bladder, a sufficiently small amount of poison to start a pathological condition. Toxic nephropathy has the following symptoms:

a decrease in the volume of urine excreted, up to its complete absence;
increase in blood pressure;
weakness, drowsiness, lethargy;
nausea, often vomiting, impurities of blood in the vomit are possible;
lumbar pain
swelling of the face and body;
upset stool;
cramps
shortness of breath, wheezing in the lungs is possible.

When intoxication with certain substances, specific symptoms attach to common symptoms, for example, in case of poisoning with streptocide or norsulfazole, the patient develops “aches” in the joints and fever. The appearance of such indicative symptoms helps the doctor determine the type of poison during diagnosis.

The development of renal failure is divided into 4 stages:

Initial. It is characterized directly by the effect of the toxin on the body, lasts up to 3 days.
Oligoanuric. At this stage, the body is unable to completely remove fluid, which causes swelling, shortness of breath and wheezing, and there is also a risk of developing cerebral edema. Stage duration - up to 2 weeks.
Polyuric. Stage indicates a favorable course of the disease. It is characterized by increasing diuresis, which is dangerous by dehydration. This stage lasts several months or years.
Recovery. Normalization of kidney function and satisfactory results of urine tests. Complete kidney repair does not occur in all patients.

Three degrees of toxic nephropathy are distinguished:

Easy.
Medium.
Heavy.

The mild degree is reversible: with proper treatment, a complete restoration of the kidney is possible. At the middle stage, the concentration of toxic substances in the blood increases, which are normally excreted by the kidneys. In severe toxic nephropathy, renal failure develops.

Signs of illness

a significant decrease in the amount of urine removed (oligoanuria);
lowering blood pressure;
severe shortness of breath;
pain of varying degrees of intensity in the sides or lower back.

Symptoms associated with the ingestion of poison or toxin in the human body are possible:

nausea and vomiting of blood;
diarrhea;
pain in the upper abdomen;
severe bloating;

Toxic nephropathy acute pathology with a threat to health and life. The disease can lead to acute renal failure, which causes death or prolonged treatment with hemodialysis.

The following symptoms are characteristic of toxic nephropathy:

nausea and vomiting of blood;
diarrhea;
pain in the upper abdomen;
severe bloating;
worsening of consciousness from drowsiness and lethargy to a fainting state.

Toxic nephropathy is an acute pathology with a threat to health and life. The disease can lead to acute renal failure, which causes death or prolonged treatment with hemodialysis.

The general symptoms of toxic kidney poisoning by various poisons is divided into several phases and the signs of pathology will depend on the phase.

So, with initial phase renal failure, the patient will experience a decrease in the volume of excreted urine. This phase lasts from 1 to 3 days, depending on the degree of poisoning.
With oligoanuric phase the patient may develop fluid retention in the body, which will lead to a general overload of the left heart ventricle. Also, the patient may show wet lung syndrome, which will be characterized by wheezing and shortness of breath. At this phase, the patient is likely to develop cerebral and pulmonary edema. The body is intensively accumulating toxins (products of protein metabolism). Possible consequences are inhibition and weakness. Possible cardiac arrest. This phase lasts 7-14 days.
The phase is polyuric. If the treatment is prescribed correctly, and the patient's body will provide worthy resistance to the pathology, then the previous phase will go into polyuric. In this case, the total volume of urine will increase day by day. In extreme cases, the daily volume of urine can reach 35 liters per day. In this case, urine will have a low specific gravity. You should be careful here, as this phase can lead the patient to dehydration. The phase lasts 15-30 days.
Then comes the recovery period, in which the specific gravity of urine and its daily volume are normalized. The recovery phase can last 6-24 months.

In general, at home, toxic poisoning in the early stages can have such morphological signs:

Drawing pain in the lower back;
Swelling of the legs and face;
Constant thirst;
Some yellowness of the skin and its dryness;
The manifestation of a rash on the palms from the inside is possible;
Nausea, diarrhea, vomiting;
Muscle and headache;
Abrupt burning of blood pressure in a patient;
Decreased urine volume;
Lethargy, lethargy, hallucinations.

Symptoms and stages of the disease

The development of the clinical picture of the pathology depends on the concentration of the toxin that has entered the body, on the individual characteristics of a particular person and on whether the patient's kidney function has been impaired. Toxic nephropathy is manifested mainly by the following symptoms:

There is pain in the area of \u200b\u200bthe projection of the kidneys, it is most often dull and aching;
The general state of health suffers, intoxication signs appear;
Impaired functioning of the kidneys leads to the development of swelling, protein and blood appear in the urine, its amount decreases.

Pathology is divided into three degrees of severity, depending on how impaired renal function.

With a mild degree, the symptoms are not pronounced, in the urine, increased protein, hematuria and leukocyturia are determined.
With an average degree, oliguria joins all of the listed symptoms, an increase in urea and creatinine is detected in the blood.
In severe cases, the patient registers all signs of acute renal failure.

Symptoms of toxic nephropathy and the severity of the course of the disease can vary significantly. Quite often, symptoms of completely different diseases — renal failure and glomerulonephritis — turn out to be more pronounced. Signs of nephropathy include the following health problems:

steadily elevated pressure;
oliguria or anuria;
swelling of the face;
pain in the lumbar region;
urinary retention for more than 4 hours;
severe cramps;
proteinuria;
hematuria.

Depending on the severity of the disease, they may join associated symptoms. Symptoms are observed from the first days of toxic kidney damage and gradually increase.

The most dangerous complication of nephropathy is renal failure. In this case, the kidney functions are completely impaired and the organs practically do not work. With this pathology, all toxic substances are retained in the blood, due to this there is a strong intoxication. If the patient is not immediately treated, then a uremic coma can develop, which is characterized by lethargy, weakness, migraine and characteristic skin rashes.

With toxic damage to the kidneys, edema initially appears on the face, so it is difficult to miss such a pathology.

In the early stages of progression, an ailment of symptoms may not occur at all. But as it develops, such disturbing signs appear:

feeling of thirst;
weakness;
fatigue;
headache;
pain at the site of projection of the kidneys.

In the later stages, the clinical picture is supplemented by such signs:

visible swelling of the tissues;
vascular pressure rises;
protein structures appear in urine;
symptoms of pyelonephritis may occur if infectious agents enter the organ.

The disease has such manifestations:

pain in the lumbar region;
swelling of the face and lower limbs;
thirst;
dry skin and mucous membranes, with hemolysis - yellowness;
scarlet-like or measles-like rash;
abdominal pain, nausea, vomiting, loose stools;
anemia, increased bleeding (petechiae, ecchymosis);
temperature increase (depending on the type of poisoning);
tendency to infections;
muscle pain, headache;
drop in blood pressure;
arrhythmia, blockade as a manifestation of hyperkalemia;
a decrease in urine output at the oliguria stage and an increase in urine output in the polyuric stage;
cramps
lethargy, psychosis, hallucinations, general weakness.

Diagnostics

ultrasound of the kidneys.

If confirmation of the diagnosis is required, an additional x-ray and tomographic examination (MRI or CT) is performed. Often enough to see the clinical manifestations and know the cause of the poisoning.

At the first stage of the examination, the doctor will always pay attention to symptoms that indicate toxic nephropathy. It is optimally accurate to know the product of poisoning or which particular factors led to nephrotoxic complications. Mandatory diagnostic methods for toxic nephropathy will be:

general clinical tests of urine and blood;
a special study to identify the causative factor in poisoning;
assessment of the functional state of the kidneys by biochemical analysis of blood;
ultrasound of the kidneys.

If the cause of toxic nephropathy is a disease or treatment, then you must try to immediately remove toxins from the blood and improve the blood supply to the kidneys. If acute renal failure has occurred, then the patient must be hospitalized, and in the intensive care unit of the hospital should be taken to emergency treatment. In chronic renal failure, therapy largely depends on the severity of changes in the kidneys.

Typically, diagnostic measures are carried out already in the nephrology department, where the patient is brought with suspected acute kidney damage. In addition to the characteristic clinical picture, the doctor draws attention to the anamnesis of pathology, finds out the possible nature of poisoning.

Examination methods for toxic nephropathy are as follows:

General analysis of blood, urine;
Blood test for pH, electrolytes;
Biochemical analysis of blood in terms of indicators of kidney function;
Ultrasound of the kidneys;
If necessary, an MRI of the kidneys.

With nephropathy, ESR most often increases, the number of leukocytes in the blood, anemia is observed. In the urine, the amount of protein, nitrogen compounds increases, hemoglobin and red blood cells, cylinders appear. The specific gravity of urine is increased, and in the peripheral blood creatinine, urea, uric acid, and potassium increase.

Often, treatment of toxic nephropathy is carried out in the intensive care unit, especially in acute renal failure. In a less serious situation, treatment is carried out in the standard ward of the Department of Nephrology (Urology). A set of measures for the treatment of the disease should be started immediately, preferably under the supervision of a toxicologist.

The most important are measures to remove toxins, poisons from the body. This is achieved by performing the following techniques:

Plasmapheresis;
Hemodialysis;
Hemofiltration;
Hemosorption;
Gastrointestinal flushing.

Forced diuresis is carried out by the introduction of aminophylline, mannitol, lasix. For gastric lavage, vaseline oil or a large amount of liquid is injected into it. Hemodialysis is recommended in the first 6 hours of the disease, then another 48 hours do peritoneal dialysis (purification of blood through the peritoneum).

Of the drugs for toxic kidney nephropathy, sorbents, diuretics, glucocorticosteroids, as well as heavy alkaline drink can be recommended. The treatment is supplemented with the introduction of glucose with vitamin C, insulin, sodium bicarbonate, calcium chloride, vitamins. If necessary, carry out a transfusion of albumin and plasma.

To accurately diagnose toxic kidney poisoning, experts conduct a number of measures:

General analysis of blood and urine. At the same time, the presence of a low level of hemoglobin, elevated white blood cells and platelets, and also the density of urine will be characteristic evidence of a toxic pathology.
Biochemical analysis of urine and blood. Here will be revealed elevated levels creatine, urea, acid-base balance is disturbed.
Also, the doctor will prescribe monitoring of the daily volume of urine and ultrasound diagnostics.
In this case, the work of the vessels of the kidneys on the angiogram will be monitored.
Perhaps the appointment of MRI or CT.

If the patient's body has been poisoned, you should immediately contact a toxicologist. Infectious-toxic kidney has a very indicative clinical picture, its diagnosis does not take much time and does not need a large number of studies and analyzes. First of all, the doctor needs to determine the type of toxin that affects the organ, he can do this according to the patient, and after conducting a series of tests. Among them:

general tests of urine and blood;
biochemical analysis blood
toxin analysis;
Ultrasound of the kidneys;
MRI (if necessary);

As a rule, tests are indicative of an accurate diagnosis. In toxic kidneys, urinary ESR, protein, and urea are elevated in urine. Perhaps an increase in the level of white blood cells in the blood, this indicates an infectious toxic kidney. Studies help determine the exact stage of the disease and the severity of intoxication. All these data are necessary for prescribing the correct treatment and predicting the further course of the disease.

Diagnostic measures are carried out in a hospital. Poisoning substance is determined. History going. The main research methods are:

clinical blood test;
biochemical blood test;
accounting for urine output and water balance;
general urine analysis;
Ultrasound of the kidneys;
sometimes MRI.

The standard diagnostic plan includes:

Ultrasound of the kidneys;
specific tests for calcification in the urine;
biochemical study of urine;
analysis of urine . It makes it possible to identify salt crystals.

To detect toxic nephropathy and monitor the condition, the following tests are used:

Clinical studies - a general analysis of blood and urine (anemia, leukocytosis, thrombocytopenia, and a change in urine density are characteristic).
Biochemical analyzes - creatinine, urea, acid-base balance, blood ion levels (K, Na, Mg), proteinogram, coagulation system assessment.
Definition of daily diuresis.
Ultrasound of the kidneys.
X-ray (survey, using contrast).
Angiography.
Excretory pyelography.
CT, MRI.

Treatment

Any of the nephrotoxic factors can lead to dangerous and life-threatening conditions. If kidney damage occurs, it is extremely important to start providing medical care in a timely manner. The main emergency methods of treating toxic nephropathy are hemosorption and hemodialysis, which allows you to quickly and effectively cleanse the blood of poison or toxin. If everything is done correctly and on time, then the chances of recovery are optimal and the prognosis is favorable.

Quite often, toxic nephropathy is treated under intensive care, especially if the disease is complicated by renal failure. If the disease is not very severe, then it is allowed to treat the patient in the urology department.

During this period, the most important task is the rapid elimination of toxic substances and metabolic products from the body. For this purpose, the following techniques can be used:

plasmapheresis;
gastric and intestinal lavage;
hemosorption;
hemodialysis;
hemofiltration.

Forced diuresis is carried out by introducing various medications. In order to cleanse the gastrointestinal tract from toxins qualitatively, Vaseline oil or a large volume of liquid is injected into it. It can be pure water, a weak solution of potassium permanganate or salted water. Hemodialysis is effective only in the first 6 hours from the onset of the disease, after which blood is purified through the peritoneum for another two days.

The patient is shown medications of various drug groups. The patient should take sorbents, diuretics, hormones and antihistamines to avoid the development of severe allergic reactions. In addition, glucose with vitamin C, insulin, sodium bicarbonate, calcium chloride and a complex of essential vitamins are indicated.

It is worth noting that toxic nephropathy is difficult to treat, since kidney cells are difficult to recover. Nephrons can begin to break down already in the very early stages of the disease. As a result, kidney function is completely impaired. It is because of this that it is so important to start treatment when the first symptoms of the disease appear.

A patient with toxic nephropathy should consume a lot of alkaline drink. This contributes to a quick recovery.

The main factor in the treatment of toxic nephropathy is the rapid elimination of nephrotoxic poisons from the body. The basic treatment options are the following methods:

If it was mushrooms or the simultaneous intake of a large number of drugs, then it is necessary to rinse the stomach.
In case of poisoning by industrial or chemical poisons, an antidote is prescribed (a drug that removes poison from the body).
To remove nephrotoxin from the blood, it is necessary to use the hemosorption method (using activated carbon).
in especially difficult cases, hemodialysis is necessary.

Any of the nephrotoxic factors can lead to dangerous and life-threatening conditions. If kidney damage occurs, it is extremely important to start providing medical care in a timely manner. The main emergency methods of treating toxic nephropathy are hemosorption and hemodialysis, which allows you to quickly and effectively cleanse the blood of poison or toxin. If everything is done correctly and on time, then the chances of recovery are optimal and the prognosis is favorable.

With serious poisoning and intoxication, the kidneys can be affected primarily with the development of toxic nephropathy. Only timely treatment will help a person avoid the most serious complication of such phenomena - renal failure.

As a rule, all therapy is aimed at detoxifying the patient's body and at restoring the kidneys. The criteria by which drug therapy is prescribed depend on the severity of the patient's condition. But in general, in the first place, such a complex of drugs is prescribed:

Specific antidotes.
Diuretics. Provide a reduction in swelling and increase urine volume.
Polyionic infusion. The patient is injected with solutions to normalize the pH of urine.
A transfusion of blood components may also be prescribed.
To clean the blood of toxins, plasmapheresis or hemosorption / hemodialysis is used - hardware pumping and blood purification.

Treatment is carried out in a hospital in the department of nephrology and often in the intensive care unit. Toxicologists are involved.

An important step is the removal of the toxin from the body - the elimination of the causes of the pathological condition.

The following activities are carried out:

hemodialysis;
plasmapheresis;
flushing the entrance gate of the toxin, for example, early gastric lavage;
hemofiltration;
forced diuresis (with the use of osmotic diuretics);
anti-shock measures.

Of the drugs in complex therapy, diuretics, glucocorticoids, sorbents and heavy alkaline drink are used. During treatment, bed rest is prescribed. Protein-rich foods, such as meat, eggs, are excluded from the diet. In cases of severe uremia, the food should be exclusively carbohydrate.

With preserved excretory function of the kidneys, heavy drinking (3-4 l / day) is recommended, preferably sweet. Particular attention is paid to clean skin, as the release of toxic products through it provokes itching and scratching. With mild edema and frequent vomiting food must be salted, as sodium chloride is lost during vomiting.

At a severe stage, the prognosis is unfavorable, since the restoration of renal function does not occur and the patient dies from uremia. Mortality depends on such factors:

type of poisonous substance;
its quantity;
initial condition and health of the kidneys;
severity of the course;
timely treatment started.

Toxic nephropathy is a very formidable condition, but timely access to a specialist and early detection of pathology increase the chances of a favorable outcome of the disease.

A treatment plan is developed only after the type of pathology that has struck a person is accurately established.

Diabetic nephropathy in the first and second stages does not require specific treatment, it is only necessary to maintain the concentration of sugar in the blood within normal values. Since the pathology progresses against the background of diabetes, it is important to follow a special diet. Also, doctors often resort to the administration of ACE inhibitors, as well as hemodialysis. If all these measures are not effective, doctors can resort to organ transplantation.

Treatment of nephropathy of pregnant women is carried out only in stationary conditions. The therapy is as follows:

strict bed rest;
drugs with high content squirrel;
diuretics;
antiplatelet agents;
potassium preparations;
antihypertensive drugs;
antispasmodics.

Treatment of the toxic form is carried out using forced diuresis, gastric lavage, hemosorption, plasmapheresis, hemodialysis, etc. After hemostasis is normalized, doctors will begin to conduct anti-shock measures.

The basic principles of the treatment of dysmetabolic nephropathies:

normalization of your lifestyle;
diet food;
drug therapy. For the treatment of ailment, vitamin E, vitamin A, vitamin B6, dimephosphon and others are prescribed.

Treatment with a gouty form is primarily aimed at eliminating the main ailment - gout, after which further therapy is carried out:

drinking plenty of fluids;
treatment plan must be supplemented with diuretics;
antihypertensive drugs;
antibiotics (in case of attachment of infectious agents).

Therapeutic measures are aimed primarily at eliminating the causative factor. When exposed to toxins, detoxification is carried out using intensive infusion therapy and hardware purification of blood.

Such drugs are used to treat toxic nephropathy:

Specific antidotes.
Diuretics. Assign with a decrease in urine output to prevent edema, including pulmonary edema. More often used Mannitol, Lasix.
Polyionic solutions. To normalize the pH of the blood, sodium bicarbonate is introduced.
Blood components. Conduct a plasma transfusion, albumin.

The following methods are used to eliminate toxic substances: hemodialysis, peritoneal dialysis, ultrafiltration.

Therapy

The treatment is aimed at removing toxins. If nephropathy is caused by acute poisoning, then gastric lavage is indicated in the first hours. In hospitals, the method of forced diuresis is used, detoxification and anti-shock therapy are used.

First aid

If toxic poisoning is suspected, the patient should be given as soon as possible. first aid. In this case, it is necessary to stop the intake of toxins in the patient. That is, if poisons come in by air, then the patient needs to be provided with fresh air (move it outside, farther from the infection site), if poisons enter the body through the mouth, then the stomach should be washed with ordinary water. A simple water enema is recommended here. As a sorbent, you can give the patient activated carbon.
If the patient has a loss of consciousness and cardiac arrest, it is necessary to conduct artificial respiration and indirect heart massage. Prior to all events, an ambulance should be called.

Complications and prognosis

Any nephrotoxic effect can cause kidney damage, of which the most severe should be distinguished:

Acute renal failure - manifested by a sharp decrease or complete cessation of urination.
Chronic renal failure - arising as the outcome of an acute condition or due to mild poisoning.

Toxic nephropathy is almost always the accidental or unintentional ingestion of toxic or harmful substances into the body. Renal complications in severe diseases and drug nephropathy are much less common.

The prognosis of the disease directly depends on the poisonous substance that has entered the body, as well as the severity of the course of toxic nephropathy. The number of deaths in this disease is quite impressive and can reach 70% of all cases. But this does not mean that almost every poisoned person is at risk of death, with a timely diagnosis and adequate treatment, the prognosis is pretty good.

The worst prognosis for nephropathy is if chemicals such as cadmium, silicon, and hydrogen arsenate enter the body.

Complications most often occur with a significant ingestion of toxic substances, and through the blood. The most dangerous complication is renal failure, which quite often leads to death.

Toxic nephropathy is a very dangerous kidney disease, which, if untreated, leads to a number of complications. It is worth remembering that kidney cells are difficult to repair and the sooner treatment is started, the better the prognosis.

Toxic nephropathy occurs due to poisoning, when damage to toxins and biological decay products leads to impaired renal function. Harmful substances enter the body from the outside or may occur due to illness.

The prognosis for toxic nephropathy depends on the type of poisonous substance and the severity of the disease, mortality ranges from 20-70%. The prognosis is favorable only with the adequacy of therapy and its timeliness. The worst prognosis when cadmium, silicon, hydrogen arsenate enters the body.

Complications most often develop with a high concentration of toxins and poisons in the body, when not introduced through airwaysbut through the blood. Complications include hemolytic uremic syndrome, interstitial nephritis, acute renal failure. The last indicated complication often leads to death due to kidney necrosis and a complete failure of their function.

The lack of proper treatment for poisoning leads to serious consequences, such as hemolytic uremic syndrome, renal failure and interstitial nephritis. The most dangerous condition is kidney failure. Pathology is characterized by a partial or complete failure of the organ. It is fraught with coma and, as a result, necrosis - the death of the kidney. Renal failure often results in death for the patient.

Prevention

Typically, specific toxic nephropathy occurs in complex chemical plants and in agriculture. In this case, the possible risks of pathologies can be warned by prohibiting the work of people with kidney problems, the risk of tumor formation.
In addition, the likelihood of toxic damage can be reduced by the method of mechanization of the enterprise. In this way, direct human exposure to chemicals will be minimized.
Chemical workers should wear protective clothing.
An annual medical examination of people working with chemicals is shown. Particular attention is paid to the kidneys.

It is worth knowing that the earlier a disease is detected, the more effective its treatment will be. Modern medicine is quite successfully coping with toxic nephropathy.

The favorable outcome of the disease is due to the type of toxin, the duration of its exposure and the timeliness of diagnosis. Statistically, the disease is cured in 20-70% of cases. Preventive measures can significantly reduce the risk of toxic nephropathy. Often, pathology occurs against the background of an overdose of drugs, taking drugs only as prescribed by the doctor and in accordance with the instructions will prevent intoxication.

You should refrain from eating dubious types of mushrooms, food and low-quality alcohol. Speaking of prevention in the professional field of activity, the use of personal protective equipment, a special form, adherence to safety precautions and regular visits to the doctor minimizes the chances of developing the disease.

Chronic kidney damage is observed in the production of polymers, rubber, in agricultural work. People with a high risk of developing tumors and background kidney diseases should not be allowed to such production. The use of mechanized labor with the maximum restriction of human contact with chemicals plays an important role in prevention.

With professional contact with toxins, an annual kidney examination is required. It is necessary to observe hygiene standards in the workplace and wear protective clothing. When identifying the initial changes, it is recommended to change the job.

In conclusion, it must be said that the success of treatment directly depends on the time of contacting a medical institution. At the first sign of malaise, an examination is necessary. Using modern treatment methods, toxic nephropathy can be cured. Be healthy!

The human kidneys play the role of a filter in the body. In severe poisoning with toxic substances, toxic nephropathy develops. This pathology is characterized by the inability of the kidneys to remove toxins, which leads to renal failure and other dangerous pathological conditions. Timely diagnosis and therapy are necessary measures to prevent the consequences of the disease.

The main causes and course of toxic nephropathy

It begins with the effects of poisons on a person or autoimmune reactions of his body. The course of the disease is due to the ingestion of the toxin, its type and quantity. At risk are people who have constant contact with toxins. But poisoning is possible at the household level. In children, the development of toxic nephropathy is due to the presence of congenital pathologies or factors that affect the kidneys during pregnancy. Among the melancholy substances that can cause this pathology, the following are distinguished:

mercury, lead and other heavy metals;
mushroom poison;
poisons of animals and insects;
nitrogen compounds: ammonia, nitrobenzene;
various solvents;
inorganic fertilizers;
various acids;
alcoholic surrogates;

The working unit of the kidney is, each of which consists of a network of blood vessels. Our kidney consists of about 1,000,000 nephrons, they filter the blood and saturate the organ with oxygen. When toxic substances enter the kidneys excessively, nephrons work at the cellular level, the blood supply to the organ and its oxygen saturation worsen. The disease has a developmental dynamics. The severity of the disease is determined by three stages, presented in the table:

Types of toxic kidney damage

Toxins of poisonous mushrooms adversely affect the condition of the kidneys.

Medicine shares 2 types of toxic kidney damage:

Specific nephropathy. It develops when exposed to poisons that destroy, directly, the kidney tissue. These are mainly heavy metals.
Nonspecific nephropathy. Pathology occurs with an indirect effect of toxins on the kidneys. Among them are the poisons of insects and animals, the poisons of mushrooms, etc.

Symptoms and stages of the disease

The symptomatology of the pathology is due to the amount of toxin ingested, the stage of development of toxicosis and the general condition of the patient's urogenital system. In the presence of chronic diseases of the kidneys, liver or bladder, a sufficiently small amount of poison to start a pathological condition. Toxic nephropathy has the following symptoms:

a decrease in the volume of urine excreted, up to its complete absence;
increase in blood pressure;
weakness, drowsiness, lethargy;
nausea, often vomiting, impurities of blood in the vomit are possible;
lumbar pain
swelling of the face and body;
upset stool;
cramps
shortness of breath, wheezing in the lungs is possible.

Joints aches with streptocide poisoning.

Development is divided into 4 stages:

Initial. It is characterized directly by the effect of the toxin on the body, lasts up to 3 days.
Oligoanuric. At this stage, the body is unable to completely remove fluid, which causes swelling, shortness of breath and wheezing, and there is also a risk of developing cerebral edema. Stage duration - up to 2 weeks.
Polyuric. Stage indicates a favorable course of the disease. It is characterized by increasing diuresis, which is dangerous by dehydration. This stage lasts several months or years.
Recovery. Normalization of kidney function and satisfactory results of urine tests. Complete kidney repair does not occur in all patients.

Dangerous consequences of the disease

The lack of proper treatment for poisoning leads to serious consequences, such as hemolytic uremic syndrome, renal failure and interstitial nephritis. The most dangerous condition is kidney failure. Pathology is characterized by a partial or complete failure of the organ. It is fraught with a coma and, as a result, with the death of the kidney. Renal failure often results in death for the patient.

Methods for diagnosing kidney damage

To determine the toxin, a biochemical blood test is necessary.

general tests of urine and blood;
blood chemistry;
toxin analysis;
Ultrasound of the kidneys;
MRI (if necessary);

With possible poisoning, the area of \u200b\u200bthe kidneys most often falls into the risk group with the further development of toxic nephropathy. To avoid complications, for example, the further development of renal failure, it is necessary to consult a specialist in a timely manner. A high-quality course of treatment will relieve negative consequences.

Toxic nephropathy is a lesion of the parenchyma of the kidneys, glomerular apparatus.

Toxic nephropathy - a schematic representation of a kidney lesion

This manifestation is characteristic of poisoning by internal or external toxic products of metabolites. In medical terminology, two types of disease are distinguished: specific and non-specific nephropathy. The first type is associated with poisoning by external toxins, which adversely affects not only the kidneys, but also the functional work of the liver. A non-specific type of disease is caused by disorders in the field of hemodynamics.

7 causes of the disease

Allocate a large number of harmful elements that can harm the body, in particular the kidneys. In addition to some of the harmful substances that a person acquires during his life, some of them can occur independently due to injuries, certain diseases.

Toxic nephropathy in case of mushroom poisoning

Among the factors that provoke the development of toxic nephropathy, medication is distinguished. This is especially true for those drugs that are used for emergency medical care and others.
Specialists in the field of medicine attribute microbial organisms to poisoning sources. Due to getting into the blood, microorganisms contribute to the septic state. Also, the infection process can occur during normal transfusion. The incompatibility of the group, or the Rh factor of the blood, provokes the development of the disease.
Poisonous mushrooms are especially dangerous, they provoke severe poisoning of the body.
Chemical substances, salts of heavy metals, have a negative effect on the functional functioning of the kidneys. This category also includes substances of a radioactive nature.
Among the possible causes of toxic nephropathy, the use of antibiotics, or anti-microbial drugs, over a long period of time is highlighted. With prolonged use, they can cause damage to health.
Poisoning with low quality alcohol, or organic poisons. The latter includes acetic acid, or carbon tetrachloride.
Harmful substances can occur after serious injuries, or burns. Tissues begin the process of destruction, as a result of which decay products enter the human blood.

Chemical poisoning is the cause of toxic nephropathy.

All these causes are the main provocateurs in the occurrence of toxic nephropathy. Normal kidney function is significantly impaired.

In the future, this leads to complications that become a serious threat to life.

Symptoms

The level of damage depends to a large extent on the type of harmful substance, or its method of exposure. A significant role is played by the state of the urinary system. Even with a small amount of poisonous substance, the clinical picture is complicated if a person suffers from chronic diseases in this area.

The main symptoms of toxic nephropathy are distinguished:

manifestations, discomfort from shortness of breath;
pain in the side, in the lumbar;
a sharp decrease in blood pressure;
decreased urine output.

In cases of toxic or poisonous particles, the symptoms may appear as follows:

bouts of vomiting and nausea, possible blood;
bloating and pain in the abdomen;
stomach upset;
drowsiness, fainting, brain activity generally worsens.

Infectious toxic nephropathy - manifestations

Toxic nephropathy is believed to be very harmful to human health. It really is. Ignoring the disease provokes the development of acute renal failure.

Diagnostics

First of all, a qualified specialist addresses the symptoms, then determines the cause of the disease. In this case, the necessary procedures are prescribed:

ultrasound examination of the kidneys;
blood and urine tests, as well as a biochemical blood test.

These procedures are necessary in order to determine the condition, performance of the kidneys, to prescribe an effective course of treatment.

Often, a specialist prescribes a number of procedures to confirm the diagnosis, for example, MRI, or CT.

Ultrasound toxic nephropathy

The method of treatment of toxic nephropathy

In order to recover soon, it is necessary to remove harmful substances. The procedure is as quick as possible. Specialists identify the following effective methods.

Rinsing will be needed in cases of poisoning with mushrooms, or drugs.
Use of antidote. This is a drug that helps to remove poison from the body in case of poisoning by industrial or other chemicals.
Hemosorption - a method that is based on the purification of blood using activated carbon.
Allocate hemodialysis. This procedure is prescribed in severe cases.

For treatment, diuretics are used, which reduce pulmonary edema (Lasix, Mannitol), as well as polionic solutions, which normalize the pH level in the blood (using sodium bicarbonate for these purposes).

Pathogenesis

Depending on the etiology, the pathogenesis of the disease occurs. Due to poisoning, for example, with ethylene glycol, edema of the nephrons occurs.

If the poisoning process occurred due to hemolytic poisons, then the nephrons become clogged. In this case, red blood cells are destroyed.

Together, all of the above factors provoke membrane ischemia in nephrons. Continuous ischemia threatens with irreversible consequences in the form of necrobiotic changes in the tangles and tubules.

Toxic poisoning in children

It is worth noting that toxic nephropathy is manifested in children. In this case, pay attention to the composition of urine.

Also, toxic nephropathy is manifested against the background of a predisposition due to hereditary pathologies. If in the family the baby’s mother was ill during or before pregnancy, the child’s disease can also worsen.

Disease provocateurs in childhood there may be artificial feeding, or infectious, catarrhal diseases that are frequent in frequency.

Toxic nephropathy in newborns due to artificial feeding

Preventative measures

Separately, it is worth noting that no one canceled the first first aid. It is worth stopping the flow of toxic substances into the patient's body. If the poisoning occurred due to vapors, then it is necessary to provide fresh air to the person, immediately remove it from the room. If chemicals enter the stomach, then rinse it urgently. Enema is also used, activated charcoal is used.

If a person does not have a heartbeat, or is unconscious, then it is necessary to do an indirect heart massage, artificial respiration.

Together with these actions it is necessary to call medical attention.

In preventive measures in industries where there is a high risk of poisoning with harmful substances, people with susceptibility to tumors or kidney damage are not allowed. Most often, such industries include heavy agricultural work, the manufacture of rubber, or polymers.

If you work in such an industry where there is a high risk of kidney damage, then you need to regularly undergo research (at least once a year). Compliance with hygiene standards, special protective clothing will also have a beneficial effect on your health. If you observe the initial stage of kidney damage, then it is advisable not to hesitate, and change your job.

Sectional kidney with toxic nephropathy

Effects

If you suspect this disease, you should immediately contact a qualified specialist. Inaction provokes further damage to the kidneys:

acute renal failure, which is accompanied by a gradual decrease or complete cessation of urine output;
chronic renal failure that occurs after severe poisoning.

Any penetration into the body of toxic, harmful substances are possible causes of the development of the disease. In order to avoid complications, it is worth taking the necessary measures in a short time.

Thanks to advances in modern medicine, the disease is treatable. It is worth remembering that with proper and quick contact to a specialist, there is a great chance to recover in the shortest possible time.

Nephropathy is a bilateral kidney injury that can occur in the most various reasons. In particular, toxic nephropathy is formed due to exposure to toxic substances. The kidneys carry out, among other things, blood filtration, freeing it from harmful and unnecessary substances, which are subsequently excreted in the urine. Thus, these substances are able to partially accumulate in the renal structures, and if their concentration in the blood is increased, then the accumulation will be significant.

The mechanism of the formation of the disease

Given the functional characteristics of the kidneys, the pattern of development of toxic nephropathy can be represented as follows. When poisonous substances enter the human body, there is a direct or indirect effect on the work of internal organs, including the kidneys. As a result, their structure is damaged, work is disrupted, a pathological condition occurs, accompanied by certain symptoms.

According to the direction of the negative impact, and accordingly, according to the mechanism of formation, toxic nephropathy is divided into specific and non-specific. In the first case, damage occurs directly to the kidneys themselves, directly as a result of poisoning. In the second, the kidneys are damaged due to poisoning of the body with poisons that do not directly affect the kidneys, but disrupt the functioning of other organs and their systems, which, in turn, leads to kidney damage.

The following processes can serve as an example of the mechanism of development of non-specific toxic nephropathy:

Direct kidney damage can occur for several reasons. Among the factors that cause this pathological condition include various negative phenomena, for example:

Other reasons can cause this process in the kidneys, for example, radiation, mechanical injuries, electric shock. When prescribing treatment, the nature of the lesion is of primary importance. In any case, this condition requires immediate medical attention.

A person who has been exposed to any of the listed factors is subject to immediate hospitalization for a full examination of the extent and nature of the damage, as well as the implementation of measures to neutralize this effect.

Symptoms of ailment

Manifestations of this pathological condition, as well as its consequences, depend primarily on the degree of its severity, of which there are three - mild, moderate and severe. The determination of the degree depends on the strength / duration of exposure to the negative factor, the nature of the toxic substance and its concentration in the blood. Toxic nephropathy is usually accompanied by the following symptoms:

In each case, the symptomatic picture may vary, depending on the nature of the poisoning and its severity. Sometimes, disorders of the central nervous system, the appearance of hallucinations, severe psychoses can be observed.

Often in a person in this condition there are signs of anemia. Body temperature may increase, in other words, the condition is characterized by the manifestation of various signs of intoxication of the body.

In addition to obvious manifestations, there are signs of kidney damage that are detected during laboratory tests and other diagnostic procedures. The patient in this condition is assigned:

general blood analysis;
general urine analysis;
dopplerography;
biochemical analyzes, etc.

As a result of the studies, in a patient with toxic nephropathy, changes in the composition of urine and blood are detected, the damaging substance, its concentration, structural and functional changes in the kidneys, etc. are determined. In the urine, the content of protein and blood may increase, and other parameters may change. In the blood, the concentration of nitrogenous bases increases. All these symptoms can be established only in the process of professional diagnosis in a medical institution.

Treatment and prognosis

You should know that toxic form nephropathy is a very dangerous condition.

Important! Under no circumstances should you attempt self treatment, and also tighten with the appeal to the doctor.

The treatment that will be required in each individual case depends on the main parameters of the pathological process, such as its severity, nature, etc. First of all, the patient in this case is prescribed antidote therapy, in addition, urine excretion is stimulated, and blood purification procedures are carried out. The list of procedures in this case may be as follows:

hemodialysis;
plasmapheresis;
hemofiltration;
gastric lavage, etc.

In addition, depending on the condition of the patient, he may be given anti-shock therapy, as well as procedures aimed at restoring homeostasis.

If the patient is provided with qualified help in the first hours after poisoning, the toxin is removed from the body, the most serious consequences can be avoided. The damaging substance will not have time to do the most harm.

Otherwise, in addition to removing the poison from the body, purifying the blood, etc. restoration of the function of the affected organ will be required, which in the case of the kidneys, for example, may take a year or more.

The prognosis of the development of the disease also depends on a number of conditions, and first of all, on the severity of the disease:

If there is a possibility of damage to the body using one of the possible methods described earlier, you should immediately contact a medical institution, without waiting for the appearance of the corresponding symptoms. In this case, damage to internal organs can be prevented, or minimized.

Among possible consequences, which in some cases leads to toxic nephropathy, we can distinguish:

neoplasms of the urinary tract;
acute and chronic renal failure;
cerebral edema;
pulmonary edema;
coma;
fatal outcome.

Note! These consequences are extremely serious, therefore it is very important to seek medical help as soon as possible and begin treatment.

The survey should describe in detail not only your condition, but also the circumstances that led to it, the time and method of poisoning (damage).

vsepropechen.ru

Toxic nephropathy It is one of the most common in acute exogenous poisoning of pathological syndromes.

The exotoxic nature of nephropathy is currently observed in 18-20% of patients with acute renal failure (ARF) who are being treated in modern "kidney centers". In this case, two main types of exotoxic lesions of the kidneys are usually found: specific, reflecting the direct damaging effect of a number of nephrotropic chemicals on the renal epithelium, and nonspecific, which constitute the general pathology of the response of the kidneys to "chemical trauma".

Specific kidney damage arise primarily in acute poisoning with nephrotoxic substances, causing during their "active transport" destruction of the excretory epithelium of the tubules with the development of the general pathomorphological picture of "excretory necronephrosis". Despite the differences in the intimate mechanism of action of nephrotoxic substances, its overall result is the same: the predominant accumulation of these compounds in the kidneys leads to sharp disorders of the enzymatic-metabolic functions and a decrease in oxygen consumption in them.

When exposed to hemolytic substances in the kidneys, a pathomorphological picture of acute hemoglobinuric nephrosis develops in the kidneys. Pathomorphological data reflect the renal transport of free hemoglobin in conditions of intravascular hemolysis and exotoxic shock.

Free plasma hemoglobin and protein products of tissue destruction absorbed in the chemical burn zone acquire the character of a foreign protein, causing the corresponding immunological reaction of the body. This reaction is manifested by spasm of the renal vessels, decreased urine output, fever and other signs of the so-called endogenous toxicosis with shock toxic etiology.

A large place in the pathogenesis of toxic nephropathy in acute poisoning occupies the "myorenal syndrome", which is a kind of well-known syndrome of prolonged crushing of muscles (Crush-syndrome). This syndrome develops due to the combined effect of various factors on the body, the most influential of which are acute poisoning by certain toxic substances of narcotic action (carbon monoxide, alcohol and its surrogates, sleeping pills, etc.) and prolonged compression of soft tissues, most often limb muscles. Patients usually in an unconscious state lie on a hard surface, usually on their side, sometimes in a half-sitting position, with their limbs tucked up. “Myorenal syndrome” may be preceded by coma, exotoxic shock, disturbances in external respiration, and cooling.

In a pathomorphological study, the phenomena of ischemic coagulation muscle necrosis (“rhabdomyolysis”) are established in areas of local positional compression, where sharp edema and compaction of muscle tissue, which looks like fish meat, are developed. In the kidneys, there is a picture of acute pigmentary nephrosis, a characteristic feature of which is the presence of myoglobin in the lumen of the nephron and in the epithelium of the convoluted tubules. Myoglobin enters the bloodstream from necrotic areas of affected muscles.

In the pathogenesis of "myorenal syndrome" great importance is attached to prolonged spasm of the vessels of the cortical layer of the kidney and the development of shunted juxtamedullary circulation. It is impossible to exclude the noticeable effect of the phenomena of diffuse intravascular coagulation of the blood developing in the kidneys under the influence of thromboplastic factors resulting from myolysis, as well as ischemic toxin, which manifests its effect as a turnstile shock.

In the pathogenesis of toxic kidney damage in acute poisoning with hepatotoxic substances (CC14, fungal toxins, etc.), the nephrotoxic effect of certain amino acids (leucine, tyrosine, etc.), which are normally deaminated by the liver, and with massive damage to its parenchyma, degenerate in large amounts by the kidneys, apparently, has a certain value. The pathomorphological data for this pathology are quite the same and represent a picture of diffuse cholemic nephrosis. Signs of necronephrosis are usually not observed.

Nonspecific renal lesions are exotoxic.
nephritis, nephrosclerosis, etc.).

Clinical characteristics of toxic nephropathy suggests the need for a total assessment of the main clinical and laboratory indicators of the functional state of the kidneys. The clinical symptoms of toxic kidney damage in the toxicogenic phase of acute poisoning include a sharp decrease in daily diuresis, pain in the lumbar region associated with increasing interstitial edema of the kidneys, and the appearance of peripheral edema (puffiness of the face). The most striking clinical picture of toxic nephropathy is usually found in the somatogenic phase with the development of acute renal failure.

Focus in early diagnosis toxic nephropathy is given to “urinary syndrome” with careful measurement of urine output, taking into account the patient’s infusion therapy and possible loss of fluid by the extrarenal route. It is believed that a decrease in urine output to 500 ml per day (20 ml / h, 0.35 ml / min) indicates the development of oliguria, and up to 100 ml per day (4-5 ml / h, 0.07 ml / min) - anuria.

One of the simplest indicators of kidney concentration is urine density, which increases significantly with glucosuria and proteinuria. At the same time, 1% glucose increases this indicator by 0.0037, and 1% protein - by 0.0026. The highest figures of urine density (up to 1024-1052) and proteinuria (up to 330%) are observed with toxic nephropathy caused by the action of hemolytic substances, such as vinegar essence, and are a poor prognostic sign. The degree of proteinuria in this case usually corresponds to the degree of hemoglobinuria. A reliable test of the functional state of the kidneys is azotemia, as well as the concentration index of urea (the ratio of the concentration of urine urea to blood urea). A decrease in this index to 10 or lower indicates severe renal dysfunction.

Modern methods for studying the functional state of the kidneys include measuring the osmotic pressure of plasma and urine using a cryoscopic method, studying the relationship between the electrolyte composition of blood plasma and urine, KHS, measuring glomerular filtration and tubular reabsorption using the Rehberg-Tareev test, measuring the renal plasma flow by Smith, toxicological studies to determine clearance of toxic substances, quantitative calorimetric determination of free hemoglobin in blood plasma and urine, as well as methods of radioisotope diagnosis of renal impairment.

Three degrees of severity of toxic nephropathy were identified.Mild toxic nephropathy, which occurs in about 25% of cases of the development of impaired renal function in various poisonings, is manifested by moderate and rapidly passing (1-2 weeks) changes in the composition of urine, a slight decrease in glomerular filtration (76.6 ± 2.7 ml / min) and renal plasma flow (582.2Hz 13.6 ml / min) with preserved concentration and nitrogen excretory function of the kidneys.

Medium toxic nephropathy, which occurs in approximately 57% of cases of this pathology, is manifested by more pronounced and persistent changes in the qualitative and morphological composition of urine (up to 2-3 weeks) and is accompanied by a marked decrease in glomerular filtration (60.7 ± 2.8 ml / min ), tubular reabsorption (98.2 + 0.1%) and renal plasma flow (468.7 ± 20.2 ml / min).

Severe acute toxic nephropathy is characterized by acute renal failure syndrome, which is observed in about 10% of cases of this pathology, with severe oliguria, azotemia, creatininemia, a sharp decrease in glomerular filtration (22.8 ± 4.8 ml / min), and inhibition of reabsorption (88, 9 ± 1.8%), a significant decrease in renal plasma flow (131.6 ± 14.4 ml / min).

Acute renal failure in acute poisoning characterized by a severe clinical course as a result of concomitant damage to the liver (toxic hepatopathy - 82% of cases) and lungs (toxic pneumonia - 36.6% of cases), which leads to high mortality, reaching 50%.

It should be borne in mind that in acute poisoning in the group of severe patients with toxic nephropathy and hepatopathy, renal hepatic insufficiency syndrome (ARI) is usually observed. As a result of combined damage to the liver and kidneys, the mutually compensating effect of the functions of these organs is excluded. Moreover, the nephrotoxic effects of a number of chemicals causing toxic hepatopathy and the hepatotoxic effects of chemicals that impair renal function should be recognized. These features make significant changes in the clinical symptoms and dynamics of laboratory data in acute renal failure of exotoxic etiology.

In the clinical picture of acute renal failure, it is customary to distinguish 4 main periods:

1) the period of the initial action of the main etiological factor;
2) the period of oligoanuria;
3) the period of recovery of diuresis;
4) the recovery period.

In acute poisoning, the period of the initial action of a factor damaging the kidney usually corresponds to the toxicogenic phase of the disease with the clinical symptoms inherent in the action of this toxic substance.

In the period of oligoanuria lasting about 2 weeks, a picture of endogenous uremic intoxication develops, which is a consequence of the blockade of glomerular filtration with loss of renal cleansing function (renal azotemia) and increased protein catabolism in tissues (extrarenal azotemia). However, despite the severe clinical condition of patients, the level of azotemia usually remains moderate (doZ-4 g / l), which is explained by a decrease in the process of urea formation in the damaged liver. In this period of acute renal failure, disturbances in water-electrolyte metabolism are constantly detected, in which the potassium ion leaves the cell into the blood and the sodium ion replaces it, as a result of which hyponatremia and hyperkalemia develop. This process is explained by the instability of the equilibrium existing between high intracellular and low intercellular potassium concentrations, which is maintained due to the expenditure of oxidative energy of cells and poor permeability of cell membranes for K + ions. In acute poisoning, which is often accompanied by a decrease in redox processes in the cells and an increase in the permeability of cell membranes, the loss of intracellular potassium is inevitable. With the phenomena of oligoanuria, excluding the constant excretion of potassium by the kidneys, hyperkalemia can cause symptoms of potassium intoxication (impaired cardiac activity and neuromuscular conduction) even in the presence of a large insufficiency of potassium in the cells.

The highest degree of hyperkalemia is observed in acute poisoning, causing hemolysis or myolysis with an intense release of potassium from damaged cells into the plasma.

During the period of recovery of diuresis or with large losses of potassium through the gastrointestinal tract, hypokalemia occurs, which is clinically usually manifested by non-specific symptoms of intracellular potassium insufficiency - muscle weakness, etc.

The degree of other electrolyte dissociations depends on the level of natural clearance of this electrolyte. The higher this clearance, the more intense its accumulation in anuria and the more pronounced is the deviation of its concentration from the norm.

Despite the fact that during oligoanuria, the excretion of all electrolytes is impaired, only a few of them increase in plasma concentration. This is due to the development of body overhydration in this period of acute renal failure, when the process of accumulation of water occurs faster than the process of accumulation of substances with low clearance (sodium, chlorine, calcium), which leads to a decrease in their concentration as a result of dilution. This is confirmed by the fact that in the phase of polyuria, when the loss of water exceeds the loss of salt, the concentration of sodium, chlorine and calcium returns to normal. In addition to the dilution mechanism, the reverse movement of ions from the extracellular space into the cells with respect to potassium should be taken into account.

Hyperhydration in acute renal failure of toxic etiology is caused not only by long anuria, but also by transudation of plasma proteins into the interstitial fluid due to increased capillary permeability, as well as hypoproteinemia due to liver damage. In this case, the osmotic pressure of the plasma rapidly drops, edema and swelling of the cells occur, which cause severe changes in the brain and lungs with the development of neuropsychiatric disorders and external respiration disorders. The latter are most clearly manifested by the "wet lung" syndrome, which is the various stages of increasing interstitial pulmonary edema.

These changes in the lungs usually undergo a complete reverse development during restoration of diuresis and a decrease in hyperhydration, however, they serve as a favorable basis for the occurrence of pneumonia, the differential diagnosis of which is extremely difficult. A constant companion of acute renal failure of toxic etiology is anemia, which is iron deficient in nature and is associated with impaired erythropoiesis. Disturbances of external respiration and anemia significantly increase tissue hypoxia, which creates unfavorable conditions for the regeneration of renal epithelium and restoration of renal function, which are observed no earlier than 30-35 days after the development of severe toxic nephropathy. Particularly long-term restoration of renal function occurs in acute poisoning with vinegar essence, when the nitrogen-emitting concentration ability of the kidneys is fully normalized only by the end of the 6th month after the onset of the disease, and in severe nephropathy caused by ethylene glycol poisoning, such restoration of functions is very rare.

The most common cause of toxic nephropathy is poisoning with vinegar essence, carbon tetrachloride, heavy metal compounds, and alcohol substitutes.

Luzhnikov E.A. Clinical Toxicology, 1982

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Causes of pathology

This pathology develops due to:

the toxic effects of the toxic substances themselves, as well as their decomposition products;
the occurrence of an autoimmune reaction of the body in the lesion focus.

Moreover, despite the different triggering mechanism for the development of a toxic kidney, its clinical manifestations are similar. The degree of kidney damage depends on the concentration of toxic substances, their chemical composition and method of entry into the body. The condition of the urinary organs also plays an important role. So, if any pathological process is already occurring in the kidneys, toxic nephropathy can develop even when low doses of toxic substances are received.

In principle, any ingestion of chemical and biological substances can lead to this dangerous condition, but most often toxic damage to the kidney is caused by:

organic solvents;
salts of heavy metals;
pesticides;
various drugs (aminoglycoside antibiotics, sulfonamides, non-steroidal anti-inflammatory drugs, anticoagulants, etc.);
physical effects (radiation sickness, electric shock, injury);
exogenous chemical compounds (substances entering the bloodstream when bitten by poisonous animals and insects, toxins of fungi, etc.).

It can be noted that toxic nephropathy is a complex polyetiological disease, therefore, it is necessary to clearly recognize by the clinical symptoms the possible factors that led to its development, and if necessary, immediately carry out antidote therapy.

Symptoms

Most often, this condition is manifested by changes in the general analysis of urine, such as proteinuria and hematuria. They pass quickly, and a person does not even know that his kidneys have just undergone a real attack of toxic substances. But if their dose and concentration are too large, then this can lead to serious, irreversible consequences.

Among all toxic nephropathies, the lion's share is occupied by the defeat of drugs, while the exposure to chemical agents occurs in conjunction with the immune responses of the macroorganism. This is due to the fact that the kidney tissue includes a widely developed vascular network, and all allergic components (mast cells, interleukins, immunoglobulins) freely enter the lesion, thereby exacerbating the course of the process.

Symptoms of drug nephropathy are similar to signs of acute glomerulonephritis, when the patient feels general malaise, weakness, irritability. He has swelling of the lower extremities and face. In the urine, hematuria and proteinuria increase. The frequency and quantity of urination (oligoanuria) is also reduced. Another important and formidable symptom should be considered the appearance of arterial hypertension, which can reach completely prohibitive numbers, causing a person to have bouts of seizures and cardiac arrest.

With the toxic effects of sulfonamide drugs, the brightest representatives of which are streptocide and norsulfazole, fever, severe pain in the joints, damage to the skin and mucous membranes in the form of hemorrhagic rashes join the above signs. At the level of the renal capillaries, it is possible to detect severe damage to the endothelium of these vessels, with ulceration of their walls and increased vascular permeability.

Complications and treatment methods

Most often, toxic nephropathy can lead to the development of interstitial nephritis, hemolytic uremic syndrome, and acute renal failure. Nephritis is manifested by acute or dull lower back pain, passing chills, a short-term increase in blood pressure, arthralgia (joint pain) and changes in the urine (polyuria, microhematuria, decrease in glomerular filtration rate, etc.).

In a general blood test, an increase in ESR, moderate leukocytosis and anemia are most common. Acute renal failure is already a formidable condition, most often leading to death. It is caused by a sudden decrease or complete loss of renal function and is manifested by a standard set of clinical symptoms: oligoanuria, delay in the body of nitrogenous toxins, impaired water-electrolyte balance and acid-base condition. The main sign of this condition is necrosis of the cortical layer of the kidneys, leading to irreversible consequences.

All options for toxic nephropathy are difficult to treat. Its most important component should be considered antidote therapy in the initial stages of the disease. If it is not performed, the doctors can only carry out symptomatic and detoxification therapy. In general, specialists try to prescribe strict treatment depending on the toxic agent that led to the development of this process. So, with poisoning with sulfonamides, plentiful alkaline drink, diuretics, drugs blocking carbonic anhydrase are prescribed.

In acute glomerulonephritis and interstitial nephritis, large doses of glucocorticosteroids, which have a powerful anti-inflammatory effect, are prescribed.

In order to excrete decay products and residues of harmful substances from the body, plasmapheresis and hemodialysis are performed. The essence of such manipulations is that a special device is connected to the patient, which takes a certain portion of blood from him, drives it through a filter system and returns it back to the body when it is already purified.

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Symptomatology

This disease is usually divided into severity. Symptoms of toxic nephropathy of various degrees have their own individual characteristics.

Light degree. The very beginning of the disease, which can signal an increase in protein levels in urine, as well as the blood that appears in it.
Medium grade. To the above symptoms are added a decrease in urine output, an increase in urea, potassium and creatinine.
Severe degree. A neglected state during which acute renal failure develops.

See also:

Learn more about the signs of nephropathy of its other species.

In the early stages, infectious toxic nephropathy is manifested by reduced diuresis, up to the onset of oliguria and anuria. Analyzes show an increase in urine density up to 1052. There is azotemia and a decrease in glomerular filtration, as well as tubular reabsorption. Patients begin to complain of lumbar pain. This happens due to an increase in interstitial edema of the kidneys. For the same reason, puffiness of the face appears.

Usually acute poisoning characterized by enlargement and hyperemia of the kidneys. At the same time, various morphological changes occur in the organs (from dystrophy to the complete death of cells). The degrees of these processes depend on the doses and types of toxins obtained.

In this case, poisonings, which are chronic in nature, are characterized by plethora. They are characterized by diffuse leukocyte infiltration, manifestations of oestracapillary intrata, expansion of the glomerular capsule cavity. Also, along with the defeat of the tubules and glomeruli and interstitial changes, as a result of which the patient suffers from swelling, the stroma argiophilic fibers are coarsened. Further, the addition of nephrosclerotic phenomena is not ruled out.

Toxic nephropathy in children also develops due to the ingestion of toxins. Manifestations are the same as in adults. Such children should be constantly monitored by a doctor, undergo preventive treatment.

Therapy

If you suspect a toxic poisoning of the body, you should immediately contact a toxicologist. And if symptoms of toxic nephropathy appear, start treatment immediately.

Diagnostic measures usually come down to compiling a clinical picture. It is also important to carefully monitor diuresis. Of no small importance is laboratory monitoring of the state of urine (especially its acid-base composition, electrolytes in the blood and nitrogen metabolism).

Diagnosis is based on the clinical picture, observations of diuresis and laboratory test data (acid-base composition, plasma electrolytes, nitrogen metabolism).

The first therapeutic stage is to undergo etiological treatment, which is most often based on preventative measures. Such therapy makes sense and gives good results only if timely seek medical help and treatment in the first hours after the ingestion of toxins.

Even the most severe cases of poisoning, for example, dichloroethane, can result in a positive outcome if measures are taken to expedite the removal of poisons from the body. In this case, the picture is more favorable if liver damage has not occurred.

If the poisoning has occurred with a hepatotoxic substance, the complex is used. therapeutic measures, which are aimed at removing poison from the body. In this case, you should first rinse the stomach, inject vaseline oil or adsorbent (activated charcoal) into it. In the first six hours, hemodialysis is recommended, within two days - peritoneal dialysis.

The prognosis for further recovery is very favorable, but only on condition that the disease is recognized at the earliest stages and adequate and emergency treatment of the patient is carried out. In addition, any further contact with toxins should be excluded without fail. The forecasts of nephropathies that developed as a result of exposure to silicon, hydrogen arsenate, and cadmium are not always favorable.

Preventive measures consist primarily in observing hygienic labor standards.

Symptoms of Toxic Nephropathy

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Causes and pathogenesis

The main causes and course of toxic nephropathy

Etiology

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Symptoms and stages of the disease

Diagnostics

Treatment

Therapy

First aid

Complications and prognosis

Prevention

The main causes and course of toxic nephropathy

Types of toxic kidney damage

Symptoms and stages of the disease

Dangerous consequences of the disease

Methods for diagnosing kidney damage

7 causes of the disease

Symptoms

Diagnostics

The method of treatment of toxic nephropathy

Pathogenesis

Toxic poisoning in children

Preventative measures

Effects

The mechanism of the formation of the disease

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Causes of pathology

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Complications and treatment methods

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