Chronic renal failure is a very serious condition. Find out the importance of creatinine in kidney failure. In chronic renal failure, the ability of the kidneys to actively maintain balance in the body is significantly reduced or completely disrupted. This is a very serious pathology and today we will tell you what is the importance of creatinine in renal failure. It should be noted that according to information from international health organizations, the number of people suffering from this disease is increasing by an average of 11 percent annually.
Pathogenesis and etiology of chronic renal failure
The presence of chronic renal failure can be said if the pathology has been observed for at least three months. Today, out of a million people, this disease is diagnosed in 300-600. Most often, the disease causes various organ pathologies. Urological diseases are often the main cause of renal failure.
Chronic renal failure develops over several stages. Gradually, the number of normally functioning nephrons decreases, which leads to a decrease in the performance of the kidneys. As a result, the normal functioning of the organ can be completely stopped. It is with this that the pathogenetic mechanism of this disease is associated.
The rate of development of this pathology can differ significantly depending on the causes of the onset of the disease. The most rapid development of chronic renal failure is observed in amyloid, as well as diabetic nephropathy and mixed nephritis. And, say, with pyelonephritis, pathology develops rather slowly.
Renal failure classification and creatinine level
When it comes to the classification of this disease, most experts take into account the work of Kuchinsky and Lopatkin, who described the four stages of pathology:
- Latent stage - there is a decrease in the glomerular filtration rate to 60-50 milliliters per minute. All changes occurring at this stage in the body can be detected using laboratory tests. The stage of clinical manifestations - the drop in the glomerular filtration rate continues and reaches the level of 49-30 milliliters per minute. Since tubular reabsorption is impaired, the daily urine output increases to 2 or 2.5 liters.
- Decompensation stage - the glomerular filtration rate is 29-15 milliliters per minute, the rate of tubular secretion worsens, and the level of creatinine in renal failure at this stage is from 0.2 to 0.5 ml mol / liter.
- Terminal stage - changes in the work of the kidneys become irreversible, and the organ cannot do its job. The concentration of urea, creatinine sharply increases, the balance of electrolytes is disturbed.
As a result, uremic intoxication develops, and urine ceases to be excreted. In addition to the kidneys, pathological changes affect other organs, for example, blood circulation may deteriorate or pulmonary edema may appear.
In addition to all of the above, each of the above described stages differs in the concentration of creatinine in renal failure:
- Stage number 1 - the level of creatinine increases to 440 μmol / liter.
- Stage 2 - the level of the substance rises to 440–880 µmol / liter.
- Stage 3 - the concentration of creatinine reaches 1320 μmol / liter.
- Stage 4 - the level of the substance exceeds the value of 1320 μmol / liter.
Kidney failure symptoms and anemia
At the first stage of the development of pathology, there are few objective and subjective symptoms. At the same time, thanks to a thorough interview of the patient, the following symptoms can be identified: dry mouth, increased weakness at the end of the day, as well as high fatigue.
At the stage of clinical manifestations, the symptoms of the disease become more pronounced, and there may also be a decrease in appetite and neurological disorders. At the third stage, the patient complains of deteriorating health. This occurs simultaneously with an exacerbation of chronic renal failure. In turn, after correct drug treatment, patients notice an improvement in their condition.
All the symptoms described above at this stage of the development of pathology are persistent. Vomiting and an unpleasant taste in the mouth appear. The skin becomes yellowish, its dryness is noticeable, as well as flabbiness. Muscle tone decreases, and small muscle twitches begin to appear, as well as tremors of the hands and fingers. In addition, the appearance of pain in the joints and bones is possible. Any mild respiratory illness is very difficult for the patient.
At the last stage of the development of pathology, in most cases, a lethal outcome occurs. This can only be avoided with a kidney transplant, and death can be delayed with lifelong hemodialysis. The main symptoms of this stage are daytime sleepiness, lethargy, sleep disturbances, and memory problems. The patient's face becomes puffy and takes on a characteristic yellow-gray tint.
In addition, unhealthy thinness is strongly noticeable, and body temperature is most often lowered. Aphthous stomatitis begins to develop and when talking with the patient, you can feel the ammonia odor from the mouth. In addition, there is constant bloating, and diarrhea and vomiting are regular.
Simultaneously with the fourth stage of the disease, anemia develops. This leads to an even more serious deterioration in the patient's health. The development of anemia is associated with a drop in the level of erythropoietin, which is necessary for the synthesis of red blood cells. As you know, red blood cells contain hemoglobin, which is necessary for normal gas exchange.
Diagnosis of chronic renal failure
As we said above, it is quite difficult to diagnose pathology at the first stage, since the disease is almost always asymptomatic. It is possible to diagnose this disease at the initial stage only with the help of laboratory tests. Among the most informative analyzes, it should be noted:
- Osmolarity of urine.
- Creatinine for renal failure.
- Glomerular filtration rate indicator.
In addition, some instrumental studies can give positive results in diagnosing the disease:
- Ultrasound of the entire urinary system with simultaneous determination of blood flow in the kidneys.
- Puncture biopsy of the kidneys.
- X-ray of the organ.
In addition, to diagnose chronic renal failure, it is necessary to seek advice from a nephrologist, ophthalmologist and neurologist.
How is chronic kidney failure treated?
As you already understood, creatinine in renal failure, or rather the concentration of this substance, is one of the indicators of the presence of pathology. Although now there is a fairly large list of medications that are used to treat this disease, there is no universal therapy. When prescribing drugs, the doctor should be based on the results of analyzes of each individual patient and the situation as a whole.
If we talk about drugs showing good results, then first of all it is minnit, epovitan, and furosemide. Antibiotics (carbenicillin or ampicillin) and aminoglyside antibiotics are also often used.
How to eat properly for kidney failure?
In chronic renal failure, a low-protein diet should be followed. It is very important to reduce the consumption of protein compounds of animal nature to a minimum, and strictly dose plant origin. The main emphasis in the nutritional program for chronic renal failure should be placed on fats and carbohydrates.
This will significantly alleviate the patient's condition. It should also be noted that the nutrition program described above can slow down the development of pathology in some diseases, for example, diabetic nephropathy. When choosing a dietary nutrition program, the following points should be considered:
- The rate and stage of development of pathology.
- Indicator of the functional reserve of the kidneys.
- The amount of protein compounds that are excreted in the urine.
- Indicators of water-electrolyte, as well as phosphorus-calcium metabolism.
- Indicator of energy expenditure, as well as the rate of protein catabolism.
At the moment, three nutrition programs have been developed for people suffering from this type of pathology. They are selected depending on the creatinine concentration in renal failure, as well as the glomerular filtration rate.
Here are some guidelines for organizing a nutritional program for kidney failure:
- It is recommended to consume from 40 to 60 grams of protein compounds throughout the day.
- Elimination of salt from the diet or maximum restriction on this product.
- The necessary indicator of the energy value of the diet should be provided through the use of fatty species of sea fish, complex carbohydrates, vegetable oils and fatty dairy products.
- Eliminate refractory animal fats from the diet.
- Instead of refined sugar, use fruits, and replace white flour with "black" cereals.
- With the help of fruits and vegetables, it is necessary to ensure the intake of all micronutrients into the body.
- Drink at least 0.8-1 liters of water throughout the day.
Products must be cooked, and the broth must be drained. We recommend eating food in small portions from 5 times a day. Thus, the treatment of high creatinine levels in renal failure consists in the treatment of the disease of the provocateur of this pathology.
All about creatinine in the following video: