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Edema in kidney disease - the mechanism of their development

  • Edema in kidney disease - the mechanism of their development

    Edema is the underlying symptom that accompanies kidney disease, regardless of the cause and severity of the pathological process. They can appear gradually, for several weeks with chronic glomerulonephritis or pyelonephritis. Their growth for several days indicates a pronounced process in the organ with the development of acute renal failure.

    Mechanism of edema development

    Their development in renal diseases contains several basic mechanisms:

    1. impaired excretory function - this condition leads to an increase in the concentration of sodium chloride in the blood, which is a hypersomolar compound, and retains water in the vascular bed, with an increase in a certain volume threshold, liquidleaves the vessels in the tissues, causing their edema;
    2. decrease in oncotic blood plasma pressure - the oncotic pressure is provided by plasma proteins( albumins) that prevent excessive fluid outlet from the vascular bed, with various kidney diseases and impaired function, the protein in large quantities is excreted in the urine, the oncological pressure decreases and the fluid exits the vesselsin the fabric;
    3. increase in the permeability of the capillary wall - occurs with various inflammatory diseases of the kidneys, as a result of increased permeability, the fluid easily exits into the surrounding soft tissues from the capillaries;
    4. increase in systemic arterial pressure-kidneys except for excretory function, perform systemic arterial pressure regulation, abnormalities in their work lead to increased fluid pressure in the vessels and its increased filtration into tissues.

    Important! The localization and severity of edema in kidney disease depends on which mechanism prevails.

    Symptoms of edema

    The appearance, localization and severity of soft tissue edema in kidney disease depends on the mechanism of their development and directly on what disease:

    • Swelling of the soft tissues of the face - first of all the area around the eyes and eyelids suffers, the swelling is more pronounced after sleep, then decreases during the day, and disappears by evening. This type is associated with a decrease in the oncotic pressure of the blood plasma because of the high excretion of proteins by the kidneys with glomerulonephritis. With a marked decrease in oncotic pressure, swelling seizes the entire area of ​​the face, changing it beyond recognition. In this case it is necessary to differentiate them from edema of the face in allergic reactions.
    • Minor edemas of facial, trunk and limb tissues in the form of skin pastosity are associated with increased permeability of the vascular wall in acute or chronic pyelonephritis. Also it is worth remembering that the pastosity of the skin can be caused by genetic factors and present in a person throughout life.
    • Pronounced edema of the lower limbs - their development is predetermined by the accumulation of sodium chloride in the blood, with its reduced excretion by the kidneys. They can appear in any disease accompanied by kidney failure. They are present with the same expression throughout the day.

    Important! Swelling of the lower extremities can accompany the development of chronic heart failure, when the pumping function of the heart is reduced. The mechanism of their development is associated with stagnation of blood in the capillaries of the lower limbs. Characteristic is that, unlike renal, the appearance of these swelling is more pronounced in the evening. In the morning after a night's sleep, they can disappear, with a gradual increase in the evening.

    Treatment of

    disease Edema is the result of a pathological process, so their treatment is associated with the elimination of the cause of their appearance. Usually, this is a conservative treatment, including antibiotic therapy for pyelonephritis, the use of immunosuppressant drugs for glomerulonephritis.

    Diuretics are also used that increase the excretion of fluid from the body and from the tissues in which it accumulates.

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