Renal insufficiency and malnutrition
Introduction
The kidney is a couple of organs located at the top of the retroperitoneum zone. On both sides of his great blood vessels for vertebrals, he is connected to him by a vascular pedicle and is provided with an excretion tube, the ureter, which drains towards the bladder. It consists of a series of blood vessels and closely connected epithelial structures, and makes it the main organ of the urinary system. This system is responsible for forming urine and expelling it from the organism.
Developing
Urine secretion and elimination is a crucial task, because together they constitute one of the basic mechanisms of the internal environment and homeostasis. The composition of the blood and the internal environment is not determined by what is ingested, but by what the kidneys retain. In addition to playing a vital role, the kidney also has the ability to produce hormones and autacoides (substances that produce effects), such as erythropoietin, renin or prostaglandins, which have a great influence on blood pressure control. This control of blood pressure, bone metabolism or red blood cell formation also makes it an endocrine organ.
There are two types of disease or renal failure. Acute renal failure and chronic kidney disease.
Acute renal failure (FR)
Acute renal failure is defined as an abrupt but reversible deterioration of renal function. This loss occurs in hours or days, altering the ability of the kidney to perform functions such as:
- The purification of waste substances produced in our body and its elimination by urine.
- The maintenance of an adequate balance of the amount of water and electrolytes in our body.
That is, it consists of a decrease in glomerular filtering with the consequent elevation of blood nitrogen products. Nitrogen metabolism products impose metabolic acidosis due to hydrogen ions and other acid species. The kidney deals with regulating the balance between hydrogen and hydroxide ions in order to counteract metabolic acidosis and ensure the constancy of the pH required for homeostasis.
Acute renal failure usually appears in patients who already suffer from a certain renal damage, worsening the renal function they already had altered.
This punctual failure is treatable and in most cases if adequate guidelines are followed, patients get to recover the function of the kidney totally or partially. However, a percentage, although not very large, dies as a consequence of the kidney failure and another percentage suffer permanent and irreversible renal damage, which is called chronic renal failure.
There are several types within acute renal failure or acute renal failure, these types are classified according to the location of the damage, therefore we are:
- Pre renal: It is due to poor renal blood perfusion. This decrease in blood can generate tubular ischemic damage, called acute tubular necrosis, if it extends over time.
- Parenquimatoso: It is caused by direct damage to the kidney. The most frequent causes are glomerulonephritis, that is, inflammation of renal glomeruli due to vasculitis, autoimmune diseases … or kidney damage due to various substances, normally medications of renal excretion. It can also be caused by renal infections or genetic diseases such as renal polychymosis although it is less frequent.
- Put it: it is due to an obstruction of the urinary tract, it is not a direct failure of the kidney. The acute renal failure only presents anuria when the obstruction is bilateral and complete;If partial can be accompanied by oliguria, normal diuresis or in some cases polyuria secondary to a defect at the level of urinary concentration.
Chronic kidney disease (ERC)
Chronic renal failure consists of the generally and progressive irreversible loss of nephrons and therefore the normal functioning of the kidney for more than three months, specifically from the glomerular filtration rate translating into uremia (accumulation of nitrogen or urea substances in the blood in the blood) and that can become lethal.
The most frequent causes of chronic renal failure are arterial hypertension, since it damages the small blood vessels of the kidneys preventing them from performing the filtration functions correctly;And diabetes because if glucose is not appropriately controlled, the blood considerably reducing renal filtration capacity.
conclusion
Although many other diseases may be direct cause of chronic renal failure such as birth defects, autoimmune disorders such as sclerodermia or systemic lupus erythematosus, reflux nephropathy or what is the same, retrograde flow of urine towards the kidneys. In addition some medications such as analgesics and drugs for cancer can be responsible for the appearance of kidney problems.
The final stage of chronic renal disease is called the terminal renal disease (ERT), in this phase the kidneys no longer have the ability to eliminate waste substances and excess liquid from the body, so that is why at this timeDialysis or extreme cases are used to a kidney transplantation. Specifically in this work I will expose the situation of malnutrition in patients with chronic renal failure, since it is a long -term disease with the nutritional level that I will explain throughout this.
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