Symptoms and major manifestations of chronic kidney disease at various times

Chronic kidney disease symptoms of chronic kidney disease at all times

Chronic kidney structure and dysfunction caused by various causes (kidney damage history greater than 3 months), including renal GFR normal and abnormal pathological damage, abnormal blood or urine composition, and imaging abnormalities, or unexplained GFR decreased (<60ml / min · 1.73m2) for more than 3 months, that is CKD.

Chronic kidney disease, including what diseases chronic kidney disease is what disease which diseases are chronic kidney disease

China is still the most common primary glomerulonephritis (especially in IgA nephropathy is the most common), followed by hypertensive renal arteriosclerosis, diabetic nephropathy, chronic interstitial nephritis and polycystic kidney disease. But in recent years accompanied by population aging and changes in people's lifestyles, diabetic nephropathy, hypertensive renal arteriosclerosis incidence was significantly increased.

Most patients with chronic kidney disease can be no early symptoms or less symptoms, with the progress of the disease, can gradually appear in varying degrees of various symptoms.

Early can be expressed as frequent fatigue, fatigue, eyelid, facial, lower extremities (especially ankle) edema, a large number of urine foam, abnormal urine, dysuria or difficulty, increased the number of urination at night.

The emergence of renal insufficiency, chronic kidney disease symptoms gradually appear, fatigue, loss of appetite, nausea and vomiting, low back pain, nocturia increased, systemic edema, blood pressure, breath with urine, bone pain, skin itching, Muscle tremor, hands and feet numbness, lethargy, slow response and other performance. Laboratory tests can be found anemia, serum creatinine and urea nitrogen concentration increased.

Into the late uremia, the above symptoms continue to increase, leading to heart, liver, lung and other organ failure, high mortality.

In the different stages of CKD, its clinical manifestations are also different. Before the CKD3 period, the patient can have no symptoms, or only fatigue, backache, nocturia increased mild discomfort; a small number of patients may have loss of appetite, metabolic acidosis and mild anemia. CKD3 after the above symptoms become more obvious, after entering the renal failure period is further increased, sometimes there may be hypertension, heart failure, severe hyperkalemia, acid-base balance disorders, gastrointestinal symptoms, anemia, mineral bone abnormalities , Hyperparathyroidism and central nervous system disorders, and even life-threatening.

Chronic kidney disease:

1. Gastrointestinal symptoms

The most common is the gastrointestinal symptoms, the main performance of loss of appetite, nausea, vomiting, oral urine smell.

Chronic kidney disease, including what diseases chronic kidney disease is what disease which diseases are chronic kidney disease

2. stomach and duodenum

Inflammation, ulcers, bleeding stomach and duodenal inflammation, ulcers, bleeding more common, the incidence of increased than normal. CKD patients with abnormal blood system mainly for renal anemia and bleeding tendency. Most patients are generally mild to moderate anemia, the main reason for the lack of erythropoietin, so called renal anemia. Excessive body fluids or acidosis can occur when the shortness of breath, shortness of breath and other respiratory symptoms, severe acidosis can cause deep breathing. Too much body fluids, heart failure can cause pulmonary edema or pleural effusion. Some critically ill patients may be associated with uremia, pulmonary edema, uremic pleurisy, uremic pulmonary calcification.

3.Cardiovascular disease heart

Vascular disease is one of the major complications of CKD and the most common cause of death. With the deterioration of renal function, the prevalence of heart failure increased significantly, to uremic period of up to 65% to 70%. Heart failure is the most common cause of death in uremic patients. Hemodialysis patients with atherosclerosis and vascular calcification than patients before dialysis heavier, atherosclerosis is often more rapid development. Uremic cardiomyopathy is mainly associated with retention and anemia of metabolic wastes, and pericardial effusion is also common in CKD patients.

Neuromuscular symptoms

Neuromuscular symptoms in the early CKD may have insomnia, inattention, memory loss and so on. With the progress of the disease often reaction indifference, convulsions, hallucinations, drowsiness, coma, mental disorders and so on. Peripheral neuropathy is also common. Hypocalcemia, hyperphosphatemia, lack of active vitamin D can induce secondary hyperparathyroidism (referred to as hyperparathyroidism); these factors have led to renal osteophotosis (ie, renal bone disease), including Fibrocystic osteitis (high turnover bone disease), osteomalacia (low turnover bone disease), poor bone formation, osteoporosis and mixed bone disease.

5. Endocrine dysfunction

CKD patients often endocrine disorders, kidney itself, endocrine disorders, including: 1.25 (OH) 2 vitamin D3, erythropoietin deficiency and renal renin-angiotensin II levels increased; can also cause hypothalamic-pituitary endocrine Disorders such as prolactin, melanin hormone (MSH), luteinizing hormone (FSH), follicle stimulating hormone (LH) and adrenocorticotropic hormone (ACTH) are elevated. Most patients have secondary hypothyroidism Kang, insulin receptor disorders, elevated glucagon and so on. About 1/4 of patients with mild thyroxine levels decreased. Some patients may be associated with skin symptoms, such as pigmentation, calcium calm, itching, sweating difficulties, ulcers and so on. Some patients may have hypogonadism, manifested as gonadal dysplasia or atrophy, low libido, amenorrhea, infertility, etc., may be related to abnormal levels of serum sex hormones, uremic toxins, some nutrients (such as zinc) and other factors.