Renal infarction: what it is, symptoms, treatment, ischemic, causes, types and stages

Myocardial ischemic kidney - a rare nephrology pathology caused by blockage of arteries authority with further tissue death and the development of renal failure. The clinical picture is determined by the volume of necrotic tissue. Mild forms are asymptomatic. To detect myocardial using hardware and laboratory diagnostic methods. Treatment in most cases is carried out in a conservative manner.

Causes

Development of myocardial ischemia and kidney help:

1. Endocarditis. Inflammation in the cardiac atria walls or bag often complicated by the formation of mural thrombi. Clots periodically break away and begin to circulate in the systemic circulation. When blockage of the lumen of the renal arteries occurs necrosis.
2. Heart disease and arrhythmias. Irregular heartbeat contributes to stagnation of blood in the ventricles, because that form clots. Such a mechanism of thrombus formation observed when the valve prolapse
3. Atherosclerosis. The emergence of atherosclerotic deposits in the aorta and coronary arteries is considered to be one of the causes necrosis of kidney tissue. Blood disorder may be associated with the growth of atherosclerotic plaque or thrombus on the appearance deposition surface. Atherosclerosis causes thickening of the renal artery wall, which also causes severe ischemia.
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4. Focal inflammation of the arteries. This pathology of unknown origin with involvement of the renal vessels causes a heart attack.
5. Surgery. Improper execution of operations in the urogenital organs causes vasoconstriction and the development of acute renal ischemia.
6. Addiction. Heart attack occurs in intravenous drug users who use opioid drugs and ephedrine. When using non-sterile syringes developing infective endocarditis with the emergence of many small blood clots.
7. DIC. Multifocal infarction develops in diffuse intravascular coagulation.

Types and step

The following types of heart attack:

1. Ischemic. Myocardial developed in the area, are powered by a single division of the vascular system. Necrosis zone has not expressed structure, fabrics become pale yellow. Affected area demarcated from healthy parenchyma. Paleness is due to spasm of the proper area. This life-threatening condition that requires immediate treatment.
2. Urate. Diagnosed in children in the first year of life. It is associated with the formation of large amounts of uric acid stones. The disease can be cured spontaneously, therefore, does not require specific therapy.
3. Hemorrhagic (venous). Because of the overlap of the veins drain blood from the affected area becomes impossible. The lesion becomes dark. This form of heart attack is rarely diagnosed.

The pathological process develops in two stages:

1. First stage. In the kidney cortex necrosis appears triangular shaped tissue portion. The symptoms at this stage are mild, making it difficult to diagnose.
2. Later stage. The organ tissues develop irreversible changes. At this stage, there is a decrease in kidney size. Parenchyma organ atrophies. Brain Kidney layer was replaced by connective tissue.

Symptoms and clinical picture

When a heart attack kidney symptoms are as follows:

1. Pain syndrome. In the early stages, this feature is two-way in nature and mild severity. In the later stages of the localization of the pain shifts to the side of the affected organ. The intensity of discomfort comparable with the severity of renal colic. Remove the pain is only possible with the help of powerful painkillers.
2. Hematuria. The severity of the symptoms depend on the volume of diseased tissue. In milder forms of myocardial detected in urine small number of red blood cells. In severe disease the urine becomes bright red color, which is associated with the emergence of a large number of blood in the urine. Often develop severe kidney bleeding.
3. Renal colic. Associated with breeding thrombus or dead tissue through the ureters or the urethra. Pain different cutting character and high intensity.
4. Renal insufficiency. While maintaining the function of the second kidney severity of the symptoms are mild. With widespread necrosis observed intoxication healthy body, which contributes to urinary retention, appearance of ammonia and odor from the mouth of the patient.
5. Signs of intoxication. the patient's body temperature rises to 38... 39ºS appear vomiting and fever. With the defeat of both kidneys of developing hypertension.
6. The symptoms of the main disease. These include pain in the heart, arrhythmias, cyanosis of the skin, increased blood pressure, shortness of breath.

For the diagnosis of disease using the following procedures:

1. Initial consultation nephrologist. The doctor draws attention to existing complaints of the patient reveals outward signs of pathology. In the analysis of the medical history revealed chronic hematological and cardiovascular diseases that can cause renal infarction.
2. Blood and urine tests. The urine always found the red blood cells and protein. In carrying out biochemical analysis of urine detected increase in the amount of lactate dehydrogenase. In most cases, it detected a slight change in the level of white blood cells. Worsens the clotting of blood.
3. Hardware techniques. When a heart attack kidney appointed ultrasound of the renal arteries, aimed at assessing the performance of blood supply to the excretory system. Election contrast angiography. The procedure helps to detect the affected area without absorbing contrast agent. Magnetic resonance imaging of three-dimensional modeling of the vascular system of the kidneys.
4. Endoscopic techniques. Cystography used to identify comorbidities. Using procedures confirm or exclude damages the bladder wall, leading to the development of bleeding.

Methods of treatment

Scheme medicament for treating a disease includes:

1. Analgesics. To eliminate the intensity of pain using opioid analgesics derived from morphine.
2. Thrombolytics (streptokinase). Drugs dissolved clots, restoring patency. The drug is used in the first stage of myocardial. After the appearance of blood in the urine can not enter the substance.
3. Haemostatics (Dicynonum). They are used in severe renal bleeding.
4. Anticoagulants (heparin). Eliminate abnormal blood clotting. Doses are selected individually.
5. Antiplatelet agents (aspirin). Shall not apply in acute myocardial infarction. They begin to enter 14 days after the elimination of hematuria.

Extensive renal infarction treated surgically. The operation is aimed at the restoration of renal blood flow. Late detection of the disease is carried kidney removal. The auxiliary therapeutic procedures include hemodialysis, aimed at the elimination of toxins from the body.

Prediction and prevention

In the mild form of the disease of the excretory system function are not violated, the forecast is assessed as favorable. With extensive necrosis of developing life-threatening complications - acute renal failure, massive bleeding. While maintaining the effect of provoking factors is present the risk of recurrence of heart attacks.