The spine consists of bones (vertebrae) that are found betweensmall discs made of a fibrous outer shell (ring) that surrounds anucleus pulposus, a gelatinous substance soft.
These intervertebral discs function as shock absorbers, as absorbshock and protect the spine and the nerves of the burden of daily activities or strenuous activities, such as lifting heavy objects.
When a herniated disc, the nucleus pulposus is pushed into thespinal canal through the fiber ring injuries. If pushing a spinal nerve,herniated disc causes pain, numbness or weakness of their arms and legs, depending on its location.
Disc herniation is most often seen at the lumbar (lower), whilecervical herniated disk (neck) is 10% of cases. Disc herniationoccurring at any age but is especially common in the lumbar levelbetween 35 and 45 years, and the neck between 50 and 60 years.
Patients with diabetes will make an annual urine test for measuringsmall quantities of protein in the urine (microalbuminuria). This testcan detect early kidney damage caused by diabetes (diabeticnephropathy).
In case of suspicion of IRC, is made of blood and urine tests todetect elevated levels of blood residue, such as urea andcreatinine.
Additional tests:
- Ultrasound - indicate the shape and structure of the kidney andhighlight a possible urinary tract obstruction that can cause kidneyfailure.
- Computed Tomography (CT)-creates detailed images of internal organs, including kidneys.
- nuclear magnetic resonance (NMR)
- Renal biopsy - a sample of kidney tissue for examination under a microscope.
Increased levels of blood urea and creatinine is an indication ofterminal renal failure - kidney function is severely and irreversiblydamaged.
The first steps are recommended in patients with CRF changes in diet, especially reducing protein intake to slow the accumulation of residues in the body and to limit nausea and vomiting associated with chronic renal failure. Your dietitian can help patients take an appropriate arrangement that takes into account the underlying disease.As kidney function to remove waste from the body is diminished, the result is either a too high concentration of electrolytes (calcium, sodium and potassium) or a premature removal of these items.Regular blood tests to measure these concentrations allow for the detection of a possible electrolyte imbalance.
In terms of the inability of the kidneys to remove excess liquid, fluid intake should be reduced to reduce the effort required kidney. The recommended daily amount of liquid depends on the amount of urine issued the previous day. For example, a person who has given 500 ml of urine into a fairy, will be able to consume 500 ml of liquid in the next 24 hours. Fluid restrictions apply only in serious cases or in case of end-stage IRC.If further deterioration of renal function despite treatment established, recourse to dialysis or kidney graft.
Dialysis supplementation reduced renal function, using a membrane which acts as a filter to remove waste and excess body fluids. Choosing a method of dialysis (peritoneal or hemodialysis) depends on the severity of renal failure.
In peritoneal dialysis, abdominal cavity, natural membrane called the peritoneum, acts as a filter. Using a catheter (small flexible tube) placed permanently in the abdomen, abdominal cavity is inserted into a solution called dialysate. After a while, dializatul (loaded with waste and excess fluid that crosses the peritoneal membrane) is replaced with fresh dialysate. Peritoneal dialysis can be done continuously in cycles. In most cases, is performed at home by the patient or family member. It is done daily, or repeating the cycle every 6 hours or just once a day, introducing the evening and then backing it dializatul morning.
Hemodialysis is an intervention that must be practiced in the hospital. Using a dialysis method (a semi-permeable membrane) to filter blood and eliminate waste and excess fluid. Blood is pumped into the dialysis patient, serving as a filter. Just as with peritoneal dialysis, wastes and excess fluid passes through the membrane and remain on dialysis. Return cleaned blood as the body. Hemodialysis is faster than peritoneal dialysis, and generally, the cycle ends at 4:00. It is repeated about three times a week.
For some patients with CRF, renal graft is the only solution. People who can benefit from a graft are those whose renal failure is caused by hypertension, diabetes or infections. In general, renal graft is performed in patients with heart failure. Kidney graft may come from a living donor, usually a relative, or a person who has died recently and that has agreed to donate their organs. After a successful renal graft and adequate medical care, the patient can lead an active life, relatively normal.
Chronic renal failure may be present many years before symptoms appear. If a patient at high risk of renal failure, conducting regularblood and urine tests help detect the disease early. In the absenceof medical supervision, the symptoms may go unnoticed untilkidney damage is irreversible.
Some symptoms such as fatigue, may be present for a long time,but gradually as it is installed, are not observed.
Some signs and symptoms are evident:
- cloudy or dark urine
- blood in the urine (haematuria)
- Frequent urination, especially at night
- reduced amount of urine
- pain or difficulty in urination
Other symptoms are less obvious, but are directly related to theinability of the kidneys to eliminate toxins and excess fluids fromthe body:
- swelling of the eyelids, upper and lower limbs
- hypertension
- Fatigue
- anorexia (appetite loss)
- Nausea and vomiting
- Unexplained weight loss
- pruritus (itching) and persistent generalized
- muscle cramps
- headache (headache)
As IRC is worse, and toxins accumulate in the blood may occurseizures and mental confusion.
Chronic renal failure (CRF) is slow and progressive reduction of kidney filtration capacity. IRC usually occurs as a complication of another illness or disease. Unlike ARF, the IRC is installed gradually over several years as kidney damage. Evolution is so slow that the first symptoms appear only after the disease has caused significant clinical and biological consequences. The kidneys are paired organs shaped like beans, retroperitoneal located on either side of the spine. The main function of kidney filtration and excretion of excess water and toxic substances in the blood.
The kidneys provide three major functions: - Filtering the blood and produce urine to eliminate waste, thus preventing the accumulation of toxins in the blood - Adjusting the concentration of minerals and electrolytes (sodium, calcium and potassium) and the amount of fluid in the body - Production of hormones that act on other body functions such as regulating blood pressure (renin) and red blood cell production (erythropoietin).
Chronic renal failure is a slow and shows few signs and symptoms in the beginning phases. For this reason, many patients with chronic renal disease are not aware of this until after renal function is reduced to 25% of normal values. Among the common causes of chronic renal failure include hypertension and diabetes. The goal of treatment of chronic renal failure is to stop or slow down the disease. This may evolve into terminal renal failure in which kidney function is much reduced below normal values. In this case, patients need artificial blood filtration (dialysis) or a kidney transplant to survive.
