DEBUT OF NEPHROLOGICAL DISEASES: ATTENTION TO THE LEADING CLINICAL SYNDROME IN THE CONDITIONS OF DIGITALIZATION
Backgrouds. Change in society is characterized by the transition from the industrial era and analog technology to the era of knowledge and creativity, based on digital technology and innovation. Remote work and training are gaining momentum. Patients are increasingly turning to social media for help, and doctors can work from home as efficiently as from a resident’s hospital – with the right technology, the right management approach, and the cutting culture.
Goal. Studying the features of remote interviewing, constructing diagnostic conclusions based on a remote assessment of symptoms and syndromes, establishing the nosological form of the disease and referring the patient to the appropriate specialist (nephrologist).
Materials and methods. Review of modern and foreign sources, analysis and discussion of a specific clinical case; methods – description, analysis, abstracting.
Results and discussion. A specific clinical case of arterial hypertension syndrome in a patient with polycystic kidney disease is presented and analyzed. Our patient has had high blood pressure for several years, but ultrasound of the kidneys was done only 4 (!) Years after the first hypertensive crisis, in addition, the first ultrasound of the kidneys was done at the age of 58 (!). It is known that the first sign of the development of renal failure is arterial hypertension. This is where it is important to note that patients who are not feeling well turn to social media for advice. But the diagnosis of polycystic kidney disease can only be established by modern instrumental methods, and advice from social networks for lowering blood pressure in patients with kidney damage is incorrect. Our patient turned to the KNP CMC of Nephrology and Dialysis page, was invited and examined by a specialist doctor, where she was provided with highly specialized care.
Helping patients consists in carrying out symptomatic and renoprotective therapy, the task of which is to stabilize blood pressure (decrease at least to 130/90 mm Hg) and relieve inflammation of the renal tissue. In end-stage renal failure, only peritoneal dialysis, hemodialysis and donor organ transplantation can save the patient’s life.
Conclusions. Thus, the syndromic approach is the stage of nosological diagnosis, that is, the identification of the essence of a certain disease. Remote assessment of the leading clinical syndrome (in this case, symptomatic arterial hypertension) by a specialist doctor can establish the debut of a nephrological disease and prevent the progression of kidney disease, in particular, polycystic kidney disease.
2. Хронічна хвороба нирок / Внутрішні хвороби. Підручник заснований на принципах доказової медицини 2018/2019. C. 957-966.
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