СИНДРОМ ГІПЕРГІДРАТАЦІЇ У ПАЦІЄНТІВ З НИРКОВОЮ НЕДОСТАТНІСТЮ

  • Inna Burzhynska KNE “Kyiv City Center of Nephrology and Dialysis”, Kyiv
Keywords: chronic renal failure, edema, hyperhydration, kidney disease, hemodialysis

Abstract

Introduction. Syndrome of fluid accumulation (overhydration) occurs when water-salt metabolism is disturbed.
In renal failure, overhydration is associated with a violation of the composition and volume of extracellular fluid. This also affects the intracellular volume, changing tissue metabolism towards catabolic processes with the breakdown of proteins, fats and carbohydrates. This situation is accompanied by symptoms: a drop in body temperature, salivation, nausea, vomiting, impaired coordination of movements, convulsions, muscle weakness, headache appear.
Goal. To describe the clinical manifestations of overhydration and analyze the dynamics of laboratory and instrumental parameters in patients with chronic renal failure and syndrome of fluid accumulation in organs and tissues.
Material and methods. Generally accepted laboratory and instrumental research methods (ultrasound, echocardiography, ECG, EGDS).
Results. A clinical case is presented: Secondary nephrogenic arterial hypertension, grade II, grade 2, high risk (3). Hypertensive heart, moderate relative mitral valve insufficiency, slight relative tricuspid insufficiency, minimal aortic valve insufficiency with preserved left ventricular ejection function (52%), bilateral hydrothorax with hydropericardium, II stage pulmonary hypertension. FKP. CKD 5D Art. glomerulonephritis. On hemodialysis from 11/01/2017. Anemia. Secondary hyperparathyroidism.
Various types of overhydration are analyzed. The mechanism of the development of fluid accumulation syndrome and the occurrence of endothelial dysfunction in patients with chronic kidney disease is presented.
Conclusion. In chronic renal failure, the main mechanism for the development of overhydration is primary sodium and water retention, which induces systolic and diastolic dysfunction of the heart, as a result of which end-diastolic pressure in the cardiac cavities and blood vessels increases. Deepening of changes simultaneously on the part of the kidneys and heart (syndrome of fluid accumulation in organs and tissues – diffuse-edematous changes in the renal parenchyma, hydrothorax, pleurisy, pericarditis, ascites) contribute to the progression of renal failure.

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Published
2020-12-22
How to Cite
Burzhynska , I. (2020). СИНДРОМ ГІПЕРГІДРАТАЦІЇ У ПАЦІЄНТІВ З НИРКОВОЮ НЕДОСТАТНІСТЮ. Actual Problems of Nephrology, (26-27), 42-47. https://doi.org/10.37321/nefrology.2020.26-27-06