Chronic renal failure.

Signs, current. In an initial stage (depression of a glomerular filtration till 40-60 ml/minute) at absence of a serious arterial hypertensia current of disease latent. At presence of an anemia, a polyuria and a nocturia for revealing an initial stage of a chronic renal failure spend the inspection taping depression of the maximal relative density of urine below 10-18 in assay of urine, depression of a glomerular filtration below 60 ml/minute (at a daily urine not less than 1,5 litres). For a conservative stage of a chronic renal failure (a glomerular filtration 15-40 ml/minute) the polyuria, a nocturia are characteristic. Patients complain of fast fatigability, dropping of working capacity, a headache, depression of appetite.

Sometimes they mark unpleasant taste in a mouth, there is an anorexia, a nausea and a vomiting. The patient is acyanotic, a skin dry, flabby. Muscles lose a tonus, fine twitchings muscles, a tremor of fingers and brushes are observed. Sometimes there are ostealgias and joints. The anemia develops, there is a leukocytosis and a staxis. Often there is an arterial hypertensia which is usually caused by a basic disease of kidneys. Borders of heart are dilated, its tones are muffled, changes of an electrocardiogram are defined. This stage can last some years. Conservative therapy enables to adjust a homeostasis, and the general condition of the patient quite often allows it to work still, but augmentation of an exercise stress, a mental strain, errors in a diet, restriction of drink, an infection, operation can lead to deterioration of function of kidneys and aggravation of uremic signs. At an end-stage of a chronic renal failure (a glomerular filtration below 15-20 ml/mines) the polyuria is often replaced by an oliguria. Conservative correction of a homeostasis is impossible. For this stage disturbance of a night dream, a sleepiness in the afternoon, retardation and an inaaccurance of behaviour are characteristic emotional lability (apathy is replaced by exaltation). The face bloated, grey yellow color, a dermal itch, hair dim, fragile. The dystrophia accrues, the hypothermia is characteristic. Appetite is not present. A voice rhonchial. From a mouth the ammoniacal smell is felt. There is an aphthous stomatitis. Tongue is imposed, the stomach is distended, a vomiting, regurgitations often repeat. Quite often - diarrhea, a chair evil-smelling, dark color.

The anemia and a hemorrhagic syndrome accrue, muscular twitchings become frequent and excruciating. At long current of a uremia monoarthritises (a secondary gout - adjournment in joints of a urinary acid), pains in arms, legs, a backbone (hyperparathyreosis), numbnesses and delicacy in legs (display of a uremic polyneuropathy) are observed. The arterial hypertensia becomes difficultly controllable, that promotes advance of a renal failure. Noisy respiration often depends on an acidosis, a fluid lungs or a pneumonia. The uremic intoxication becomes complicated a shaggy pericardium, a pleuritis, an ascites, an encephalopathy and a uremic coma.