The concept of anuria
Anuria - complete cessation of urine entering thebladder. Anuria is different from acute urinary retention, in which the bladder is full of urine, but urine is not possible due to outflow obstruction of urine through the urethra. At the anuria bladder is empty. The urine excreted by the kidneys or not, or does not enter the bladder due to obstacles in the course of the upper urinary tract. Depending on the cause distinguish arenalnuyu, prerenal, renal, and subrenal reflex anuria. Arenalnaya anuria is rare. It happens in newborns with congenital absence (aplasia of kidneys). The absence of urine in infants in the first 24 hours of life - a normal phenomenon and should not inspire fear. Longer absence of urination infant requires find out the reasons of urgency. Newborns may experience urinary retention due to the presence of thin adhesions in the area of the external opening of the urethra or congenital urethral valves.
Prerenal oligoanuria occurs as a resulttermination or insufficient blood flow to the kidneys. This form relates oligoanuria anuria in advanced heart failure, when there are peripheral edema, fluid retention in the tissues and the abdominal cavity. The disorder also occurs in renal blood flow during heavy blood loss (trauma, obstetric and others.). Lowering blood pressure below 50 mm Hg. Art. (In shock and other disease states) lead to anuria.
Renal anuria cause pathologicalprocesses in the kidney itself. Termination of urine by the kidneys as a result of the disease occurs in the later stages of chronic glomerulonephritis, chronic pyelonephritis, kidney disease with hypertension. Sometimes renal anuria occurs in acute glomerulonephritis, also cause acute renal anuria may be poisoning poisons and drugs (Sulek, pahikarpin, acetic acid, etc.), Incompatible blood transfusion, kidney damage with extensive burns, massive crush injuries to the muscles. Renal Anuria may develop after major surgery as a result of absorption of tissue decay products after septic abortion and childbirth.
Postrenal anuria occurs when there is an obstacle outflow of urine from the kidneys, so this form is excretory anuria. The most common cause of its occurrence are urinary tract stones.
The main symptoms of the disease
Cease urination. After 1-3 days the absence of urine join renal failure symptoms that appear dry mouth, thirst, nausea, vomiting, headache, pruritus. The nitrogenous toxins accumulate body - protein decomposition products and potassium chlorides, non-volatile organic acid. Disrupted water and salt metabolism. Increasing the concentration of nitrogen in the blood leads to the development of uremia. Uremia appears weakness, drowsiness, vomiting, diarrhea, and sometimes swelling, shortness of breath, dimming of consciousness, the smell of ammonia from the mouth.
Emergency care in anuria
In patients with pre-renal anuria form secretoryemergency medical assistance must be aimed at the maintenance of cardiovascular activity. With symptoms of vascular insufficiency, collapse enter caffeine solution, glucose and put heating pads to the legs. When a shock is necessary as soon as possible to achieve the restoration of normal blood pressure levels. When large blood loss requires its immediate compensation and application of funds, contributing to the stabilization of vascular tone.