Solitary kidney or bilateral renal obstruction due to ureteral calculi and obstruction anuria cause side contralateral renal reflex (referred to as 100ml less than daily urine urine urine every day less than 400ml called oliguria) is calculous anuria. At this point, the kidneys hardly secrete urine, accompanied by acute renal failure, uremia, and water electrolyte imbalance. Obstruction of any part of the urinary system can lead to hydronephrosis and impaired renal function. After obstruction, it is easy to complicated with infection. The latter also speeds up the development of the disease. Bilateral upper urinary tract (kidney or ureter) or unilateral ureteral obstruction in solitary kidney, renal pelvis, renal interstitial collection tube obstruction caused by increasing pressure, if timely, only minor damage, as long as the obstruction causes serious damage, can cause loss of renal function.
In the early stage of acute urinary obstruction, the swelling of the kidney is due to edema, the obstruction persists, the renal papilla is deformed, and the renal skin and medulla tissue are thinned. Renal cortical thickness is a predictor of residual renal function in patients with chronic hydronephrosis, but only in patients with chronic urinary tract obstruction. After 24 hours of calculous anuria, ureteral pressure continues to rise, more than 7.9kPa, glomerular filtration rate decreased significantly, the pressure continues to rise can be terminated by filtration. Because the metabolites in vivo can not be excreted, the clinical symptoms of renal failure appear earlier. Obstruction itself can be asymptomatic, some patients feel pain in the waist or obvious low back pain. Concurrent infection can have urinary tract infection symptoms.
Examination: ultrasound and X-ray are the first examination methods. When the diagnosis is not clear before the treatment, CT scan should be done.
Laboratory examination: we can see the increase of red blood cell in urine and mild albuminuria in some patients. The patients with urinary tract infection have the corresponding experimental quantity to check the abnormal results. When the renal failure occurs, the blood creatinine and urea nitrogen increase.
Treatment: emergency treatment to relieve or relieve obstruction and symptoms, prevent infection, restore and preserve renal function. 4~6 weeks after the obstruction, renal damage is still possible. There is inpidual difference in the recovery of renal function, but complete obstruction and infection can destroy the kidney in a few days. Therefore, emergency measures should be taken to remove the obstruction at an early date. The immediate use of non nephrotoxic antibiotics was used to monitor the amount of access and daily water and electrolyte requirements. If there are indications of renal failure dialysis, dialysis should promptly eliminate the toxic substances and water permeability in vivo accumulation, correct acidosis and electrolyte disorder. The incidence of gastrointestinal bleeding in patients with acute renal failure is about 10%, and should be actively prevented and treated.
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