Anemia (lack of urine ) - Causes, Symptoms and Treatment .MF .
anuria - is a clinical symptom that manifests complete absence of urine in the bladder and, as a result, the termination of her release from the urethra.
Since anuria is a complete lack of urine is in the bladder, it is logical that the problem lies above this body, namely, in the ureters or kidneys.As a classic example in the medical literature, the cause of anuria called blockade ureter urinary calculus ( "stone").But if you look, in order to completely stopped the flow of urine in the bladder is necessary that the two ureters were blocked simultaneously.You must accept the fact that such a clinical situation in medical practice is rare, so it is necessary to consider the maximum criticism.
More often anuria observed in other diseases.For example, in cancer adjacent organs where the tumor, reaching larger sizes, can symmetrically compress the ureters, blocking the flow of urine from the kidneys to the bladder.
addition, anuria frequently observed in patients with cardiovascular ins
addition, heavy metal poisoning, or alcohol may also contribute to disruption of filtration and, therefore, lead to the development of anuria.
course, do not forget about kidney disease, such as chronic pyelonephritis or glomerulonephritis, which lead to a gradual thinning of the renal parenchyma and disturbance filter urine.Despite the fact that today they no longer have its former importance in the development of anuria, but sometimes come across such clinical examples.
also anuria may occur due to blood transfusion, which is a group or Rh is different from the recipient's blood.Often, such cases were observed in wartime, when a careful check of blood does not have enough time and the biological liquid is poured, based on the data history.
diseases, leading to anuria
first on disease frequency in which there is such a clinical symptom is cardiovascular insufficiency.Recognize pathology can be on the typical appearance of a sick man with blue fingers, ear lobes, lips and nose.In addition, such patients complain of shortness of breath, dry cough, accompanied by the release of small amounts of sputum, and pain in the heart.Quite often, these patients have hypertensive crises, but at the time of anuria just holds another state - severe hypotension.If the background of these complaints noted the termination of urine excretion, then such a patient needs immediate consultation of the urologist and general practitioner.
As already mentioned, anuria can occur in large tumors that compress the lumen of the ureter.At the same time patients have to bother complaints about permanent aching pain as urinary retention does not develop spontaneously and gradually.At the same time there may be a loss of weight, which is one of nonspecific signs of cancer.
Despite the fact that the bilateral blockade of the ureter develops not so often, urolithiasis and should be considered as one of the diseases, in which the uremia may occur.In this case, patients have the typical pattern of renal colic when they complain about the sharp pain that is accompanied by a lack of urine.
If we are talking about pyelonephritis, as the cause of anuria, it must be remembered that this clinical condition develops only in chronic forms of the disease.These patients complain of recurrent pain in the kidneys, which are accompanied by general symptoms and fever.But in glomerulonephritis similar symptoms and there is no accurate diagnosis can only be based on the results of histological examination of kidney parenchyma.
anuria may occur in some infectious diseases, such as yellow fever, HFRS, leptospirosis, cholera.
Clinical diagnosis in anuria
should be noted that if the patient per day is not allocated a single gram of urine, it does not mean that he has a place anuria.First of all, it is necessary to exclude acute urinary retention, when it is excreted by the kidneys, but not out from the bladder because of the block on the level of prostate or urethra.In addition, the countries of the equatorial climate with minimal use of liquid, there may be a physiological lack of urine that can not be interpreted as anuria.
Thus, in order to put the diagnosis of anuria, it is necessary to carry out one of the fundamental research in urology - secretory (excretory) urography.In this case, if the urine is not contrasted in general, or it can be seen only in the kidney cavity, it means that the patient actually takes place anuria and it is necessary to conduct additional studies to identify a number of reasons for it.
Anuria on excretory urogram
First of all, carried ultrasound of the kidneys and bladder, which makes it possible to eliminate not only urolithiasis, but any oncological processes in the pelvic cavity.
If this method does not give a definitive answer as to the causes of anuria, the patient must perform several laboratory studies that will help to put the correct diagnosis.First of all, you need to dial the blood on the overall analysis.If this study is found a large number of white blood cells, it will be possible to talk about because of the inflammatory disease.Validate assumptions results of urinalysis is not possible, because this biological fluid just does not stand out.
Computed tomography of the retroperitoneal space is performed to detect cancer and to avoid kidney malformations.Also, using this method, you can assess the condition of the renal parenchyma, and determine whether it is not struck by purulent process.At the anuria
necessarily need to identify the level of urea and creatinine, as they are fully responsible for renal function and show how this body can not cope with their excretory function.
Among instrumental diagnostics in anuria is often used cystoscopy.That it gives the most accurate differential diagnosis of anuria and acute urinary retention.If anuria exposed by mistake, and in fact there is acute urinary retention, then the introduction of the cystoscope into the cavity of the body, the doctor detects a full bladder.If there is a really anuria, then celebrated sleeping bladder and absence of urine from the ureteral orifices.It should be noted that cystoscopy may be not only diagnostic but also therapeutic procedure.For example, if the cause of anuria is obturation ureteral stone, this issue can be solved by setting the stent into the ureter.
Symptomatic treatment anurii
After confirming the diagnosis of anuria, even before the exact cause of this disease, patients are already under some measures aimed at eliminating anuria.Primarily, they are assigned loop diuretics, such as furosemide.If the cause was anuria cardiovascular disorders, within a certain time after the administration of furosemide can obtain the first urine.The opposite situation is observed, for example, when a bilateral ureteral obstruction.After the introduction of the diuretic is observed only enhanced clinical symptoms.In some ways, it is a kind of breakdown that allows to distinguish renal anuria from infrarenal.
If during administration of the diuretic is observed increase in clinical symptoms, it resorted to the second stage of symptomatic therapy - the imposition of nephrostomy.Nephrostomy allows you to "unload" the kidney, resulting in the immediate clinical improvement due to the elimination of urinary block.If it
of uremia, which is related to the direct violation of renal membrane, and diuretics are ineffective in this situation, then doctors is one the only way - to transfer the patient to the artificial kidney.Once the patient's condition improves, may conduct further diagnostic search and try to use other methods of treatment.
Since anuria directly impaired kidney function, then the protein products of metabolism that are normally displayed by the agency remain and accumulate in the blood.This leads to another major urological symptoms - uremia.
If this clinical condition does not give medical or hardware correction, the patient is disturbed function of the nervous structures of the brain that, in turn, lead to a variety of neurological symptoms, which find its logical conclusion in a coma.As is known, uremic coma is very serious not only for treatment, but also in terms of prognosis.Even those patients who can avoid the lethal end, can come out of a coma with obvious neurological deficit.
To which the doctor ask for anuria
Naturally, urologist consultation is very important in such clinical situations, but sometimes there are times when it is simply a waste of time for both the patient and the doctor.For example, if the patient during the day, in hot climates, or actively engaged in physical labor, used a small amount of water, then he has nothing to worry about the small amount of urine.Just a day you need to do some research - during the day to fix the amount of used and discharged liquid.The latter should be added to 300 ml of loss through sweat and breathing.If the above numbers will be about the same, it means that the kidneys are working perfectly fine.In that situation, when the amount of fluid intake will significantly exceed the amount of urine, and thus on the patient's body will be seen clear signs of swelling, then it should immediately run to the reception to the urologist.
Ed.urologist, sexologist-andrologist Plotnikov AN