Kidneys shrink

Introduction An abnormal phenomenon that is relatively small or significantly reduced according to the size of the kidney and the age, sex, and height and weight of the human body. Long-term kidney disease causes nephron, especially glomerular damage, which causes the entire kidney to shrink in size. Renal shrinkage of the kidney should be considered as renal atrophy and renal vascular disease of congenital renal hypoplasia or end stage renal disease. Renal atrophy can be seen in congenital renal hypoplasia and collagen and calcareous or some acute lesions, such as: acute glomerular disease, diabetic nephrosclerosis, renal transplant rejection, chronic glomerulonephritis, renal cortex Necrosis, Alport syndrome, acute tubular necrosis, hypertensive nephrosclerosis. Destruction of focal or diffuse renal parenchyma is seen in any mass lesion (eg cyst, tumor, abscess and hematoma), focal pyelonephritis, parenchymal scar (eg renal infarction or atrophic pyelonephritis), infant type Cyst kidney, chronic pyelonephritis or injury and other diseases. Renal atrophy caused by renal vascular disease can be caused by several diseases: endarterial disease, trauma, malignant lesions or embolism caused by heart disease. Renal atrophy is a pathological anatomy, which means that the kidneys are atrophied and the volume is significantly reduced, also known as the end-stage kidney. At this time, most or all of the glomerular tubules (ie, the nephron) have been destroyed, and the kidney has lost its physiological function.

Cause

Kidney atrophy usually shows left kidney atrophy, right kidney atrophy and kidney atrophy. In general, the causes of renal atrophy are as follows: First, it is necessary to consider congenital renal hypoplasia after renal atrophy, followed by end stage renal disease, namely renal failure, uremia or some acute conditions. Such as: acute glomerular disease, diabetic nephrosis, renal transplant rejection, chronic glomerulonephritis, renal cortical necrosis, Alport syndrome, acute tubular necrosis, hypertensive nephrosclerosis.

Bilateral kidney or one side of the kidney is mostly the cause of chronic pyelonephritis, which is a common cause of renal atrophy.

In general, chronic kidney disease develops into renal insufficiency, especially in renal failure and uremia, when serum creatinine and urea nitrogen are elevated, kidney damage is severe, kidney essence is damaged, and the kidneys are reduced. Therefore, patients with renal atrophy must be highly valued. Kidney disease is highly concealed. If the glomerular filtration rate is less than 50%, the clinical symptoms will be correspondingly caused by severe kidney damage. After the diagnosis of kidney atrophy, we must actively find the cause in order to check the condition.

In addition, there are two reasons for renal atrophy: renal tuberculosis (unilateral kidney shrinkage, with contralateral hydronephrosis or compensatory increase), renal artery stenosis and congenital hypoplasia.

an examination

Related inspection

Renal ultrasound renal angiography

Patients with renal atrophy may have nausea and vomiting, fatigue, anemia, etc. Continue to worsen will cause uremia. Patients with renal atrophy will also have swollen face and legs, and there will be symptoms of itchy skin, and they will be able to accompany the feet with edema. Some patients will have a bad back pain and cannot sit for a long time. Kidney atrophy is caused by long-term kidney problems, caused by overwork, kidney atrophy, swelling of the legs and feet, and blood pressure will increase with the severity of the disease. The body will gradually lose weight.

Patients with renal atrophy may also have hematuria. Hematuria refers to an abnormal increase in red blood cell excretion in the urine, which is a sign that the urinary system may have serious diseases. Centrifugal sedimentation of urine per high power field of view 3 red blood cells, or non-centrifugal urine more than 1 or 1 hour urinary red blood cell count of more than 100,000, or 12 hours of urine sediment count of more than 500,000, all showed an abnormal increase in red blood cells in the urine, It is called hematuria. Lighter only found red blood cells under the microscope, called microscopic hematuria; heavy appearance is washed water or contains blood clots, called gross hematuria. Usually 1mL of blood per liter of urine is visible to the naked eye, urine is red or washed water.

Differential diagnosis

Need to be identified with the following symptoms:

Renal interstitial damage: one of the symptoms and signs of hypokalemia nephropathy when renal interstitial damage. Hypokalmicnephropathy is a chronic interstitial nephritis or kidney disease caused by persistent hypokalemia, also known as kalium-losing nephropathy. The manifestation of hypokalemia nephropathy is mainly caused by tubule dysfunction, mainly due to decreased dysfunction, manifested as polydipsia, polydipsia, nocturia, nocturnal urinary incontinence, renal hypotonia, and poor response to vasopressin. There is a small amount of proteinuria and cast in the urine. Early potassium loss can cause metabolic alkalosis. After renal interstitial damage, metabolic acidosis occurs due to renal tubular acidification dysfunction. The disease is easy to be complicated by pyelonephritis, the clinical manifestations of urinary tract infection, and chronic renal insufficiency gradually appears as the disease progresses. In addition to the symptoms of nephropathy, the patient's systemic manifestations mainly include hypokalemia symptoms, such as muscle weakness in the limbs, soft paralysis of the intestines, weakened tendon reflexes, and arrhythmia.

Axillary atrophy: Focal segmental glomerulosclerosis (FSGS) is a common primary glomerular disease common in children and adults with nephrotic syndrome (NS). Histopathological features are glomerular segmental scars with or without glomerular capillary cell formation and adhesion. Focality means that only part of the glomerulus is involved (affected glomerulus <50%); segmental means that part of the glomerulus is involved; spherical sclerosis refers to the entire glomerular phase of the glass Change or scar formation. Pathological features are often associated with tubular atrophy and renal interstitial fibrosis.

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