Amyloidosis of the kidneys is a relatively rare pathology, which is characterized by a violation of protein-carbohydrate metabolism with the formation and deposition in the kidney tissues of a specific substance - amyloid. Amyloid is a complex protein-polysaccharide compound, resembling starch, which is abnormal for the body and disrupts kidney function.
Forms of amyloidosis of the kidneys
There are several forms of amyloidosis:
- primary amyloidosis of the kidney is an independent disease, the development of which is not associated with other pathologies that can lead to the formation of an abnormal protein;
- secondary amyloidosis of the kidneys - the most common form, is a consequence of some chronic diseases;
- amyloidosis associated with hemodialysis is a form of the disease that develops in patients who have repeatedly undergone renal dialysis;
- congenital amyloidosis is a genetically determined form of the disease;
- senile amyloidosis is a form of the disease that occurs in adulthood (after 80 years).
Causes of amyloidosis of the kidneys
In some cases, the causes of the development of pathology remain unknown (primary amyloidosis). Among the known causes of amyloidosis, the following diseases can be distinguished:
- pulmonary tuberculosis ;
- malaria;
- syphilis ;
- osteomyelitis;
- rheumatoid arthritis;
- lymphogranulomatosis;
- myeloma, etc.
Long-term exposure to chronic infection can lead to abnormal changes in protein synthesis in the body. The consequence of this is the formation of antigen proteins - foreign substances, to which antibodies start to be produced.
Symptoms of kidney amyloidosis
Amyloidosis of the kidneys proceeds in three stages, each of which has its manifestations:
- Early stage (preterm) - in this period there are no significant manifestations of the disease, there is mainly a decrease in activity, general weakness. In urine is found a small amount of protein (proteinuria), in the blood - high cholesterol. The functions of the kidneys are practically unchanged at this stage.
- Ointment (nephrotic) stage - characterized by gradual progression of edema, sclerosis and amyloidosis of the renal marrow, the development of nephrotic syndrome. There is a significant proteinuria, hypercholesterolemia, hypoproteinemia, and sometimes - arterial hypertension. The kidneys are enlarged and compacted, becoming matte grayish pink in color.
- The terminal stage corresponds to the development of chronic renal failure. There are persistent edema, uremia, general exhaustion of the body, amyloidosis is often complicated by thrombosis of renal veins with anuria and pain syndrome.
Diagnosis of kidney amyloidosis
In the initial stage, the disease is very difficult to diagnose. To suspect the development of amyloidosis can be as a result of laboratory tests - the analysis of blood and urine. Conducting a coprogram can also be indicative.
An electrocardiogram of the heart can show reduced levels of impulse voltage and false signs of a heart attack. Kidney ultrasound can be used to assess their size.
To confirm the diagnosis, a kidney biopsy is used (evaluation of organ morphology), which makes it possible to detect the presence of amyloid.
Treatment of amyloidosis of the kidneys
Treatment of amyloidosis is effective only in the initial phase of its development. It is aimed at eliminating the factors contributing to the formation of amyloid, and on the suspension of the production of this substance.
With secondary amyloidosis, treatment is aimed at eliminating the infection that is the cause of the disease. For this, conservative and surgical methods are used.
A significant role in the treatment of amyloidosis is given to a diet that is prescribed depending on the stage of the disease and the indicators of the tests. As a rule, it is required to limit consumption of salt, protein, increase in the amount of foods rich in vitamin C and potassium salts.
Drug treatment of amyloidosis of the kidneys involves the appointment of various drugs - antihistamines, anti-inflammatory, diuretic, etc. Renal dialysis is recommended.