Diffuse changes in the kidney parenchyma: what is it? Causes and methods of treatment
The term “diffuse changes in the kidneys” does not indicate the presence of any disease, but an extensive pathology (or even a whole set) that disrupts the functionality of the kidneys.
The most frequent causes of their occurrence are chronic diseases of the cardiovascular system (since both kidneys are associated with the circulatory system and are indirectly part of it), diabetes, pyelonephritis, overweight, the appearance of neoplasms of unknown etiology (including malignant).
What it is?
Diffuse renal changes must be implied. as a symptomand not diseases. These organs are complex filters responsible for salt metabolism in the human body.
The deterioration of their functionality is a natural process. And that is why the average thickness of the parenchyma in an adult is about 2.5 centimeters, while in the elderly it is around 1.1 centimeters. With the passage the kidneys are getting thinner and this is directly related to the work of the cardiovascular system.
Learn more about the pathologies of the kidney parenchyma here.
But if this very thinning occurs too quickly, then when diagnosing (most often ultrasound), a note on the presence of a diffuse change in the kidneys is made in the patient's card. Conventionally, they are classified into:
- diffuse changes of the parenchyma (of the filter layer itself, consisting of accumulation of blood vessels and capsules),
- diffuse changes of the renal sinuses (“sinuses” should be understood as poles, pelvis, exit to the ureter, incoming and outgoing blood vessels).
It is also customary to divide diffuse changes into paired and asymmetric changes (respectively, affecting only one or both organs).
- pain or discomfort in the lumbar region,
- violation of the frequency of normal urination (for example, during the daytime there is almost no desire, but at night - very often),
- pain and discomfort when urinating,
- swelling of tissues (indicates problems with regulation of water balance),
- renal failure (may indicate the appearance of tumors, which hampers the nominal blood flow).
Main reasons diffuse heterogeneous changes of the parenchyma are:
The reasons diffuse sinus changes:
However, quite often, patients are recorded in the card "diffuse changes in the kidneys of unknown etiology," which implies the impossibility of establishing the original cause of the pathology.
This often happens with late diagnosis diseases affecting the functionality of the kidneys.
Signs of diffusion and ongoing research
For the final diagnosis of the patient is sent to the following analyzes and studies:
- Ultrasound (is the basis)
- CT or MRI (magnetic resonance imaging allows you to create a clear clinical picture of the patient),
- general urine analysis,
- general blood analysis.
In some cases, the patient may also be given a biopsy (if there is a suspicion that the tumor is malignant).
The main signs of diffuse changes on ultrasound:
- thickening of the sinus (incoming and outgoing blood vessels, inflammation of the pelvis),
- thickening or depletion of the parenchyma (abnormal thickness),
- the presence of cystic neoplasms in the parenchyma or sinuses,
- poor renal vein imaging,
- fuzzy outlines of the parenchyma,
- the presence of so-called "echoes" when conducting ultrasound,
- symptoms of tumor thrombosis and blood flow disorders.
Is pathology treated?
A detailed algorithm for the treatment of diffuse changes in the kidneys does not exist, since the clinical picture for each patient will be purely individual.
The main thing is to establish the exact or apparent cause of the pathology.
Further therapy is aimed at its elimination and minimization of the rate of flow of pathological changes in kidney functionality. It is possible that this does not even require drugs. For example, if you are overweight, you only need to normalize the weight of the patient.
The most common reasons for which treatment is prescribed:
- urolithiasis disease,
- infectious etiology glomerulonephritis,
- chronic diseases of the cardiovascular system.
Thus, diffuse changes in the kidneys are a symptom indicating a violation of the functional structure of the organs. In most cases, it indicates the course of chronic diseases affecting the cardiovascular system, or indicates the presence of tumors.
The most difficult is establish the cause.
If this is not possible, then the patient is prescribed supportive therapy.
What are the diffuse changes in the kidneys on ultrasound - see the video:
How to determine the presence of pathological changes?
If there is no kidney disease and they fully function, the organ has the following indicators:
- length - up to 12 cm
- width - up to 5-6 cm
- thickness - 4 cm
- total weight of one pack - up to 200 g.
If a diffuse change in the parenchyma of the organ occurs, the structure is transformed. Under such circumstances, the patient’s overall health deteriorates as the organ grows. When reducing the size of the kidneys with diffuse changes in the parenchyma, immediate treatment should begin, this phenomenon is often a sign of neglected disease. The disease may be:
- acquired due to an infectious disease.
Only a doctor can determine the form of pathology.
The main reasons for the development of pathology
Diffuse changes in the renal parenchyma. What is it and for what reasons? Such changes develop most often in older people or when the disease of the organs is neglected. There are several reasons that can provoke the appearance of such a pathology. Of them emit:
- disorders of the urinary tract,
- inflammatory process in the tubules,
- the presence of fatty plaques in the pyramids.
What is dangerous calcinates? Due to the accumulation of calcium salts, diffuse changes in the parenchyma may occur. In the event of their appearance, there are severe pains in the lumbar region, which are aggravated in the process of spontaneous removal of stones through the urinary tract. The concept of pathological diffuse transformation of parenchyma tissue is not a clinical diagnosis. This is not an independent disease, but only a consequence of another serious illness.
If the kidneys are enlarged, it is necessary to carefully examine the patient. The results obtained after the diagnosis will help determine the nature of the changes.
Features of parenchyma thinning
This pathology can occur not only in older people. If the disease is not treated or self-medicated, then parenchymal tissue may become thinner. Sometimes the symptoms of diffuse changes are reminiscent of signs of renal failure. When the parenchyma becomes thinner, nephrons die off due to disturbances from peripheral vascular resistance. Under such circumstances, the full functioning of the body is disrupted. This is often expressed in changes in urine excretion products. In addition, diuresis may decrease, and the disease will become chronic. For this reason, doctors recommend that when one of the symptoms of a diffuse change in the parenchyma of the right kidney (or left) appears, seek the help of a specialist and not self-medicate at home.
What are the reasons for a cyst in the parenchyma?
Such a pathological condition is observed in the event that the nephrons will delay the liquid for a long time. Cystic formation is sometimes found in both kidneys. Pathology can be either congenital or acquired. Most often, the acquired form of pathology is found in the elderly. Diffuse changes in the renal parenchyma in children are rare. The cyst has the shape of a bubble with a thin wall, which is filled with a liquid substance. The new growth can be both single, and plural. The cyst is able to grow to 9.5 cm. At a more global size, nearby tissues are compressed, which lead to dysfunction of the paired organ. Among the main signs of cystic formation are:
- the presence of blood clots in the urine,
- pain in the lumbar region.
In some cases, at an early stage of development of the pathology, the symptoms may not appear. To remove small formations, use the puncture. When running stage - abdominal surgery.
Symptoms of neoplasm development
In the tissues of the parenchyma often appear various tumors. They can be either benign or malignant. The first category includes adenoma and angiomyolipoma. If a benign neoplasm is not treated in time, they develop into a cancerous tumor. If there is a suspicion of oncological disease, the patient is prescribed an ultrasound and computed tomography. Additional tests may be needed to make an accurate diagnosis. You should know that diffuse changes in the renal parenchyma in children are extremely rare.
If the tumor is located in the renal sinus, then it can be detected in the process of finger examination by a doctor. When kidney disease can increase body temperature and swelling occur. What are the echo indications of diffuse changes in the kidney parenchyma?
Kidney echogenicity index
Echo is the degree of reflection of the sound wave. To determine it, it is necessary to examine the density of the tissue. With a dense structure in the picture you can see a bright spot, at low density - a dark area. Normally, fabrics should be uniform. If the doctor after the ultrasound revealed a bright spot, then this indicates that the echogenicity of the kidneys is increased. Under such circumstances, there is little fluid in the kidney tissue. Such a diagnostic result may indicate the presence of the following diseases:
- development in the body of a strong inflammatory process,
- malfunctions of metabolic processes and the endocrine system,
- the effects of diabetes.
On ultrasound, signs of diffuse changes in the renal parenchyma are clearly visible to the specialist. The density of the tissues of organs increases with the development of a foreign tumor. It can be both stones and sand.
How to recover tissue?
How is the treatment of diffuse changes in the kidney parenchyma? The main feature of the organs is the ability to self-repair. Even with the recurrence of the disease, regeneration of the parenchyma tissues occurs. Much depends on the general health of the patient. A special role is played by the protective function of the patient and the speed of the metabolic process. During normal operation of the endocrine system, parenchymal tissues recover faster. To improve immunity, doctors recommend eating right, walking more in the fresh air, not abusing alcohol and cigarettes, playing sports and regularly visiting a doctor. This will help prevent the development of pathological complications.
Therapy depending on the identified disease
You should know that the choice of treatment for diffuse changes in the renal parenchyma directly depends on the identified pathology. Namely:
- If urolithiasis is found, the doctor applies a therapeutic method. Depending on the nature of the calcium, the doctor selects the drug and the diet. If the stones are small, then treatment with medication is enough. In the presence of large stones, ultrasonic crushing is often carried out. Children rarely have stones. In frequent cases, this is due to a congenital anomaly or an infectious disease. It is forbidden to engage in self-treatment, since it is impossible to diagnose pathology at home.
- If a cyst is found in one of the kidneys, it is necessary to monitor the patient regularly. In the event that there are a large number of neoplasms of a huge size, it is important to begin immediate treatment. If there is a need to perform a surgical operation, laparoscopy is performed. During this procedure, a cyst is removed and drainage in the retroperitoneal area is established. In the process of puncture, a cyst is punctured and the substance from the formation is sucked off.
- For glomerulonephritis and acute pyelonephritis, the treatment process is based on taking antibiotics. If, after conservative treatment, the general well-being of the patient has not improved, then an operation should be carried out.
- When a tumor is formed, the doctor prescribes an individual program. In that case, if it is of a benign nature and does not progress, then the tumor is only observed. Otherwise, a resection or nephrectomy is prescribed.
- In the process of cancer therapy, chemotherapy is prescribed by specialists.
Treatment of changes in the parenchyma of the kidneys of a diffuse nature is determined by the severity of the pathology and the general state of health of the patient. It is often based on Ampicillin antibacterial treatment.
The duration of the course of treatment and medications is prescribed strictly by the doctor, depending on the general health of the patient, the presence of other diseases and the age category. After a complete study of the patient, the attending physician prescribes suitable medications that must be taken in accordance with the recommendations. Self-medication can harm. You should be aware that high body temperature is a frequent sign of diffuse changes in the parenchyma of both kidneys.
In the course of treatment, it is important to follow the diet that the doctor prescribes, since the therapy must be comprehensive. Without proper nutrition can not do, because the drugs will not give the desired effect, if you lead an unhealthy lifestyle.
Doctors prescribe special nutrition not only in cases when diffuse changes in the structure of the renal parenchyma are detected, but also in case of:
- gallstone disease
- chronic gastritis,
- chronic colitis,
Proper nutrition has a positive effect on the general health of the patient and speeds up the healing process. In addition, it fills the body with beneficial elements, positively affects the stomach, normalizes the functioning of the liver, positively affects the functioning of the intestine.
Most often, diffuse changes in the parenchyma and renal sinuses occur because:
- the patient is abusing alcoholic beverages,
- eating wrong
- an infectious disease has occurred
- hereditary predisposition is present,
- the duodenum has inflamed,
- late treatment of diseases of the stomach,
- there was urolithiasis,
- there is stagnation of fluid
- There was a long-term treatment with certain medicines.
Now it is clear what the diffuse changes in the kidney parenchyma mean. You should know that when belching, hiccups, heartburn, bloating and weakness appear, it is important to immediately consult a doctor and begin treatment. A special therapeutic diet will help relieve the liver and pancreas, will positively affect the process of recovery of the body. Due to the intake of the necessary substances in the body, the general well-being of the patient will improve.
Essence of the diet
In the event that a patient has pronounced diffuse changes in the renal parenchyma, it is often necessary to eat in small portions. Products are recommended to bake and cook. Best steamed. Vegetables and cereals, it is important to thoroughly boil. It is advisable to consume no more than 8 g of salt per day.
Permitted products include:
- vegetarian vegetable soup,
- low-fat dairy products
- beef meat
- steamed vegetables,
- tea with lemon,
- rosehip juice,
- semolina, rice, oatmeal, buckwheat porridge,
- boiled vermicelli.
It is forbidden to include in your diet:
- fried foods
- alcoholic drinks,
- spicy seasonings
- fat broth,
- sweet and flour products,
- smoked products.
Patients know what diffuse changes in the kidney parenchyma mean, but not everyone knows that it is equally important to monitor the water balance in the body and drink at least 2 liters of water a day. A detailed menu that is scheduled for each day can be checked with your doctor.
Treatment of renal failure folk remedies
Важно знать, что исключительно лечащий врач может назначить народное средство, поскольку самолечение может привести к осложнениям. If a patient is diagnosed with renal failure, treatment is often carried out using burdock root. For the preparation of folk medicine ingredient must be crushed, then prepare 250 g of boiling water. Water should be filtered. Then boiling water pour 1.5 tablespoons of the mixture and leave to infuse for a day. If the urine does not depart in the required amount, swelling will occur. For this reason, the treatment process should be monitored by the attending physician.
With the help of echinacea tincture can improve the patient's condition. To do this, 100 g of grass must be poured with vodka and infused for 13 days. From time to time, the vessel must be thoroughly shaken. A few weeks later, the remedy is drunk 9 drops several times a day. Can be diluted with water.
Walnuts with the addition of honey - a tasty and useful tool that will help not only strengthen the immune system, but also to clean the blood. To do this, you need to combine the ingredients in equal proportions and insist for 20 days. Take medication throughout the day for 1.5 tsp. Honey can cause allergies, so it is not recommended to apply the recipe to those people who are prone to allergies. If in the course of treatment the general state of health has worsened or a side effect has arisen, you should immediately go to the hospital and tell the doctor in detail about everything. Otherwise, the kidneys may refuse.
With the help of field horsetail it is possible to improve the patient’s condition and normalize the work of the kidneys. To do this, pour dry grass with boiling water in a ratio of 1: 2. Broth insist a few hours. Then strain and drink throughout the day.
Effective method of therapy
With the help of dill seeds, kidney dysfunction is treated. To do this, you need to prepare the infusion in proportions of 1:19. The healing tool to drink 120 g several times a day. Thanks to this tool, the outflow of fluid is accelerated, inflammation and pain are relieved.
Experts recommend to use more iodine in case of renal failure. Laminaria contains a large amount of this element, so it is necessary to include it in your diet and make salads from it. But before you include this product in the diet, you need to consult with your doctor.
Note to the patient
At home, it is impossible to identify the disease that provoked the development of diffuse changes. In such cases, an ultrasound is prescribed. If echo signs of diffuse changes in the parenchyma of the kidneys appear, it is recommended that you seek medical advice. First of all, the specialist will prescribe a complete examination of the patient. Based on the result of the research, he will prescribe a comprehensive treatment, during which it is necessary to maintain a healthy lifestyle and not engage in heavy physical labor, eat right, avoid stress and worries.
There are several diseases that can trigger the occurrence of such a pathology. At the initial stage of development of the disease treatment is carried out more efficiently with the help of drugs. When running form, it is necessary to carry out surgical intervention. Under such circumstances, the patient recovers significantly longer. To reduce the risk of pathology, experts recommend regular medical examinations, as there are cases when there are no symptoms at the initial stage of development of diffuse changes in the parenchyma. If someone in the family had a similar disease, then you should visit the hospital every six months.
The term "diffuse change in the kidneys" is rather vague, since it often means an increase in body size or a decrease. In addition, this term may hide cavities detected on ultrasound, which may be filled with exudate or purulent contents forming an abscess.
In some cases, the term "diffuse changes in the kidney" is used in the presence of pathological abnormalities in the structure of the renal veins, and in addition, if thrombosis is suspected. The appearance of violations of the structure of tissues, depending on their characteristics, may indicate the presence of an inflammatory or degenerative process, and sometimes the presence of sand and stones.
Symptomatic manifestations of diffuse changes in the parenchyma of the kidneys largely depend on the characteristics of such a pathological condition and the causes that caused it.
In some cases, such changes do not cause unpleasant symptoms, since the healthy parts of the kidneys take on additional stress and successfully cope with it. Sometimes signs of pathology can manifest itself very clearly. The symptoms of this pathological condition may include:
- blood impurities in the urine
- pain when urinating,
- lower back pain
- abdominal discomfort,
- violation of urination,
- nausea and quota
- increase in blood pressure.
During ultrasound, diffuse changes are manifested by asymmetry of location, uneven thickness, deformations of the brain area, irregular contours of the organ and other deviations of the structure. Identifying these features of the structure of the kidneys in some cases allows us to determine the possible cause of their occurrence and prescribe adequate treatment.
Therapy for diffuse changes depends a lot on what pathological condition provoked the appearance of such a disorder. If there is no marked symptomatology of the kidneys, the use of renal fees and other means to improve the general condition of this paired organ may be indicated. Kidney fees, including medicinal herbs, allow you to remove harmful substances from the tissues and activate the regeneration process. Such medicinal herbs can be included in the renal boron:
- juniper berries,
- flax seeds,
- oats straw
- a succession
- parsley root,
- crushed watermelon peels,
- birch leaves,
- calamus root,
- shepherd's bag.
In addition, often people who do not suffer from severe symptoms, shows a certain diet and drinking regime. These measures, in the absence of chronic or acute diseases, help normalize the functioning of the kidneys and improve their condition.
Considering that such abnormalities are often the result of diseases such as diabetes mellitus, glomerulonephritis and inflammatory processes of various etiologies, additional diagnostics and directed treatment of the root cause are required. To determine the cause of the development of pathology, a necessary measure is to conduct laboratory tests of blood and urine, as well as biopsy of the tissues of the organ. The treatment is further aimed at eliminating the primary disease.
Diffuse changes in the kidney parenchyma
The kidney consists of the parenchyma and the system of accumulation and excretion of urine. The outer part of the parenchyma consists of glomeruli, surrounded by a developed circulatory system, and the inner part - of the renal tubules. The latter form the so-called pyramids, through which the liquid enters the calyx and pelvis - the components of the system of excretion.
The thickness of the parenchyma changes with age - it becomes thinner. For young people, a thickness of 16-25 mm is considered the norm. In the older age group - more than 60 years, the thickness of the parenchyma rarely exceeds 1.1 cm.
Although the kidney is protected by a fibrous capsule, the renal parenchyma is quite vulnerable. The blood entering it contains the products of decay, metabolism, toxins, and so on, so that the kidneys often react first to changes in the body.
Diffuse changes are usually accompanied by changes in the size of the organ itself, and to the same extent in children and adults. As a rule, in acute diseases the parenchyma thickens, and in chronic it becomes thinner. Moreover, in old age, thinning is also observed due to purely age-related changes. The thinning of the parenchyma in childhood indicates a serious situation.
Diffuse changes in the kidneys in the newborn can be caused by a variety of reasons, such as congenital malformations - polycystic disease, congenital nephrotic syndrome, and acquired ones - pyelonephritis, secondary organ damage. Due to the peculiarities of the body of the newborn, changes are swift in nature and are especially dangerous.
On the other hand, up to 3 years old, the kidney of a child has a lobed structure, which is visualized on ultrasound in a very specific way. If no signs of illness are observed, the process is not pathological. If there are other signs of the disease, diagnosis is necessary.
Diffuse changes can be caused by various reasons, but in any case, this is a reason to be carefully examined.
The beginning urolithiasis - at the first stage in the pyramids formed by the tubules, plaques form. Later they can turn into stones. On ultrasound they appear as hyperechoic inclusions.
Calcinates occupy a special place - accumulating particles of dead renal tissue, covered with deposits of calcium salts. Such changes are diffuse, do not depend on age or gender. The appearance of calcite is not the disease itself, but a sign indicating improper diet, metabolic disorders or the appearance of an inflammatory disease. A single calcinate is not dangerous, but their multiple appearance may be a sign of cancer.
- Congenital changes - the same polycystic disease, for example.
- Age changes - the parenchyma becomes thinner and partially changes the structure. Thinning in young people indicates undertreated or sluggish chronic inflammation and needs treatment.
- Chronic inflammatory diseases - glomerulonephritis, for example, urolithiasis, of course, affect the state of the parenchyma.
- Growth of adipose tissue - fat formations block the outflow of fluid, which leads to its accumulation. And this, in turn, provokes inflammation of adipose tissue and blood vessels. The disease leads to hyperechogenicity of the parenchyma.
- Cysts - in the parenchymal tissue, they represent a greater danger compared with cysts in other areas. A cyst is a limited cavity with fluid or serous secretion. The size of the usual does not exceed 8-10 cm. The formation of squeezes the surrounding tissue, which leads first to their dysfunction - violation of urine outflow, and then to death. If the cyst is single and does not increase, it is only observed. If the formation of multiple, then appoint the operation to remove.
Cyst of the kidney parenchyma
In children, a congenital form is observed, in adults, as a rule, over 50 years old - acquired. Usually cysts infect one kidney, most often the left. With congenital polycystic disease, both kidneys are damaged. In 2/3 of the cases, children with this disease are born dead.
- Benign tumors - adenoma, oncocytoma. Accompanied by the appearance of blood in the urine, painful symptoms in the lower back, oligogorrhea.
- Amyloidosis - an insoluble protein, amyloid, is deposited in the renal tissue. Protein disrupts the kidneys, which gradually leads to chronic insufficiency.
- Atherosclerosis of the renal vessels is a narrowing of the vessels due to the deposition of cholesterol plaques on the walls.
- Diseases associated with metabolic disorders - diabetes, for example, hyperthyroidism.
- In the end, diffuse changes may be associated with acute or chronic kidney disease.
Regardless of age or gender, damage can be observed in both or one kidney. Risk factors are overweight, smoking, diabetes and poor diet. If, after examination, no serious violations have been identified, it is the diet and quitting smoking that becomes the guarantor of the restoration of the functionality of the organs.
To determine the diffuse changes apply several classifications.
By changing the parenchyma are distinguished:
- increase in kidney size due to inflammation. Parenchyma is usually compacted,
- a decrease in size, which is typical for chronic ailments,
- parenchyma thickening - it should not exceed 25 mm,
- thinning - is allowed in old age, but is a sign of damage in groups under 50 years old. This includes the deterioration of sinus structures - compaction due to the formation of stones or the deposition of atherosclerotic plaques or the formation of cysts.
In the acute course of the disease, the symptoms are completely hidden by the signs of the main disease:
- An increase in kidney size causes almost any inflammation. For adults, it is most often glomerulonephritis acute pyelonephritis. Within 8–10 days, the disease is asymptomatic, then vomiting, nausea, shortness of breath, pain in the heart, headaches. At this stage, the disease can already be diagnosed using ultrasound or puncture biopsy. Characterized by the appearance of puffiness. In chronic course, the clinical picture is blurred, but the hyperechogenicity of the kidneys may suggest the cause of a poor condition.
- The decrease in size is a consequence of almost any chronic disease, the same pyelonephritis, for example. At the same time, there is a change in the size of the organ, asymmetry, the thinning of the parenchyma - as a rule, uneven. These signs indicate the progression of the disease, even if the external signs are mild.
- Thickening of the parenchyma and organ asymmetry accompanies the appearance of a cyst, for example. Its first signs are edema. The latter cause a violation in capillary permeability, which leads to an increase in pressure.
Due to blood pressure, congestion develops, the reverse absorption of fluid decreases, and urination is disturbed as a result. There is severe pain, burning during urination, hematuria is observed. The kidney with a cyst increases in size and the fibrous capsule begins to squeeze it. This causes the appearance of back pain.
When forming tumors, there are similar signs. The pain is given in hypochondrium, asymmetries are sometimes so great that it is found during palpation. Chills and fever are added.
Thinning of the parenchyma - both age-related and due to postponed diseases is similar in symptoms to renal failure. The death of part of the nephrons leads to a decrease in the functionality of the organs, which provokes nocturia, a decrease in urine output, a change in the composition of urine and blood, and so on, which is typical of symptom insufficiency Treatment in this case is urgent, since diffuse changes, if ignored, can easily turn into chronic kidney failure.
Ultrasound as a research method in this case is so significant that a classification exists and is applied, indicating the degree of visualization of the change on the monitor during ultrasound. Healthy kidney tissue is characterized by normal echogenicity. Increased hyperechogenic characterized by damaged tissue.
On this basis, there are diffuse changes:
- clear and fuzzy
- weak (moderate)
The decisive method of examination is ultrasound. In essence, these changes are only recorded with this study. On the monitor of the device, changes are visualized as areas with increased echogenicity. These can be cysts, tumors, stones, sand, and so on. Healthy tissue has a uniform structure and the same echo-signs.
Decoding ultrasound performs only a doctor. Whatever the average indicators, when deciphering and even more diagnosed, it is necessary to take into account the patient's history and condition.
If any violations in the structure are observed, the doctor describes them in conclusion:
- Echotenis, microcalculosis - stones or sand are found in the organs.
- Volumetric formations - cysts, tumors, abscesses.
- Echo-positive formation - most often means a cancer. It has uneven contours, heterogeneous, that is, areas with increased and reduced echogenicity are combined. Echonegative patches due to hemorrhage or necrosis may also occur.
- Hyperechoic - cyst, lipoma, adenoma, fibrolipoma and so on. These structures are homogeneous in structure, similar to perirenal fiber.
- In relation to the cyst, the term “anechoic formation” is also used. Moldings have clear contours, filled with uniform content.
In case of amyloidosis, an increase in the echogenicity of the cortical and medulla is observed, and in the hyperechogenic zones the boundaries between them are indistinguishable, and in the zones with normal echogenicity are clearly visible. This feature - the indistinguishability of the boundaries between the layers is considered characteristic of diffusion change.
In addition to the above data, ultrasound can record:
- changes in the kidney sinus,
- blood supply disorders and vasoconstriction,
- thrombosis and even signs of its formation,
- the presence of fluid in the pelvis,
- lack of blood circulation in the renal veins or the presence of reverse blood flow.
- MRI or CT - localizes the location of stones, tumors, cysts and any other formations. If surgical intervention is necessary, this method is the most informative.
- Excretory urography is an x-ray method of examination, which involves the introduction of special contrast agents. Последние усваиваются здоровой и поврежденной тканью по-разному, что позволяет с очень высокой точностью установить функциональность органа.
Нельзя сбрасывать со счетов и лабораторные исследования. Например, пиелонефрит не дает сколько-нибудь внятной картины при УЗИ – КТ предоставляет лучшие результаты. But the standard test Zimnitsky - urine analysis for 24 hours is very revealing.
With pyelonephritis or chronic insufficiency, the urine density is markedly lower than the density of blood plasma, which indicates insufficient water absorption:
- A urinalysis provides important information about the functionality of the kidneys. Detection of erythrocytes, protein, leukocytes, an excess or lack of creatinine - all these factors indicate a particular ailment that can cause diffuse changes in the kidneys.
- Blood test - the most important indicator is the ratio of creatinine and urea in serum with the concentration of the same substance in the urine. For abnormalities establish the primary diagnosis.
- To clarify it, more specific studies are used - functional tests, biopsy, and so on.
Diffuse changes of the kidney parenchyma on ultrasound:
Diffuse changes of the parenchyma and renal sinuses are not the disease itself, but only its consequence. It is necessary to treat the primary illness, whatever it may be.
In urolithiasis, therapeutic methods are preferred. The selection of drugs and diet - the latter is mandatory, depending on the nature of the stones: circular, phosphate, uric. When it comes to sand and stones with dimensions of no more than 0.5 cm, a medication course is usually sufficient. In the presence of stones of larger size, resorted to ultrasonic crushing. At the initial stage of the disease - the deposition of plaques in the pyramids, sometimes it is enough proper nutrition.
In children, the appearance of stones is extremely rare.
This is usually associated with congenital abnormalities or urinary tract infection:
- Cysts - a single stable cyst of the right or left kidney needs only observation. If the formations are many or the cyst has reached a large size - more than 5 cm, they resort to treatment. In relatively mild cases, prescribed drugs. If necessary, resort to surgery. This laparoscopy is the removal of a cyst with the installation of drainage in the retroperitoneal area, more often appointed when the formation is unsuccessful. Puntia - puncture of a cyst, in which the fluid from the cavity is sucked off and filled with alcohol.
- Glomurolonefrit, acute pyelonephritis and other inflammatory diseases. Treatment must include an antibiotic - fluorochionolones, ampicillin. Children are often prescribed cephalosporin. If necessary, after obtaining the results of bacteriological seeding, the antibiotic can be replaced. Surgery is possible only if the conservative treatment did not produce results.
- When tumors are formed, an individual program is assigned. If the tumor is benign in nature, does not increase in size and does not affect the functionality of the organ, then the formation is only observed. Otherwise, prescribe resection - elimination, or nephrectomy - excision of the kidney.
- Treatment for cancer is necessarily complemented by chemotherapy.
- Treatment of chronic diseases - renal failure, chronic pyelonephritis, and so on, is determined by the stages of the disease and the patient's condition. However, it is also based on antibacterial therapy.
Diffuse changes of the parenchyma are not an independent disease. This is a consequence of other diseases, possibly only in an early stage, but affecting kidney function. For this reason, how to treat depends on the main form of the disease.
Causes and types of changes of diffuse nature
Diffuse changes in the kidneys arise from many causes, and not only diseases and developmental abnormalities can be attributed to this. The kidneys are a complex part of our body, with important functions necessary for the normal functioning of the body. Studying the structure of the kidney, it is necessary to allocate such parts: the parenchyma and CLS.
The structure of the parenchyma is represented by the cortical substance (composed of nephrons) and the medulla (formed by the urinary canaliculi). CLS is necessary for the accumulation and removal of urine formed. Most changes in the structure of the body leads to disruption of its functioning, therefore it is very important to diagnose abnormalities in time.
Note! During the day, 150-170 liters of fluid can pass through the kidneys, from which 1.5-1.8 liters of urine later form.
Depending on where the diffuse changes of both kidneys are located, there are violations in:
An important role in the diagnostic plan is played by the nature of the changes, due to which a presumptive diagnosis can be made.
Signs of diffuse changes in the kidneys are as follows:
- increased kidney size
- reducing the size of the body
- thickening or thinning of the kidney parenchyma,
- focal or uniform deterioration of the sinus structure,
- asymmetric contours of the kidney,
- pockets of low or high density in the parenchyma,
- liquid in CLS,
- change of structure of CLS
- consolidation of the structure of the renal vein.
It is worth noting that in acute pathologies an increase in the organ is noted, and a decrease in the size of the kidneys is characteristic of chronic diseases.
The reasons for the deterioration of the structure of the kidneys, can be very different, ranging from inflammatory diseases and ending with congenital abnormalities. For example, with congenital bending of the ureter in women, in the process of carrying a child, hydronephrosis may develop.
Thus, in general terms, diffuse changes in the kidney occur when:
- congenital anomalies of the kidney structure,
- acute or chronic inflammatory diseases of the kidneys,
- recurrences of non-treated diseases.
There is a suspicion of early abscess, the presence of fluid in the pelvis, impaired metabolic processes, thrombosis, stone formation and structural change in the renal vein, in such cases, the doctor prescribes additional diagnostic measures. Diffuse heterogeneous changes in the structure of the sinuses of the kidneys indicate the development of several pathologies due to the characteristics of the localization and structure of the organ entrance gate.
The change in the structure of the sines occurs in the background:
- stone formation in the pelvis,
- seals the walls of the pelvis in chronic pathologies,
- seals of vessels against atherosclerotic plaques,
- developmental abnormalities, with inflammation and changes in the fiber of the sinuses,
- cysts of the sinuses pressing on the vessels and causing renal dysfunction.
Quite often, on the background of fibrolipomatosis or penduculitis, diffuse changes in the structures of the renal sinuses of both kidneys occur. In this case, the sclerotic lesion of the organ develops.
Pathology occurs due to inflammation of the renal pelvis, tuberculosis, prostate adenoma. Over time, stagnant processes develop in the kidney, which leads to the appearance of sharp pains similar to radiculitis.
Parenchyma diffusely changes when:
- kidney tuberculosis,
- parenchymal cysts.
Disturbances in the structure of the kidneys give the doctor to suspect the presence of a certain pathology, but diffuse changes themselves are not considered a full-fledged diagnosis, but merely the conclusion of a diagnostic study.
Detection of Ultrasound Changes
Diffuse change in the kidneys - what we already know, but how to detect it in the process of ultrasound we will now consider. Ultrasound is widely used due to the absence of complex preparation, high information content and speed of implementation. In addition, its price is very affordable, and the service itself is provided in every medical institution.
Depending on what is visualized on the monitor during the research process, the changes are:
The instruction, which determines the type of violations, indicates that the echo signs can be manifested by such changes:
- from the renal sinuses an echo is given,
- there is a weakened echo,
- kidney tissue is darkened,
- parenchymal tissue has unclear outlines,
- sinuses thin,
- signs of fluid in the pelvis are detected,
- kidney tissue is heavily saturated with blood vessels,
- blackout in the renal vein,
- circulatory disorders of the organ,
- problematic to determine the echo structure,
- it is impossible to identify the renal veins,
- in the renal arteries, a reverse blood flow is visualized.
In the protocol, the specialist should describe the location and size of the kidneys, their shape, thickness of the parenchyma and capsules, external contours, describe CRS and how much the organs are displaced during respiration. In addition, they describe volumetric formations (localization, echostructure and echogenicity), stones (number, size, location, presence of acoustic shadow), anomalies of the organ (cysts, sponginess, hypoplasia, aplasia, etc.). Of course, these CIs describe if they were detected.
From the photos and videos in this article, we received information about the types of diffuse changes and the reasons for which they occur in the kidneys, as well as learned about how these changes are determined by ultrasound.
Propagation of changes
Hello. Recently I underwent an examination of the gastrointestinal tract and kidneys on an ultrasound scan, and in the conclusion indicated “diffuse changes in the liver and kidneys”, what does this mean?
Good evening. Such changes may indicate an increase in the liver parenchyma and changes in the structure of the kidneys. This can be caused by various diseases, but it is worth noting that smoking, drinking alcohol, an unhealthy diet and long-term use of potent drugs often lead to DI.
When a problem is detected, the size of the bean-shaped organs increases, the difference between the right and left kidney is often noticeable. Diffusion is not a disease, it is a tissue condition, a sign indicating the development of negative processes. When abnormalities are detected, physicians do not treat diffusion, but eliminate the root cause of pathological changes.
Negative symptoms develop in two sections:
- kidney parenchyma. Tissue formation lines the bean-shaped organs from the outside. There are two layers - cortical and brain. The thin fabric consists of tiny capsules interlaced with capillaries. Millions of capsules produce urine. Along the sinuses, through the medulla, the fluid flows below, going into the calyx and pelvis. The average thickness of the parenchyma is normal in adults - from 1.4 to 2.6 cm, in elderly patients - from 1 to 1.1 cm. Thinning or thickening of the layer is a sign of renal pathologies. After healing, the parenchymal structures in many cases are fully restored,
- sinus of the kidney. The bean-shaped paired organs have an upper and lower poles, a gate with incoming and outgoing blood vessels. Another element - the pelvis and part of the ureter, which is derived from the processed fluid. Gate plus the listed elements is a sine of a kidney. Each section performs a certain work, has a complex structure. Any changes in the kidney sinus violate the filtration, excretory function of important organs.
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Signs and symptoms
When diffuse changes thicken the walls of the parenchyma, the sinuses of the kidneys increase, the organs differ in size from each other. In the early stages of negative changes, signs are mild, as the pathological process develops, symptoms appear that need to be paid attention to.
- swelling of tissues due to increased intracapillary pressure,
- pain while urinating,
- violation of the frequency and volume of the excreted fluid while maintaining the usual drinking regime,
- discomfort in the lumbar region, in most cases, bilateral. Pain develops when a kidney capsule is stretched,
- in the sinuses and parenchyma, physicians detect cysts, the size of the bean-shaped organs increases,
- with the growth of cysts, the blood supply to the tissues is disturbed, and a dangerous condition develops - renal failure.
According to the results of ultrasound, doctors diagnose the following abnormalities:
- poor renal vein imaging,
- reduced echogenicity
- fluid in the renal pelvis,
- tumor thrombosis,
- parenchyma has fuzzy outlines,
- decrease in sinus thickness,
- parenchyma thickening,
- venous thrombosis
- echo signal from the renal sinus zone,
- back circulation in the renal arteries.
Depending on the area on which deviations are detected, there is a diffusion of sinus and kidney parenchyma. Violation of the structure and size are very similar, the causes and precipitating factors are almost the same.
Diffuse changes in the renal sinuses
The main reasons for structural changes:
- compaction of the sine against the background of the appearance of calculus,
- compaction of blood vessels in the development of atherosclerosis, the formation of plaques that interfere with normal blood flow,
- sealing of the walls of the pelvis with a sluggish inflammatory process,
- inflammation of the perivascular fiber in congenital anomalies,
- fluid accumulation, the appearance of kidney cysts.
Diffuse changes in the renal parenchyma
- problems with arterial blood flow
- thinning or thickening of the parenchyma,
- the appearance of liquid inclusions
- violation of the proportions of both kidneys,
- the emergence of areas with low and high echogenicity.
Kidney problems causing diffuse changes:
- the appearance of calcifications. Salt deposits are formed in case of metabolic disorders, malnutrition, pathologies of other organs. In the parenchyma, dead renal tissues accumulate, calcium microcrystals gradually cover the surface. One of the signs of salt deposits is tissue swelling. To prevent a negative process, you need to move more, do not abuse protein foods and dairy products, treat inflammatory diseases in time,
- development of tumors. In the parenchyma appear benign education. In some patients, quite safe tumors are regenerated into kidney cancer. To clarify the nature of the neoplasm, a CT scan, an MRI scan and an ultrasound scan of the problem organ will be needed. With the development of a malignant tumor in the renal sinus, negative changes can be detected already on palpation of the problem area. Chills, high pressure, increased fertile temperature over a long period, swelling of tissues,
- cystic formations. Cavities filled with fluid, with thin walls, appear in the sinuses and parenchyma of the kidneys. Buzzings have an oval or round shape. Cysts are congenital and developing in the process of life. Signs of cystic formations: pain in the lumbar region, high blood pressure, the appearance of blood in the urine. Patients with congenital abnormalities periodically undergo a course of therapy to reduce the volume of fluid. Single growths are removed by puncture. With timely removal of cystic formations, kidney functions are restored fairly quickly,
- thinning of the parenchyma. The problem occurs with chronic renal disease. Pathogenic bacteria provoke an inflammatory process, if left untreated or improperly treated, the infection leads to the death of part of the natural filters, the kidneys shrink, the area of the tissue decreases. In advanced cases, the parenchyma is so thin that it seriously disrupts the functions of important organs. Delaying a visit to an experienced nephrologist is life threatening: renal failure develops.
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Reasons for change
In the case of diagnosing such changes, we can safely talk about the development of one of the diseases of the kidneys. A less common cause of this condition may be diseases of other organs and systems. As a rule, such factors can provoke a diffuse renal lesion:
- Neoplasms of benign and malignant nature.
- Incorrect work of the thyroid gland (hyperthyroidism).
- Inflammation of the renal parenchyma.
- Single or multiple renal cysts.
- Vascular pathology.
- Accumulation of calcifications in the paired organ.
- Obesity, as well as increased levels of cholesterol in the body.
In the neonatal period, renal diffusion is formed in conditions such as pyelonephritis, polycystic renal disease, congenital nephrotic syndrome, and secondary kidney disease.
If in the human body there is an incorrect functioning of metabolism, then over time this condition can lead to moderate or severe diffuse damage of one or both kidneys.
In addition to these factors, poor nutrition, alcohol and tobacco abuse, burdened heredity, and associated diseases of the gastrointestinal tract can affect the development of this condition.
Although diffuse changes in the kidneys are not a separate diagnosis, this condition poses an open threat to human health and life. Only timely diagnosis and treatment of major diseases can prevent irreversible processes in the paired organ.
Диффузное почечное поражение не сопровождается какими-либо характерными проявлениями. Those symptoms that appear in humans tend to indicate the development of complications associated with damage to the tissues of the paired organ. When a kidney partially loses its function, the following symptoms come to the fore:
- General weakness and decreased performance.
- Dizziness and headache.
- Nausea and vomiting.
- The so-called renal edema, the place of localization of which is the facial part, upper and lower eyelids, and lower limbs.
- Pulling pain and discomfort in the lumbar region.
- Change in frequency and volume of urination.
- Increased blood pressure.
- Pale or earthy skin color.
Edema of the lower extremities in renal lesions. During instrumental examination of the organ, medical specialists can detect those factors under the influence of which the patient developed a diffuse lesion of the renal tissue. On the development of the pathological process say the following survey results:
- Single or multiple cysts,
- Signs of impaired renal blood flow,
- Increased volume of one or both kidneys,
- Presence of kidney stones
- The vagueness of the boundaries of the body
- Increase or decrease the thickness of the parenchymal part.
In some cases, such changes are asymptomatic, so patients do not feel any changes in the general condition and do not seek medical help in a timely manner.