Neerukahjustus

Neerukahjustus is a medical term describing injury or damage to the kidneys that impairs their ability to filter blood. In Estonian-language medical literature, the term covers both acute kidney injury (AKI) and chronic kidney disease (CKD) with kidney damage as a common feature. AKI refers to a rapid decline in kidney function over hours to days, while CKD denotes persistent damage and gradual loss of function over months to years.

Common causes include dehydration and low blood flow to the kidneys, sepsis, urinary tract obstruction, autoimmune diseases, and exposure to nephrotoxic substances such as nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, radiographic contrast agents, and some chemotherapy drugs. Diabetes mellitus and hypertension are major contributors to CKD, often resulting in progressive nephron loss and scarring.

Symptoms of AKI may include reduced urine production, swelling in legs or ankles, fatigue, nausea, and confusion, though some cases have no early symptoms. CKD often presents later with fatigue, weakness, swelling, high blood pressure, anemia, and laboratory signs such as elevated creatinine or proteinuria.

Diagnosis relies on labs (serum creatinine, estimated glomerular filtration rate, BUN), urinalysis (proteinuria, hematuria), imaging (ultrasound, CT), and, when indicated, kidney biopsy to determine cause and extent.

Treatment depends on the cause and disease stage. AKI management focuses on restoring kidney perfusion, avoiding nephrotoxins, managing electrolytes, and providing renal replacement therapy if necessary. CKD management emphasizes blood pressure control, glycemic control in diabetes, restriction of dietary protein, management of mineral bone disorder, and planning for renal replacement therapy in advanced disease, including dialysis or transplantation.

Prevention includes adequate hydration, careful medication use, vaccination, and regular monitoring in high-risk groups. The prognosis varies with cause, severity, and timeliness of treatment; some patients recover kidney function after AKI, while others progress to chronic kidney disease or end-stage renal disease requiring long-term dialysis or transplantation.