Symptoms of chronic renal failure in the elderly

Chronic renal failure in the elderly is actually just a kidney disease, but in reality the incidence of chronic renal failure in the elderly is still very high. Just looking at the disease of chronic renal failure, people of all ages can develop the disease. There are many symptoms of chronic renal failure in the elderly, and many doctors rely on the symptoms of chronic renal failure in the elderly to diagnose this disease.

Chronic renal failure in the elderly can cause great harm to the patient's body. Many elderly patients with chronic renal failure suffer from this disease, which causes their kidney function to completely degenerate over a long period of time, and eventually leads to death. So, let’s talk about the symptoms of chronic renal failure in the elderly.

Chronic renal failure, also known as chronic renal insufficiency, refers to a syndrome in which various kidney diseases or cumulative systemic diseases of the kidney lead to chronic progressive renal parenchymal damage, rendering the kidney unable to maintain its basic functions, such as excreting metabolic waste, regulating water-salt and acid-base balance, secreting and regulating the metabolism of various hormones, etc., thus presenting a series of clinical symptoms such as azotemia, metabolic disorders and involvement of various systems. Chronic renal failure is one of the common urinary system diseases in the elderly. As kidney disease continues to progress, renal function may progressively decline, and chronic renal failure is an irreversible damage.

Symptoms and signs

In addition to anemia, metabolic acidosis, hypertension and general uremic symptoms, the clinical characteristics of CRF in the elderly include prominent neuropsychiatric symptoms, such as slurred pronunciation, epileptic seizures, muscle tremors, hemiplegia and impaired consciousness. Uremic encephalopathy is often seen. The clinical manifestations of each system are described as follows.

1. Water and electrolyte imbalance

(1) Water: CRF patients may suffer from both dehydration and water retention. Therefore, the patient's water balance must be dynamically observed clinically. When patients have secondary infections, fever, vomiting, diarrhea, etc., it is easy to cause water loss. If water is not replenished in time and in an appropriate amount, it is easy to have insufficient blood volume, decreased GFR, increased BUN, and worsening symptoms. The latter will promote more water loss, aggravate uremia, and form a vicious circle. On the other hand, because the kidneys have lost the ability to regulate water, excessive and rapid water replenishment can easily lead to water retention, which can lead to heart failure.

(2) Sodium: Patients with uremia have poor sodium regulation and are prone to hyponatremia.

2. Acid and alkali balance

Patients with uremia have metabolic acidosis of varying severity. Mild carbon dioxide binding capacity is between 22 and 16 mmol/L, and severe cases can drop to below 4.5 mmol/L. When GRF drops to 20 ml/min, the kidneys can only excrete part of the acid products every day, H+ is retained in the body, and acidosis occurs. The kidneys excrete hydrogen ions mainly through three links, namely, reabsorption of bicarbonate, excretion of titratable acid and excretion of ammonium.

3. Digestive system

In CRF, almost every part of the digestive system may be affected. Early symptoms are often loss of appetite, glossitis, diarrhea, nausea, vomiting, black stools, etc. There may be a smell of urine in the mouth, oral mucosal erosion and esophagitis. The stomach, duodenum, colon, and pancreas may all become inflamed, with mucosal edema and bleeding. In severe cases, ulcers, necrosis, infection, intestinal obstruction, intestinal perforation, etc. may occur.

4. Cardiovascular system

Cardiovascular disease is a common complication in CRF patients. About 50% of them die from cardiovascular disease, which is more prominent in the elderly. Cardiovascular complications of CRF patients include pericarditis, heart failure, cardiomyopathy, heart damage caused by metabolic abnormalities, and hypertension.

We can see from the above introduction that the symptoms of chronic renal failure in the elderly are many. In fact, as introduced in the above article, there are many symptoms of chronic renal failure in the elderly, usually manifested as: anemia, muscle tremors, diarrhea, intestinal perforation, etc. These symptoms can basically be used to determine chronic renal failure in the elderly.