000564

78 • Increased blood pressure. A distinctive feature of arterial hypertension in kidney pathology is an increase in mainly diastolic blood pressure, its resistance to hypotensive therapy. With nephrogenic arterial hypertension, patients complain of headache, dizziness, pain in the heart, insomnia, lethargy, malaise may occur. Persistent increase in blood PRESSURE sometimes leads to visual impairment, headache and edema are the priority problems of a patient with acute glomerulone- phritis. Often, an increase in blood pressure is asymptomatic, detected accidentally during medical examinations, when contacting a doctor about intercurrent diseases. • Dyspeptic disorders (loss of appetite, dry and unpleasant taste in the mouth, nausea, vomiting, diarrhea), hoarseness of voice, shortness of breath and persistent dry cough. All these phenomena are usually caused by the retention of urea and other nitrogenous slags in the body (due to a decrease in the filtration and reabsorp- tion function of the kidneys) and their excretion by the gastrointestinal mucosa and respiratory tract. The development of kidney failure is a potential problem in all chronic kidney diseases. • Hemorrhagic manifestations  – bleeding gums, nosebleeds, skin hemor- rhages, frequent manifestations of chronic kidney failure. • General complaints  – weakness, reduced ability to work, weight loss, ir- ritability, decreased appetite. Anamnesis morbi Kidney damage often develops after hypothermia, colds, streptococcal infec- tion (angina), allergic reactions, toxicosis of pregnant women, taking medications. Nephropathy can develop in systemic diseases (systemic lupus erythematosus, rheumatoid arthritis, etc.), liver cirrhosis, can complicate diabetes, gout, hyperten- sion, chronic purulent processes (osteomyelitis, bronchiectatic disease, tuberculo- sis) and oncological diseases (bronchogenic lung cancer, lymphogranulomatosis, myeloid disease, etc.). To interpret the Genesis of nephropathy, it is important to indicate the develop- ment of anuria (oliguria) after shock or collapse, blood transfusion, septic abortion, and the use of nephrotoxic medications (aminoglycosides). It is very important to analyze the features of the course of nephropathy, pay- ing special attention to the dynamics of urinary, nephrotic and hypertensive syn- dromes, identifying factors that provoke an exacerbation of the disease, as well as the treatment used. Anamnesis vitae When studying a professional history, you should pay attention to contact with ionizing radiation, hydrocarbons and organic solvents, heavy metals (mer- cury, lead), hemolytic poisons (nitrobenzene). It should be clarified whether the patient had a history of tuberculosis, viral hepatitis, or syphilis. Knowledge of family history is necessary to exclude heredi- tary nephritis, tubulopathy.