Without properly functioning kidneys, it is impossible to maintain good health. Extreme renal dysfunction is life-threatening, and its complete absence, unless renal replacement therapy is performed, will inevitably lead to death.

As an organ, the kidneys perform not only an excretory function, but also play an important role in maintaining the homeostasis of the internal environment of the body. The most important physiological tasks of the kidneys are:

elimination of harmful metabolic products from urine ,
retention of body components that are filtered into primary urine ( resorption),
regulation of body fluids and osmolarity ,
effects on blood pressure ( renin-angiotensin-aldosterone system),
effects on normal erythropoiesis (production of erythropoietin ),
effects on acid-base balance (pH ) due to the possibility of acidification of urine,
the effect on the bone system through the production of active forms of vitamin D3 .

The relationship between the amount of active renal parenchyma and the severity of homeostasis disorders. The so-called "A. Manitous curve";

Kidney function
The degree of kidney effectiveness is determined by the glomerular filtration rate (GFR), a decrease in which is directly related to the number of active nephron losses. Since the kidneys have a significant functional reserve, gradual kidney damage does not cause symptoms of the disease for a while. It is possible to live with only one kidney, which is associated with a significant functional reserve and activation of numerous adaptation mechanisms. It is estimated that for the development of serious diseases as a result of impaired kidney function, it is necessary to destroy up to 75% of their normal parenchyma. This means that one normally functioning kidney is enough to maintain health.

However, after irreversible damage to a significant number of nephrons and depletion of the adaptive reserves of the kidneys, symptoms of organ failure appear.

According to the duration of the violation of the excretory function of the kidneys, it can be divided into acute and chronic.

Acute renal failure, formerly known as "acute renal failure" (ARF), which is a potentially reversible condition of sudden deterioration in the excretory function of the kidneys. There are prerenal, renal and atrophic AKI.
Chronic kidney disease (CKD, called chronic kidney disease, CKD), including chronic renal failure (CRF), is a condition of irreversible damage to the glomeruli that requires renal replacement therapy to maintain the patient's life. The most common causes of PNN are glomerular diseases (primary and secondary), diabetic kidney disease, vascular diseases (stenosis, nephrosclerosis), tubulointerstitial diseases, diseases with concomitant kidney cysts, and others. Depending on the excretory function (GFR), there are five stages of CKD.
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