Shock Nephrogenic

**Nephrogenic shock** is an acute condition in the terminal stage of acute renal dysfunction, characterized by cytolysis of cerebral cortex cells and inhibition of bone marrow hematopoiesis. Refers to secondary shocks and develops as a result of impaired renal function (intoxication, blood loss, acute renal failure of various origins) or secondary damage to the endocrine structures themselves. It manifests itself as depression of the central nervous system, impaired peripheral blood supply, development of septic infectious-toxic shock, and anemia. Rare forms also include neurotoxic shock (reflex), caused by an overdose of a defibrinizing drug during electrical cardiac massage and electrical defibrillation, and toxicosis, which develops with long-term use of antibiotics from the cyclosporine group.

The reason for the development of Sh. n. are both direct functional disorders of the kidneys (tubular, preglomerular nephritis, acute renal colic, etc.) and a violation of the sympathetic and later parasympathetic regulation of the kidneys of neuroendocrine origin, which requires the use of appropriate inhibitors. The mechanism of development is characterized by acute renal arterial hypertension and microangiopathies with spasm and hyporesorption of the vessels of the glomerular wall, complicated by disseminated intravascular coagulation. Morphologically, dystrophic changes in the endothelium of arterioles are revealed, especially in the microvessels of the medulla of the kidney and capillaries of the adrenal gland. Histochemical studies reveal autoimmune or neurotransmitter damage in the renal tissue. Pathological hemodynamic changes are characterized by a decrease in cardiac output, an increase in oncotic pressure, and its inadequate increase due to the activation of blood flow and an increase in azotemia, which results in a deterioration in the resorption of water and salts by the kidneys. *Symptoms:** The disease is characterized by the formation of the so-called “panic syndrome”: this condition is accompanied by fear, psychomotor agitation, salivation and sweating, fear of death, severe tachycardia and hypotension, intensification of already existing symptoms of Shock (pallor, weakness, nausea and vomiting ). It should be remembered that diseases accompanied by nephrogenic hypertension often proceed unnoticed and latent for a long time. Patients may not pay attention to changes in well-being; their clinical picture may include minor dull pain in the lumbar region, fatigue, dry mouth and other symptoms; These patients are subject to active identification. Sometimes nephrogenic hypertension develops latently, with the gradual development of severe manifestations of heart failure and cardiac decompensation.

*Diagnostics: *The diagnosis is based on instrumental studies of the functions and structure of the kidneys. The development of autonomic reactions and the clinical picture typical of acute PN are complemented by laboratory changes. Among the laboratory signs of acute PN, the leading ones are hyperproteinemia, hypoproteinemic edema, leukocytosis and dysproteinemia. In the urine - hematuria, cylindruria, moderate increase in ESR.*

Nephrogenic shock is an emergency condition that can occur in a patient with renal colic. Renal colic is an acute attack of pain in the lumbar region associated with impaired outflow of urine from the kidneys. With renal colic, the blood supply to the kidneys is disrupted, which can lead to the development of shock.