Uremia Disease: Symptoms, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr G Gokul Nachiketh , Urologist

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Uremia is a severe disorder that develops when waste products related to impaired kidney function accumulate in the blood. Uremia, which means "urine in the blood," refers to the effects of waste product accumulation, affecting the entire body.

Uremia is most commonly caused by CKD (Chronic Kidney Disease), which can lead to end-stage renal (kidney) disease (ESKD); however, it can also arise unexpectedly, resulting in possibly reversible acute kidney injury and failure (AKI).

Uremia can lead to significant health concerns such as fluid accumulation, electrolyte imbalances, hormone imbalances, and metabolic disorders.

Uremia is always fatal if left untreated, and it was always so before kidney dialysis and transplantation were accessible.

What Is the Difference Between Azotemia and Uremia?

• Azotemia happens when there's too much waste (like urea and creatinine) in your blood because your kidneys aren't filtering properly. It often shows no symptoms at first.
• Uremia is more serious. It means the waste buildup has started causing symptoms like nausea, tiredness, or confusion.
• Think of azotemia as the early warning sign, and uremia as the stage where the body starts to feel the effects.
• Both need medical attention, but uremia usually means the kidney problem has become more severe.

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What are the Uremia Symptoms or Signs?

Uremia disease symptoms are similar to those of chronic kidney disease. Because of these similarities, people with kidney disease who experience kidney failure may be unaware they have Uremia.

People with renal disease must have frequent blood tests and urinalysis to ensure their kidneys function correctly.

It is vital to remember that symptoms differ from person to person and can change, improving and then deteriorating.

Kidney disease is a potentially fatal condition, so anyone who suspects they have kidney disease or Uremia should consult a doctor immediately. Here are some of the listed symptoms of Uremia:

• Cognitive dysfunction (problems with thinking and remembering)
• Fatigue
• Shortness of breath from fluid accumulation
• Loss of appetite
• Muscle cramps
• Nausea and vomiting
• Itching
• Unexplained weight loss

Uremic fetor (a urine-like smell on the breath) and uremic frost (urea in perspiration causes yellow-white crystals on the skin) may occur in severe cases.

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What are the Causes of Uremia?

Healthy kidneys use urine to filter waste and fluids from the body. The kidneys help maintain proper levels of electrolytes, hormones, and acids such as vitamin D and erythropoietin (EPO).

Damaged kidneys do not function efficiently, enabling toxins to accumulate in the blood. Most people become ill when their kidney function drops below 15% (15 ml/min) of normal and require dialysis when it falls below 10% (10 ml/min).

Uremia occurs when the kidneys fail to remove waste properly, resulting in a buildup of waste in the blood. This can happen due to several health problems that damage kidney function.

• Polycystic kidney disease
• High blood pressure
• Inflammation of the glomeruli, which are filtering units in the kidneys.
• Enlarged prostate
• Some types of cancer
• Diabetes (both type 1 and 2)
• Kidney infections that recur
• Inflammation of the tubules of the kidney and the tissues around them
• Kidney stones that cause a long-term blockage of the urinary system

Who Is Most Likely to Get Uremia?

Uremia disease is most common in people with chronic kidney disease. CKD can be caused by either renal disease or a more widespread condition. Certain conditions or habits can increase your chances of developing uremia, especially if they aren't managed well.

• High blood pressure
• Diabetes mellitus
• PKD, or polycystic kidney disease (caused by fluid-filled sacs, cysts, or, in or around the kidneys)
• Glomerulonephritis (GN) is damage to the filters in the kidneys
• Frequent use of painkillers or anti-inflammatory drugs
• Smoking
• Poor hydration

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How is Uremia Diagnosed?

Uremia is usually found during regular health checkups, especially if you have kidney problems.

Nephrologists look for signs like tiredness, nausea, or swelling. If they suspect uremia, they'll check how well your kidneys are working using blood and urine tests.

In order to detect Uremia disease, the healthcare professional would:

• Evaluates the symptoms
• Performs a physical examination
• Review the medical history, especially the kidney health and family history.
• Check the lab mentioned above. Creatinine and BUN blood tests assist the provider in confirming a uremia diagnosis. These tests look for elevated levels of waste products in the blood.
• They're also used to calculate the glomerular filtration rate (eGFR), which evaluates the kidneys' function.

A kidney ultrasound examines the size and shape of your kidneys and the presence of scarring. Ultrasonography can detect kidney blockages, such as stones or damage. In some cases, additional testing may be required.

What Tests Are Conducted for Uremia?

The Kidney Specialists use simple tests to determine if your kidneys are functioning correctly to clear waste. These tests check waste levels in your blood and assess how well your body is producing and eliminating urine.

Common tests include:

• Blood Urea Nitrogen (BUN): Measures waste in the blood
• Serum Creatinine: Checks kidney function
• Glomerular Filtration Rate (GFR): Shows how well your kidneys filter waste
• Urine Test: Finds protein or blood in urine
• Electrolyte Panel: Checks salt and mineral balance

These tests help doctors determine the severity of the condition and the necessary treatment.

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What are the Proper Treatment Options for Uremia‹?

Treating uremia focuses on removing waste from the body and managing the underlying kidney problem. Here's how doctors usually approach it:

• The most common treatment for Uremia is dialysis (a blood-cleaning technique). Dialysis is classified into two types. Hemodialysis involves using a machine to filter blood outside the body.
• Peritoneal dialysis filters blood using the lining of the abdomen and a specific solution. Individuals may require a kidney transplant if the Uremia is caused by end-stage renal (kidney) failure.
• A kidney transplant replaces the failing kidney with one from a living or deceased donor.
• The doctor may recommend taking iron supplements for anaemia, EPO replacement, calcium and vitamin D supplements, and phosphorus binders with meals to avoid bone loss caused by hyperparathyroidism.
• Blood pressure must be regulated, and any risk factors for heart disease must be treated. Other underlying medical issues must also be tackled.

Are There Any Specific Medications to Treat Uremia?

There's no single medicine that œcures uremia, but some medications help manage symptoms and prevent it from getting worse:

• Phosphate binders: Help control phosphorus levels, which often rise in kidney problems.
• Erythropoietin (EPO): Boosts red blood cell count to treat anemia caused by kidney failure.
• Diuretics: Reduce fluid buildup in the body.
• Blood pressure medications: Help protect the kidneys from further damage.
• Antibiotics (if infection is present): Used if an underlying infection is worsening kidney function.

Always follow a certified nephrologist's advice on what medicines are right for your situation.

Foods or medications that should be avoided

Before changing the diet, taking medicine, or taking supplements, consult a healthcare professional or a dietitian. Certain medications must be changed or avoided, and your healthcare provider can help you make the best decisions.

Most people follow a healthy diet that is low in salt and potassium; uremia patients must limit their consumption of potassium, phosphate, sodium, and protein.

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When to see a Doctor for Uremia?

If you're feeling more tired than usual, struggling with nausea, or noticing swelling in your legs or feet, it might be time to check in with your doctor.

Uremia can creep up slowly, and its symptoms often seem like everyday problems. But if left untreated, it can be serious.

If you have kidney problems or a history of kidney disease, don't ignore signs like confusion, breathlessness, or a metallic taste in your mouth. The earlier you catch it, the better. Regular checkups and early treatment can help you feel better and prevent complications.

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What are the Preventive Measures for Uremia?

Toxins should be controlled in people with end-stage renal disease with frequent dialysis. Anyone with chronic kidney disease may be able to avoid Uremia disease development by doing the following:

• Maintaining a healthy weight
• Eating a heart-healthy diet
• Controlling blood pressure, diabetes, or other medical problems
• Taking the prescribed medications
• Exercising
• Avoiding medications that may further damage the kidneys
• Quitting smoking

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What Is the Recovery Process After Uremia Treatment?

Recovering from uremia depends on how severe the condition was and the type of treatment received. With the right care and healthy habits, most people can feel better and avoid future complications. Here's what the recovery usually involves:

Recovery Process:

• Regular follow-up visits with a kidney specialist to track your health
• Sticking to a kidney-friendly diet low in salt, potassium, and protein
• Taking prescribed medications without missing doses
• Staying well-hydrated, but only as advised by your doctor
• Monitoring blood pressure and blood tests regularly
• Managing any other conditions like diabetes or high blood pressure
• In severe cases, continuing dialysis or planning for a kidney transplant
• Resting enough and avoiding heavy physical stress during recovery
• Learning how to spot early signs of kidney trouble to avoid relapse
• Emotional support and lifestyle counseling to stay on track long-term

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How Complicated Is Uremia if Left Untreated?

If Uremia is not treated, it may result in serious complications. The body may develop imbalances in hormones, electrolytes, especially potassium, or excess acid that can harm the heart. These issues can interfere with the body's conversion of food into energy or metabolism.

Additionally, pollutants in the blood might cause blood vessels in the body to calcify (harden). Calcification causes issues with bones, muscles, the heart, and blood vessels. Other uremia side effects could be:

• Anaemia (too few healthy red blood cells)
• Acidosis (too much acid in the blood)
• Hyperkalemia (too much potassium in the blood)
• High blood pressure
• Hypothyroidism (underactive thyroid)
• Hyperparathyroidism (too much calcium and phosphorus in the blood leading to bone abnormalities and elevated parathyroid hormone levels)
• Malnutrition (lack of nutrients in the body)
• Infertility (inability to get pregnant)

Additional complications of Uremia may include

• Angina (chest pain)
• Defective platelet function and blood clotting
• Uremic encephalopathy (reduced brain function as a result of toxin buildup)
• Pulmonary oedema (fluid in the lungs)
• Atherosclerosis (hardened arteries)
• Heart valve disease
• Heart failure
• Stroke
• Pericardial effusion (fluid around the heart)

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Do's and Don'ts in Uremia

A person suffering from uremia must follow a strict diet. Adequate care is essential for controlling this condition and other medical treatments. Follow these listed dos and don'ts-

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Our Experience Treating Uremia

At Medicover hospitals, we have the most excellent team of nephrologists with a proven track record in treating kidney-related problems such as Uremia and chronic kidney disorders and performing renal transplants with high success rates.

Our nephrologists have extensive experience diagnosing and treating all types of renal diseases, including Uremia. Consult with our highly trained and experienced experts for the finest kidney care.

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