What is Uremia?
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 major 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 dialysis and transplantation were accessible.
Symptoms
Uremia 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 the renal disease must have frequent blood tests and urinalysis to ensure their kidneys function properly.
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.
When to see a doctor?
Uremia is a severe disorder that can be fatal. If you have any symptoms that you suspect are related to a kidney problem, you should consult the doctor immediately.
Causes
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).
- 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
Risk factors -
Uremia is most common in people with chronic kidney disease. CKD can be caused by either renal disease or a more widespread condition.
- High blood pressure
- Diabetes mellitus
- PKD, or polycystic kidney disease (caused by fluid-filled sacs, cysts, or , in or around the kidneys)
- Glomerulonephritis (GN)-damage to the filters in the kidneys
Complications
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:
- Anemia (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 and )
- 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 edema (fluid in the lungs)
- Atherosclerosis (hardened arteries)
- Heart valve disease
- Heart failure
- Stroke
- Pericardial effusion (fluid around the heart)
Diagnosis
In order to detect uremia, the healthcare professional would:
- Evaluates the symptoms
- Performs a physical examination
- Reviews the medical history, especially the kidney health and family history
- Check the above-mentioned lab tests. 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 figure out the glomerular filtration rate (eGFR). This rate evaluates the function of the kidneys.
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.
Treatment
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 anemia, 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.
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, and uremia patients must limit their potassium, phosphate, sodium, and protein consumption.
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
Do’s and Don’ts
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-
| Do’s | Don’ts |
| Stay hydrated | Take medications that damage the kidneys. |
| Limit the intake of tea and coffee | Have salty foods |
| Avoid potassium-rich foods | Smoke |
| Exercise regularly | Drink alcohol |
Uremia Care at Medicover
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 most highly trained and experienced experts for the best and finest kidney care.
