Uremia occurs in the course of advanced renal failure. Damaged kidneys are unable to remove harmful waste products, which leads to an increase in urea concentration in the body. What are the symptoms of uremia? How is her treatment going?
Uremiais a symptom complex that occurs in end-stage chronic renal failure. The body collects harmful waste products, which are removed from it by he althy kidneys along with urine.
In end-stage renal failure, renal function declines and urine output decreases, leading to a series of complications caused by increasing urea levels.
What is urea and how is it made
Urea is the final product of the transformation of proteins and other nitrogen compounds, this process takes place in the liver with the participation of a number of enzymes in the so-called ornithine cycle.
In medicine, urea concentration is tested to assess kidney function, toxemia in people with end-stage renal disease, to assess the adequacy of dialysis and to diagnose metabolic diseases. The norm of blood urea concentration is 15-40mg / dl.
Its level is influenced by the excretory capacity of the kidneys, the breakdown of the body's own proteins, the amount of protein supplied with food and the hepatic protein synthesis.
- Urea as urea nitrogen (BUN) - standards
The increase in serum urea concentration above the norm is usually caused by impaired renal function - anuria, oliguria (acute / chronic renal failure), less often it may be the result of a high-protein diet or increased catabolism of endogenous proteins of the body, e.g. in such disease states like:
- hyperthyroidism
- severe debilitating cancer
- amyloidosis
- multiple myeloma
- heavy tissue injuries
- burns
Decreased urea levels may be associated with a low-protein diet, liver disease, or polyuria (polyuria).
Uremia: symptoms
Symptoms of developing uremia are an indication to start renal replacement therapy in the form of hemodialysis or peritoneal dialysis. Rising urea levels cause:
- loss of appetite
- sleepiness or irritability
- numbness
- limb cramp
- headaches
- they cannausea and vomiting appear
- metabolic acidosis develops, disturbances of consciousness leading to uremic coma, including
The very dangerous effects of uremia also include uremic pericarditis, uremic lung, and epileptic seizures. These are just some of the symptoms that rising serum urea levels can cause. Undoubtedly, it is a life-threatening condition that requires making and implementing quick therapeutic decisions.
Uremia: treatment
In the case of uremia that is not very intense, and due to reversible causes, in acute kidney damage, the treatment is both causal and symptomatic. It is recommended to limit physical exertion and reduce protein intake in the diet.
In more advanced uremia, in end-stage renal failure, treatment consists in starting renal replacement therapy aimed at removing excess urea from the blood, compensating for water and electrolyte and acid-base disorders, and removing excess water from the body (in the case of patients with hyperhydration , with anuria or oliguria).
It can be done by hemodialysis - usually 3 times a week for 3-4 hours the patient stays in a dialysis station, where the blood is cleaned using specialized filters contained in an artificial kidney - or through peritoneal dialysis performed by the patient at home by introducing dialysis fluid into the peritoneum and changing it several times a day, using a special catheter with an outlet on the abdominal wall.
During the waiting period and preparation for dialysis, symptomatic treatment is applied, consisting of combating acidosis, correcting electrolyte disturbances, controlling nausea and vomiting.
A living or deceased kidney transplant is an effective treatment method. This procedure requires a medical qualification, which requires very careful examination, and then often a long waiting period for a transplant, especially in the case of a deceased donor, as it requires finding a donor with the appropriate degree of compliance.