Uremia is a medical condition where the level of the blood urea nitrogen is increased. This level is an indicator of the nitrogen waste products and its increase occurs as a result of failure of kidneys to filter the nitrogen waste. Uremia is a life-threatening condition as excess of nitrogen in the blood is harmful to the body. Symptoms of uremia are disorientation, losing consciousness, decreased urine production, dry mouth, lethargy, weakness, pallor, rapid heart rate (tachycardia), edema, and increased thirst. Patient may also experience pain in uremia.
If treatment is sought promptly, then uremia can be reversed; however, there may be permanent damage to the kidneys and failure of the kidneys. Treatment comprises of hospitalization where the cause of the kidney injury is treated in order to prevent further accumulation of the nitrogen waste in the blood. Treatment may also consist of dialysis, fluid therapy, blood transfusions, and medications to stabilize the blood pressure. After the initial acute phase of uremia has passed, treatment is continued with administration of medications, dialysis, and dietary changes. Complications of uremia include cardiac arrest, kidney, and respiratory failure.
Causes and Risk Factors of Uremia
Any condition which impairs the ability of the kidneys to filter the waste products may result in uremia.
Renal Causes of Uremia include:
- Certain drugs, like nonsteroidal anti-inflammatory drugs (NSAIDs) given in high doses or excessive intravenous contrast material.
- Any injury or trauma to the kidney.
- Certain medical conditions such as hypertension or diabetes may cause damage to the kidney.
- Other medical conditions of kidneys such as kidney stones, failure of kidneys and anomalies of the kidneys.
- Occlusion or embolism of the renal artery which hinders the blood flow to the kidney.
- Surgery to the kidney.
Other causes of uremia include:
Certain medical conditions which cause decrease in blood volume or blood flow may also result in uremia and these are:
- Burns.
- Congestive heart failure.
- Dehydration.
- Excessive diarrhea, vomiting, or bleeding.
- Shock.
Risk Factors for Uremia
- Hypotension (low blood pressure).
- Recent injury, infection or surgery.
- Certain medications if taken in excess may increase the risk of developing uremia such as nonsteroidal anti-inflammatory drugs (NSAIDs) or intravenous contrast material.
Signs and Symptoms of Uremia
The symptoms of uremia can occur suddenly and are serious, as the nitrogen waste, which accumulates in the bloodstream poisons the body.
General Symptoms of Uremia
- Pain in the abdomen.
- Disorientation.
- Loss of consciousness.
- Dryness in the mouth and nose.
- Edema.
- Increased thirst.
- Lethargy.
- Hypotension (low blood pressure).
- Skin pallor.
- Tachycardia (increased heart rate).
- Weakness.
Serious symptoms which require prompt medical attention are:
- Disorientation.
- Losing consciousness even for a short time.
- Decreased urine output.
- Increased thirst.
Tests to Diagnose Uremia
- Urine test.
- Blood test.
- Renal function test.
- Blood biochemical profile.
Treatment for Uremia
Patient is usually admitted into the hospital where the treatment comprises of focusing on the cause of low blood flow to the kidneys and resolving it. The next step involves removing the nitrogen waste from the blood and reestablishing the blood volume and blood pressure. Lastly, the treatment is continued to prevent and treat the waste accumulation and damage to the kidneys. The main goal in treating acute uremia is to stabilize the patient and resolve the cause of uremia and it includes:
- Hospitalization with IV fluids.
- Blood products.
- Blood transfusions.
- Fluid therapy.
- Hemodialysis.
- Medications, such as dopamine, are given to bring up the blood pressure and the cardiac output.
After the acute stage has been dealt with, the treatment is continued with dialysis, modifications in the diet and medications.