Uremia

What is Uremia

Uremia is when blood contains too much of a compound called urea. Urea is a waste product that is normally filtered from the blood by the kidneys and removed from the body through urine. Uremia develops when the kidneys have lost most of their ability to filter the blood and function normally (renal failure). Renal failure causes urea and other waste products to build up in the blood.

Renal failure can happen suddenly (acute renal failure) or over a long period of time (chronic renal failure). Both kinds of renal failure can cause uremia, but chronic renal failure is most often the cause.

What are the causes?

The most common causes of renal failure and uremia are diabetes and high blood pressure. Other causes of uremia include:

  • Infection.
  • Injury (trauma).
  • Tumor.
  • Kidney diseases that are passed from parent to child (inherited).
  • Certain medicines, including NSAIDs and some antibiotics.
  • Abnormalities of the body’s disease-fighting system (autoimmune diseases).
  • Decreased blood supply to the kidneys.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Having high blood pressure.
  • Having poorly controlled diabetes.
  • Being of African American or American Indian descent.
  • Being male.
  • Being older than 75.

What are the signs or symptoms?

Common symptoms of uremia include:

  • Feeling tired and having no energy.
  • Having no appetite.
  • Being thirstier than usual.
  • Nausea or vomiting.
  • Muscle aches.
  • Itchy skin.
  • Headache.
  • Restless legs.
  • Changes in vision.
  • Depression.
  • Trouble sleeping.

How is this diagnosed?

This condition may be diagnosed based on your symptoms and a physical exam. You will also have tests to confirm the diagnosis of uremia and to show how well your kidneys are filtering your blood. These tests may include:

  • Blood and urine tests.
  • Imaging tests, such as ultrasound of the kidneys.
  • Removal of a small piece of kidney tissue to be examined under a microscope (kidney biopsy). This may be done to determine whether you have acute or chronic renal failure.

How is this treated?

Treatment usually involves having your blood filtered by a machine (dialysis) or having a kidney transplant. Treatment may also include:

  • Taking a type of medicine called an erythropoiesis-stimulating agent (ESA) to prevent the loss of red blood cells (anemia) that is often caused by uremia.
  • Taking medicine to correct your levels of phosphorus and calcium. Uremia can cause these minerals to build up in your blood.
  • Having certain glands in your neck (parathyroid glands) removed. In people who have kidney disease, the hormones made from these glands can cause high levels of calcium in the blood and itchy skin.

Treatment varies depending on your symptoms and the type of renal failure you have.

Follow these instructions at home:

Lifestyle

  • Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Work with a health care provider who specializes in diet and nutrition after renal failure (renal dietitian). Your renal dietitian may recommend that you eat a diet that is low in fat, salt (sodium), and potassium. Check ingredients and nutrition facts on packaged foods and beverages. Diet and nutrition is a very important part of managing renal failure and uremia.
  • Exercise regularly, as directed by your health care provider. Ask your health care provider what types of exercise are best for you.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever or chills.
  • You are struggling to control your symptoms.

Get help right away if:

  • You have a fever or symptoms that last for more than 2–3 days.
  • You develop new symptoms.
  • You have vomiting that does not go away.
  • You have blood in your vomit.
  • You have trouble breathing.
  • You have chest pain.
  • You cannot urinate.
  • You feel confused.
  • You have trouble staying awake.

Summary

  • Uremia is when blood contains too much of a compound called urea.
  • Uremia develops when the kidneys have lost most of their ability to filter the blood and function normally (renal failure).
  • The most common causes of renal failure and uremia are diabetes and high blood pressure.
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