Uremia Facts, Conditions When Kidneys Are Severely Damaged

2. Risk factors

Reported Medical News Today, chronic kidney disease is a major risk factor for uremia. The following conditions can increase the risk of kidney disease:

• Family history of kidney disease.
• Diabetes.
• High blood pressure.
• Heart disease.

Older adults are also more susceptible to kidney failure and uremia than younger people. In addition, African Americans, Asian Americans, Pacific Islanders, and Hispanic Americans may be more susceptible to kidney disease.

People with chronic kidney disease who are not on dialysis or who fail to follow their doctor’s treatment recommendations are more likely than others to develop kidney failure and uremia.

3. Signs and symptoms

The symptoms of uremia are similar to those of chronic kidney disease. This similarity means that people with kidney disease who have kidney failure may not be aware that they have uremia.

People with kidney disease should have regular blood tests and urinalysis to make sure their kidneys are working properly. It is important to note that symptoms vary between individuals and can change. First it shows improvement and then it gets worse again.

Kidney disease is a life-threatening condition. So, if you suspect you have kidney disease or uremia, see your doctor immediately. Some of the symptoms of uremia that are likely to appear are:

• Weakness, fatigue, and confusion. These symptoms tend to get worse over time and do not go away with rest or increased nutrition.
• Nausea, vomiting and loss of appetite. Some people will likely lose weight because of this problem.
• A group of symptoms called uremic neuropathy or nerve damage from kidney failure. Neuropathy can cause tingling, numbness, or electrical sensations in the body, especially the hands and feet.
• Blood test changes. Often the first sign of uremia is the presence of urea in the blood during a routine blood test.
• People with uremia can also show signs of metabolic acidosis, a condition in which the body produces too much acid.
• High blood pressure.
• Swelling, especially around the feet and ankles.
• Dry and itchy skin.
• Urinate more frequently, as the kidneys work harder to remove waste.

4. Complications that can arise

Uremia can lead to serious complications if left untreated. This condition makes the body accumulate excess acid, or an imbalance of hormones and electrolytes, especially potassium, which can affect the heart. These problems can affect metabolism or the body’s process of turning food into energy.

The buildup of toxins in the blood can also cause blood vessels to calcify (harden). Calcification results in bone, muscle, and heart, and blood vessel problems. Other uremia complications include:

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

Additional complications of uremia include:

• Pulmonary edema (fluid in the lungs).
• Impaired platelet function and blood clots cause bleeding.
• Uremic encephalopathy (decreased brain function due to toxic buildup).
• Angina (chest pain).
• Atherosclerosis (hardened arteries).
• Heart valve disease.
• Pericardial effusion (fluid around the heart).
• Stroke.

Even if treated with dialysis, there are still some complications that can affect people on dialysis at a higher rate than the general population. This includes:

• Cardiovascular problems.
• Heart attack as a cause of death.
• Severe itching due to mineral imbalance.
• Amyloidosis, a rare disease that causes joints to feel painful and stiff and retain fluid.
• Depression.

5. Diagnosis

To make a diagnosis of uremia, the doctor will evaluate the patient’s symptoms and perform a physical examination. In addition, the doctor will also review medical history, especially kidney health and family medical history.

Apart from that, the doctor will also do a blood test for creatinine and BUN. These tests check the blood for high levels of waste products. These tests are also used to estimate the glomerular filtration rate (eGFR). This level measures kidney function.

The doctor may also perform an ultrasound of the kidneys to check the shape and size of the kidneys and look for scar tissue. Ultrasound can also detect kidney blockages, such as kidney stones, or injuries. Additional tests may be needed in certain situations.

6. Treatment

When you have uremia, the condition of the kidneys is very damaged. Dialysis is the main treatment option. This is a procedure to clean the blood. In this procedure, the removal of waste, extra fluid, and toxins from the bloodstream is handled artificially, not by the kidneys. There are two types of dialysis, namely:

• Hemodialysis: Machines are used to remove waste from the blood.
• Peritoneal dialysis: A catheter (small tube) is inserted into the patient’s abdomen. Dialysis fluid fills the patient’s stomach. This fluid absorbs waste and extra fluids. Ultimately, the fluid will flush waste from the patient’s body as it drains out.

The patient may also need a kidney transplant, if the uremia is the result of end-stage renal failure. A kidney transplant replaces a failing kidney with a healthy kidney from a living or deceased donor. The patient will be given long-term anti-rejection drugs to prevent his body from rejecting the donor kidney.

The doctor may also recommend iron supplements for anemia, replacement of EPO supplements, calcium and vitamin D, phosphorus binders taken with food to prevent bone loss due to hyperparathyroidism. Blood pressure also needs to be controlled and any risks of heart disease also need to be managed. In addition, other medical problems that underlie uremia must also be managed.

Regenerative medicine is being researched. This type of treatment could help people with kidney disease and uremia in the future. This treatment uses cells that can help the body heal its own organs. It is hoped that this treatment will eventually slow the progression of kidney disease.

7. Prognosis

Kidney disease is a chronic disease that can cause many potentially fatal health problems. People with uremia can die from kidney failure, especially if they don’t get treatment.

Reported Cleveland Clinic, Severe uremia can lead to coma or death. The most common complication is heart disease. People who receive kidney transplants as a treatment for kidney failure are more likely to survive than those who receive dialysis alone.

Some people who experience uremia due to a temporary condition can be treated, such as a blockage in the kidney or an enlarged prostate. The outlook for them depends on whether the kidneys are permanently damaged, and whether the uremia is damaging other organs.