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Uremia represents a group of symptoms and signs that occur with severe and terminal kidney insufficiency. They are caused by agglomeration of toxic substances, azotemia, metabolic acidosis, infection and hypoxia. Chemical structure of the uremic toxin is not clear. Before, everything was attributed to nitrogen materials, but lately a possibility that is considered is that these are intermediate molecules – polypeptides, the size from 300 – 2500 Daltons of the molecule mass.
Uremia Clinical Picture
Uremic syndrome is series of signs, like intense itch on the skin that occurs because of the subsidence of calcium salts in the skin. So, excoriation (scratches) on the skin from scratching is very often. Metabolic acidosis evokes deep and rapid breathing (Kussmaul breathing). Muscle cramps are often, especially in the lower leg areas, most probably caused by dehydration.
Uremia also implies disorders of number of metabolic and endocrine kidney functions which lead to: water and electrolytes disorders – increase or decrease of fluid volume, hyper and hyponatremia, metabolic acidosis, hyperphosphataemia, hypocalcemia, endocrine – metabolic disorders – renal osteodystrophy, osteomalacia, secondary hyperparathyroidism, hyperuricemia, hypothermia, hypertriglyceridemia, protein malnutrition, growth and development disorders, infertility and sexual dysfunction, amenorrhea (menstruation absence), gastrointestinal disorders – anorexia, nausea and vomiting, gastroenteritis, peptic ulcer, gastrointestinal hemorrhage, hepatitis, peritonitis, cardiovascular disorders and pulmonary-hypertension (high blood pressure), cardiac decompensation, pulmonary edema, pericarditis, arrhythmias, neuromuscular disorders-sleep disturbances, headache, lethargy, muscular irritability, peripheral neuropathy, paralysis, coma, myopathies, hematological disorders-anemia, increased risk of infection, increase in the spleen, leukopenia.
Patient who suffers from uremia breaths hard, with a changed rhythm of breathing, has visual disorders, often blindness, his functions of digestive organs are out of order (vomiting, diarrhea), and finally, brain and other neural functions. It is not a rare case that uremia ends with eclamptic seizures and coma, or complete loss of consciousness.
Uremia Diagnosis
Concentration of many polypeptide hormones in plasma is reduced, with development of insufficiency, including PTH, insulin, glucagon, LH, PRL not only because of decreased catabolism, but also because of increased secretion, as a result of renal excretory or secretory dysfunction. In uremia, renal synthesis of erythropoietin (EPO) and 1, 25 – dihydroxycholecalciferol is decreased.
Uremia Treatment
In the case that uremia signs appear, patient must immediately go to the hospital, where only are some possibilities for help. It is much more important to take prevention measures so uremia does not occur. And these measurements are composed of systematic, correct treatment of the kidney disease and keeping a proper diet and proper hygienic measures.
