Uremia
| Uremia | |
|---|---|
| Synonym | uraemia |
 |
|
| Urea | |
| Classification and external resources | |
| Specialty | Nephrology |
| ICD-10 | N19, R39.2 |
| ICD-9-CM | 585-586, 788.9 |
| DiseasesDB | 26060 |
| eMedicine | med/2341 |
| MeSH | D014511 |
Uremia is the condition of having "urea in the blood". Urea is one of the primary components of urine. It can be defined as an excess of amino acid and protein metabolism end products, such as urea and creatinine, in the blood that would be normally excreted in the urine. The Uremic Syndrome can be defined as the terminal clinical manifestation of kidney failure (also called renal failure). It is the signs, symptoms and results from laboratory tests which result from inadequate excretory, regulatory and endocrine function of the kidneys. Both uremia and the uremic syndrome have been used interchangeably to define a very high plasma urea concentration that is the result of renal failure. The latter definition will be used for the rest of the article.
Azotemia is another word that refers to high levels of urea but is used primarily when the abnormality can be measured chemically but is not yet so severe as to produce symptoms. Uremia is the pathological manifestations of severe azotemia.
There is no specific time for the onset of uremia for people with progressive loss of kidney function. People with kidney function below 50% (i.e. a glomerular filtration rate [GFR] between 50 and 60 mL) and 30 years of age may have uremia to a degree. This means an estimated 8 million people in the United States with a GFR of less than 60 mL have uremic symptoms. The symptoms, such as fatigue, can be very vague, making the diagnosis of impaired renal function difficult. Treatment would be to perform dialysis or a renal transplant.
Classical signs of uremia are: progressive weakness and easy fatigue, loss of appetite due to nausea and vomiting, muscle atrophy, tremors, abnormal mental function, frequent shallow respiration and metabolic acidosis. Without intervention via dialysis or kidney transplant, uremia due to renal failure will progress and cause stupor, coma and death. Because uremia is mostly a consequence of kidney failure, its signs and symptoms often occur concomitantly with other signs and symptoms of kidney failure. Below is a table showing more of the principal signs and symptoms of uremia.
Glomerular filtration rate (GFR) measures the amount of plasma being filtered through the kidneys. As the GFR decreases, the prognosis worsens. Some of the effects can be reversed with dialysis. See below for a chart on GFR rates and their effects.
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