Uremia - Causes and Symptoms

Definition

Uraemia is a pathological condition that occurs in the advanced stages of renal failure.

When the kidneys are no longer able to eliminate toxic waste products (such as urea, creatinine, phosphates and acid substances), chemical changes occur in the blood and other organic liquids. These changes result in a characteristic complex of symptoms, such as tiredness, nausea, vomiting, loss of appetite, urinary odor of breath, sweating, pallor, shortness of breath, hypertension, swelling of the legs, sensitivity disorders, itching and sometimes, convulsive state and coma.

Other manifestations associated with uremia vary according to the extent of renal failure, the speed with which it is established and the simultaneous functional impairment of other systems.

Uremia can result from various pathological processes. The most common causes include chronic glomerulonephritis, chronic tubular and interstitial nephropathies, type 1 or type 2 diabetes mellitus and vascular nephrosclerosis.

Uremia can also result from rheumatologic pathologies, heart failure, prolonged renal ischemia, malignant neoplasms, previous surgical operations on the urinary tract, viral hepatitis or HIV infection.

Other causes include obstructive uropathy, renal calculosis, recurrent urinary tract infections, multiple myeloma, amyloidosis and some vasculitis. Furthermore, advanced stages of renal failure can be induced by nephrotoxins (including heavy metals, methotrexate and radiopaque contrast agents) and as a reaction to some drugs (eg antihypertensives, NSAIDs etc.).

If not properly treated, uremia has a progressive course and can lead to the patient's death due to various complications. Management of these conditions requires intervention on the triggers and may require dialysis or renal transplantation.