Uremia


Uremia
Uremia
Classification and external resources

Urea
ICD-10 N19, R39.2
ICD-9 585-586, 788.9
DiseasesDB 26060
eMedicine med/2341
MeSH D014511

Uremia or uraemia (see spelling differences) is a term used to loosely describe the illness accompanying kidney failure (also called renal failure), in particular the nitrogenous waste products associated with the failure of this organ.[1]

In kidney failure, urea and other waste products, which are normally excreted into the urine, are retained in the blood. Early symptoms include anorexia and lethargy, and late symptoms can include decreased mental acuity and coma. Other symptoms include fatigue, nausea, vomiting, cold, bone pain, itch, shortness of breath, and seizures. It is usually diagnosed in kidney dialysis patients when the glomerular filtration rate, a measure of kidney function, is below 50% of normal.[2]

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 can also result in uremic pericarditis. There are many dysfunctions caused by uremia affecting many systems of the body, such as blood (lower levels of erythropoietin), sex (lower levels of testosterone/estrogen), and bones (osteoporosis and metastatic calcifications). Uremia can also cause decreased peripheral conversion of T4 to T3, producing a functionally hypothyroid state.

Physical signs, symptoms, and laboratory findings

Neural and muscular

Endocrine and metabolic

Other

Because uremia mostly is a consequence of kidney failure, its signs and symptoms often occur concomitantly with other ones signs and symptoms of kidney failure, such as hypertension due to volume overload, hypocalcemic tetany, and anemia due to erythropoietin deficiency.[3] These, however, are not signs or symptoms of uremia.[3] Still, it is not certain that the symptoms currently associated with uremia actually are caused by excess urea, as one study showed that uremic symptoms were relieved by initiation of dialysis, even when urea was added to the dialysate to maintain the blood urea nitrogen level at approximately 90 mg per deciliter (that is, approximately 32 mmol per liter).[3]

Condition Prothrombin time Partial thromboplastin time Bleeding time Platelet count
Vitamin K deficiency or warfarin prolonged normal or mildly prolonged unaffected unaffected
Disseminated intravascular coagulation prolonged prolonged prolonged decreased
von Willebrand disease unaffected prolonged prolonged unaffected
Hemophilia unaffected prolonged unaffected unaffected
Aspirin unaffected unaffected prolonged unaffected
Thrombocytopenia unaffected unaffected prolonged decreased
Liver failure, early prolonged unaffected unaffected unaffected
Liver failure, end-stage prolonged prolonged prolonged decreased
Uremia unaffected unaffected prolonged unaffected
Congenital afibrinogenemia prolonged prolonged prolonged unaffected
Factor V deficiency prolonged prolonged unaffected unaffected
Factor X deficiency as seen in amyloid purpura prolonged prolonged unaffected unaffected
Glanzmann's thrombasthenia unaffected unaffected prolonged unaffected
Bernard-Soulier syndrome unaffected unaffected prolonged decreased or unaffected

Causes

Besides renal failure, the level of urea in the blood can also be increased by:

  • increased production of urea in the liver, due to:
    • high protein diet
    • increased protein breakdown (surgery, infection, trauma, cancer)
    • gastrointestinal bleeding
    • drugs (e.g. tetracyclines and corticosteroids)
  • decreased elimination of urea, due to:
    • decreased blood flow through kidney (e.g. hypotension, cardiac failure)
    • urinary outflow obstruction
    • bladder rupture
  • dehydration
  • chronic infection of the kidney such as chronic pyelonephritis

References

  1. ^ "uremia" at Dorland's Medical Dictionary
  2. ^ Meyer TW and Hostetter, TH (2007). "Uremia". N Engl J Med 357 (13): 1316–25. doi:10.1056/NEJMra071313. PMID 17898101. 
  3. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac Meyer, T. W.; Hostetter, T. H. (2007). "Uremia". New England Journal of Medicine 357 (13): 1316–1325. doi:10.1056/NEJMra071313. PMID 17898101.  edit [1]

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Look at other dictionaries:

  • uremia — f. hemat. Presencia excesiva en la sangre de urea, creatina y de otros compuestos nitrogenados productos del metabolismo de las proteínas. ⊆ Por extensión, sintomatología relacionada con la insuficiencia renal crónica. Medical Dictionary. 2011 …   Diccionario médico

  • Uremia — Urea Clasificación y recursos externos CIE 10 R 39 2, r 30 …   Wikipedia Español

  • uremia — (n.) 1857, Modern Latin, from Gk. ouron urine (see URINE (Cf. urine)) + haima blood (see EMIA (Cf. emia)) …   Etymology dictionary

  • uremia — s. f. [Medicina] Intoxicação geral provocada pela falta de eliminação, pela urina, das matérias tóxicas produzidas no funcionamento orgânico …   Dicionário da Língua Portuguesa

  • uremia — {{/stl 13}}{{stl 8}}rz. ż IIb, blm {{/stl 8}}{{stl 7}} ostre zatrucie organizmu produktami przemiany materii, np. mocznikiem, zwykle powodowane niewydolnością nerek, wywołujące gwałtowne bóle głowy, wymioty, śpiączkę oraz wyniszczenie organizmu;… …   Langenscheidt Polski wyjaśnień

  • uremia — (Del gr. οὖρον, orina, y αἷμα, sangre). f. Med. Conjunto de síntomas cerebrales, respiratorios, circulatorios, digestivos, etc., producidos por la acumulación en la sangre y en los tejidos de venenos derivados del metabolismo orgánico eliminados… …   Diccionario de la lengua española

  • uremia — [yoo rē′mē ə] n. [ModL < Gr ouron, URINE + haima, blood] a toxic condition caused by the presence in the blood of waste products that are not being eliminated in the urine because of a failure of the kidneys to secrete urine uremic adj …   English World dictionary

  • uremia — /yoo ree mee euh/, n. Pathol. a condition resulting from the retention in the blood of constituents normally excreted in the urine. Also, uraemia. [1855 60; < NL; see UR 1, EMIA] * * * Excess nitrogenous waste products in the blood and their… …   Universalium

  • Uremia — The presence of excessive amounts of urea in the blood, which may be a sign of kidney disease or failure. See also urea. * * * 1. An excess of urea and other nitrogenous waste in the blood. 2. The complex of symptoms due to severe persisting… …   Medical dictionary

  • uremia — ► sustantivo femenino MEDICINA Síndrome clínico debido a la retención de sustancias nitrogenadas en la sangre, secundario a una insuficiencia renal. * * * uremia (de «ur » y « emia») f. Med. Existencia patológica de orina en la sangre, que… …   Enciclopedia Universal


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