Uremia

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Written by Wang Li Bing
Intensive Care Medicine Department
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What causes uremia?

Uremia is very common in clinical practice. It is mainly caused by abnormal kidney functions, leading to abnormalities in glomerular filtration, as well as in the reabsorption and secretion functions of the renal tubules, which results in a series of symptoms. Once uremia occurs, it can disrupt the internal environment of the body, cause electrolyte abnormalities, and even lead to life-threatening arrhythmias. Uremia is very dangerous in clinical practice and often requires regular hemodialysis treatment. Therefore, once uremia occurs, medical attention must be sought promptly.

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Written by Guan Hai Fang
Urology
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What department is for uremia?

Patients with uremia are generally recommended to consult nephrology or urology departments. Uremia primarily results from the obstruction of toxic metabolic waste excretion, characterized by the accumulation of excessive protein metabolism products in the body, such as urea nitrogen and creatinine. This occurs due to amino acid metabolic disorders, leading to a reduction in essential amino acids, and consequently, symptoms of uremia manifest. Therefore, in the diet of uremic patients, it is important to restrict protein intake, particularly focusing on high-amino acid foods, mainly essential amino acids. It is generally advisable to adhere to a low-protein diet, with about 20 grams of protein supplied daily to alleviate the burden on the kidneys. Hence, choosing potassium-containing foods is crucial; if urine output is below 1000 milliliters, low-potassium foods should be selected to avoid consuming high-phosphorus foods like animal organs and brains, preventing an increase in blood phosphorus levels. Moreover, strict restrictions should be imposed on irritant foods, such as alcohol and chili peppers.

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Written by Zhou Qi
Nephrology
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How to diagnose uremia

Uremia is the final state of chronic renal failure. This disease cannot be diagnosed through physical examination and medical history inquiry alone. Diagnosis requires testing, combined with the patient's physical examination and medical history, to comprehensively determine the diagnosis. Patients with uremia first need to have a blood test to check kidney function, with blood creatinine levels needing to exceed 707μmol/L. Secondly, they should undergo an ultrasound of the urinary system. Typically, the kidney size in such patients is reduced, which can be detected by the ultrasound. These two diagnostic methods used together can diagnose uremia. Patients also need to be checked for potential complications caused by uremia, such as measuring blood pressure and performing a complete blood count to check for renal anemia, among others.

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Written by Zhou Qi
Nephrology
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Is uremia contagious?

Strictly speaking, uremia is not an independent disease and it is not contagious. Uremia refers to the state where numerous causes chronically damage the kidneys over a long period, eventually leading to the destruction of most kidney tissue, resulting in the kidneys' inability to excrete metabolic waste. There are many causes of uremia, including chronic nephritis, diabetes hypertension, systemic lupus erythematosus, urinary system stones, and even prostate hyperplasia, among others, which damage the kidneys and lead to this condition. Generally, these causes are not contagious as they do not involve bacteria, viruses, or fungi. However, if uremia is caused by infectious diseases, such as hepatitis B virus or HIV, these infectious diseases can be contagious, but uremia itself is not contagious.

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Written by Zhou Qi
Nephrology
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How is uremia caused?

Uremia, also known as end-stage renal disease, is actually the late stage of chronic renal failure development, capable of causing long-term chronic damage to the kidneys. There are many reasons for this, and if these causes persist over a long period, continuously harming the kidneys without effective removal or control, it could eventually lead to severe renal failure, ultimately causing uremia. The causes that can chronically harm the kidneys mainly include diabetes, hypertension, chronic nephritis, polycystic kidney, urinary system stones, tumors, and other such conditions.

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Written by Zhou Qi
Nephrology
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Is high creatinine uremia?

High creatinine levels do not necessarily indicate uremia. High creatinine often implies that the patient is experiencing renal failure, which can be classified into acute renal failure and chronic renal failure based on factors such as the patient's medical history and course of the disease. Uremia is the final state of chronic renal failure. Thus, even if high creatinine levels suggest the possibility of chronic renal failure, it does not necessarily mean that the patient has reached the final stage. Uremia, also known as end-stage renal disease, generally requires a patient's blood creatinine to exceed 707 µmol/L. Additionally, patients often simultaneously present with clinical manifestations such as renal anemia, disorders of calcium and phosphorus metabolism, and reduction in kidney size.

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Written by Zhou Qi
Nephrology
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Does uremia hurt?

The so-called uremia refers to patients whose kidney function has been lost by more than 90%, and the vast majority of kidney tissue has been destroyed. Although the condition of these patients is very serious, they do not experience pain symptoms. In patients with uremia, the kidney tissue has hardened, and in most of the causes leading to uremia, pain is not induced. Even though the kidneys have severe problems, there are no nerves in the kidneys to sense pain, as there are no sensory nerves, so the kidneys do not feel pain. Causes that can lead to uremia include diabetes, hypertension, chronic nephritis, urinary system stones, tumors, and more. Painful conditions are mainly caused by urinary system stones, while other causes generally do not entail pain.

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Written by Tang Da Wei
General Surgery
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Can holding urine lead to uremia?

Holding urine will not cause uremia. Holding urine may lead to bladder fullness, and after a long time, it might cause dilation of the ureters, but it will not lead to uremia. Uremia is caused by renal insufficiency or end-stage renal failure, characterized by significantly increased creatinine and urea nitrogen in the patient's body, with reduced urine output or even anuria. Once uremia is diagnosed, it generally requires hospitalization for dialysis treatment, which involves removing toxins from the body through dialysis. Additionally, it is advised to consume nutritionally rich foods in daily life.

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Written by Guan Hai Fang
Urology
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Is uremia serious?

Uremia is very serious. For patients with uremia who wish to be cured, the current method is to undergo kidney transplantation. Kidney transplantation is currently considered the best method for treating uremia. If no suitable kidney source is found, or economic conditions do not allow, or for some other reasons, it is recommended that patients undergo dialysis. Dialysis is also quite expensive, but if economic conditions permit, and physical health and mood among other factors allow, patients with uremia who undergo regular dialysis can generally have their lives extended by several years. It is not uncommon to see reports of lives being extended by more than a decade.

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Written by Huang Feng Fei
Urology
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Why would someone get uremia?

Uremia, also known as end-stage renal failure, has many causes. Common surgical conditions include urological obstructions such as urethral blockage, kidney tumors, malformations, kidney cancer, and others, as well as numerous kidney cysts, all of which can lead to renal failure. Common internal medicine causes include chronic glomerulonephritis, long-standing hypertension, hypertensive nephropathy, diabetes, diabetic nephropathy, etc., which can also lead to renal failure. In summary, end-stage renal failure is referred to as uremia.