How to diagnose uremia

Written by Sun Chun
Urology
Updated on September 18, 2024
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Uremia primarily refers to high levels of creatinine in the blood. Generally, a creatinine blood test can be used to evaluate kidney function, thus diagnosing whether the kidneys are in a compensatory stage, in a chronic stage, or during a period of uremia. Renal insufficiency, which causes uremia, has specific causes. It is essential to determine whether the causes are renal or post-renal by performing routine urinary system CT scans to identify any obstructions, stones, or space-occupying lesions that may lead to hydronephrosis and a decline in renal function. Other internal medical diseases, such as chronic nephritis syndrome and kidney disease, can also lead to increased creatinine levels. In such cases, renal biopsy and pathology are necessary to confirm the diagnosis. Once an individual reaches the uremic stage, the overall condition tends to deteriorate, characterized by fatigue, anorexia, and weight loss. Additional issues include toxin accumulation in the body leading to anemia and various other problems, including gastrointestinal issues and reduced digestive capacity resulting in loss of appetite. When the aforementioned symptoms occur, there generally are only two treatment options: dialysis to filter out the toxins or, if an appropriate kidney source is available and economically feasible, kidney transplantation can be considered.

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How long can uremia last?

Currently, kidney transplantation is the best method for treating uremia, but if a kidney source cannot be found or the financial costs are unaffordable, dialysis can be administered. Advances in dialysis technology mean that, under economically permissible circumstances and with a positive personal attitude, it can potentially extend life by several years, and there are often reports of cases extending up to a decade or more. Uremia results from kidney failure, and generally speaking, there is still no way to cure it intrinsically, so kidney transplantation should be pursued whenever possible.

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Written by Li Fang Xiao
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Is high creatinine uremia?

High creatinine levels do not necessarily indicate uremia, but during uremia, creatinine levels will certainly increase. Clinically, we consider creatinine levels above 707 as uremia. Once uremia is diagnosed, treatment mainly involves renal replacement therapy or transplantation. Renal replacement therapy mainly includes hemodialysis and peritoneal dialysis, each with its own advantages and disadvantages, and the choice should be based on the patient's individual condition. Renal transplantation is currently the best treatment option, which can be done through relatives or donations. After a kidney transplant, one can live and work like a normal person, but long-term oral immunosuppressive medication is required.

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Written by Zhou Qi
Nephrology
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What should I do about uremia heart failure?

Patients with uremia often develop complications of heart failure, which is actually the leading cause of death in patients with uremia. This type of heart failure is mainly due to the decreased ability of the kidneys to excrete water, leading to an increase in blood volume and an increased burden on the heart. It is also related to many factors such as the patient often having hypertension, anemia, coronary heart disease, etc. For such diseases, it is first necessary to assess whether the patient has excess water in the body. If there is too much water, urgent dialysis ultrafiltration is needed to remove the water. After the water is removed, the symptoms of heart failure will be significantly relieved. Secondly, it is necessary to deal with some other complications related to heart failure. For example, in the case of anemia, temporary blood transfusions or the use of erythropoiesis-stimulating agents to promote hematopoiesis can be used. Hypertension requires the use of antihypertensive drugs to control blood pressure and other comprehensive treatment measures. (Please use medications under the guidance of a doctor)

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Written by Guan Hai Fang
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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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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.