Causes of Uremia

Written by Li Liu Sheng
Nephrology
Updated on December 03, 2024
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Uremia is a syndrome caused by the progressive development of various chronic kidney diseases that ultimately leads to bilateral renal failure in patients, unable to timely remove excess water, electrolytes, and various toxins from the body. The causes of uremia are many and complex. Common causes include chronic nephritis, diabetic nephropathy, and hypertensive nephropathy. Other diseases such as chronic interstitial nephritis, chronic pyelonephritis, uric acid nephropathy, chronic obstructive nephropathy, renal vascular diseases, and hereditary nephritis can also lead to uremia. Once uremia occurs, patients often exhibit symptoms of general discomfort and may need to choose dialysis treatment, which can be either hemodialysis or peritoneal dialysis, depending on individual circumstances.

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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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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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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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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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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.