Precursors of uremia

Written by Li Liu Sheng
Nephrology
Updated on February 14, 2025
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The kidneys have a very strong compensatory ability. When kidney function is slightly impaired, they can generally still handle the basic physiological functions of the human body through compensation, so patients may feel that everything is normal. Despite the fact that the occurrence and development of uremia is a long and gradually worsening process, which can sometimes be very severe, it is still possible to detect early signs of uremia if one actively seeks them out early on. Early indications of uremia can be identified in time by going to the hospital for urine and blood tests. The early signs of uremia often manifest as general fatigue, which is the symptom most easily overlooked. Other symptoms of early uremia include edema, especially noticeable swelling of the eyelids and facial area after waking up in the morning. If it develops into systemic or persistent edema, the condition is already very serious. Additionally, early-stage uremia patients may also experience an increase in the frequency of nocturnal urination and more foam in the urine, as well as increased blood pressure, and even dizziness, headaches, and a lack of appetite. These are all early signs of 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 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 uremia hereditary?

Uremia is not actually an independent disease, so it's difficult to say that uremia is hereditary. Uremia refers to a condition where the kidneys are 90% damaged. However, there are many reasons that can cause more than 90% of kidney tissue damage; among these, some are genetic diseases, but most are not hereditary. Common causes of hereditary uremia include diabetes, as well as primary chronic glomerulonephritis, hypertension, urinary system stones, and even prostate tumors, allergic purpura, etc., which can all cause kidney damage. These factors are generally not genetic diseases. However, there are very few causes of uremia that are genetic diseases, mainly including autosomal dominant polycystic kidney disease.

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Written by Li Liu Sheng
Nephrology
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Causes of Uremia

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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Written by Sun Chun
Urology
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How to diagnose uremia

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.