The precursors of uremia

Written by Zhou Qi
Nephrology
Updated on February 27, 2025
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The so-called uremia refers to the end result of chronic kidney disease causing long-term damage to the kidneys in patients. Patients with uremia often have long-standing conditions, as it takes time to progress from mild kidney failure to uremia. Before the onset of uremia, patients may experience symptoms related to kidney failure, such as swelling of the limbs and face, reduced urine output, proteinuria which leads to foamy urine, and visible blood in the urine due to hematuria. Patients are also prone to developing high blood pressure. These symptoms can be precursors to uremia, although other diseases can also cause similar symptoms.

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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 Li Liu Sheng
Nephrology
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Precursors of uremia

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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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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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 Li Liu Sheng
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Symptoms of pre-uremia

The pre-uremic stage is the period of chronic renal failure. During the pre-uremic stage, many patients may have no symptoms at all. However, some patients do experience many uncomfortable symptoms, such as back soreness and weakness, fatigue, and feeling cold easily. During this stage, patients may also experience nausea and vomiting, especially pronounced nausea after waking up in the morning, as well as weight loss. Some patients in the pre-uremic stage exhibit symptoms of edema, which can occur in the eyelids, facial area, or in both lower limbs. Additionally, patients may experience feeling cold, anemia, and an increased frequency of urination at night. Of course, some patients may also experience itching of the skin on both lower limbs.