Uremia, which means there is urea (a main component of urine) in the blood, is a symptom indicating kidney disease or kidney failure. Normally, the kidneys filter what the body consumes as it passes through, but when they aren't working as well, waste and potentially dangerous substances end up back in the blood. Because uremia occurs as a result of kidney failure, affected individuals need to treat the kidneys to treat the condition effectively.
Patients who suffer from uremia generally test positive for creatine, proteins, and other substances directly in the blood. All systems suffer when the blood is contaminated, so most with uremia will exhibit several other symptoms indicative of kidney failure. Unfortunately, those who suffer from the earlier stage of chronic kidney disease are likely not to show symptoms until it's nearly too late.
Nausea And Vomiting
Patients suffering from kidney disease and kidney failure often experience nausea and vomiting, and there are many potential direct causes for this. For example, those with uremia may be experiencing a buildup of uremic toxins in the blood, which can cause sickness. Other potential causes include gallbladder disease, gastroesophageal reflux disease, ulcers, or gastroparesis. Prescribed medications can also cause vomiting if the kidneys are not properly processing the drugs. Regardless, it's important to make a doctor's appointment and have an evaluation to determine a specific diagnosis, which will allow patients to apply a specific prescribed treatment option.
Remember, there are usually few symptoms in the earliest stages of chronic kidney disease, meaning the illness may not become apparent until significant damage has already occurred to the kidneys. Those with medical conditions that can increase their risk of kidney failure should have regular appointments with the doctor to monitor kidney function and blood pressure. These can be done during typical doctor's office visits. Patients should be sure to ask their doctor if this is the right path for them.
When chronic kidney disease worsens to the point where the kidneys no longer have any valuable function, the patient has entered chronic renal failure. At this point, the kidneys work no better than ten percent of their standard function. Because the kidneys are the organs that maintain the balance of potassium, calcium, and incoming wastes, there is a real chance individuals will not have the ability to correctly digest food, resulting in malnutrition and unintended weight loss.
If individuals undergo chronic kidney failure, it is important for them to try and eat more calories than they usually would to give themselves enough energy on a day-to-day basis. However, this does not mean patients should eat all foods indiscriminately; if their kidneys are not working properly, there are foods they need to avoid to reduce the stress on their organs. For example, maintain a low-sodium, low-potassium, and low-phosphorous diet. In some cases, patients may also need to restrict fluid intake depending on what their doctor feels is best.
One of the side effects of kidney failure and uremia is elevated potassium in the body, resulting in hyperkalemia, of which muscle cramps are a symptom. High levels of potassium adversely affect smooth, skeletal muscle, which can translate to nausea and abdominal cramping. Additionally, patients may experience fatigue, muscle weakness, numbness, tingling, or diarrhea. High levels of potassium are a surprisingly deadly symptom in late-stage kidney disease. As the kidneys begin to fail and stop filtering phosphorus from the blood, they will also stop properly filtering potassium.
Unfortunately, the symptoms are usually so subtle that patients don't know this is happening until cardiac symptoms occur. As long as patients are regularly checking in with a doctor, they will be told whether they should keep an eye on their potassium. Cramps can also occur in the lower back; it is common to experience dull aching. Seek emergency medical help for sharp, severe, stabbing pains, however, as this is not consistent with kidney failure flank pain.
Concentration problems are also common with uremia and kidney failure. If individuals are at risk for kidney disease due to a family history of the condition, or if they have either diabetes or high blood pressure, or if they are older than sixty, it is best to get tested once a year for kidney disease. It is equally important to discuss with a doctor any new symptoms. Those with kidney failure have noticeably less energy, difficulty with concentration, and are more tired overall.
When kidneys stop working, the blood gets filled with impurities, toxins, and other substances that slow them down. This results in feeling weak, tired, and unable to focus, which is doubly true thanks to the anemia kidney failure can cause as iron levels deplete. Over thirty million American adults unknowingly live with kidney disease, believing their symptoms to be the result of other conditions, delaying treatment until high levels of protein are already found in the urine.
Given what we've already learned, it should come as no surprise that patients with uremia and kidney failure experience unusual fatigue on a daily basis. Toxins build up in the blood when the kidneys don't filter them out, which makes it hard to sleep and thus regain any energy overnight. Given the link between obesity and kidney disease, some of this fatigue can also be attributed to sleep apnea. Likewise, iron-deficiency anemia causes serious fatigue, and it occurs towards the beginning of kidney failure.
When the kidneys begin to fail, the bone marrow stops producing as many red blood cells, causing anemia, resulting in an overall reduction in energy levels and strength. Doctors regularly monitor a patient's anemia when they're on dialysis or waiting for a kidney transplant. Other symptoms suggesting anemia include headaches, dizziness, pale skin, chest pain, cold extremities, brittle nails, dry skin, sore tongue, and strange cravings for dirt or ice.
An individual who has uremia may experience abnormal bleeding as a symptom manifestation of their condition. Abnormal bleeding in uremia can present as easy bruising of the skin, oral bleeding, nasal bleeding, blood in the urine, blood in the stool, or blood in coughed-up sputum or mucus. An affected individual may also lose an abnormally large quantity of blood when undergoing invasive procedures or when they have become injured. This type of bleeding occurs when the toxins that build up in the blood of uremic patients render a large number of their platelets non-functional. The exact mechanism of the action is not entirely understood.
However, other factors that can contribute to this symptom are anemia and an abnormal reaction between the platelets and endothelial tissues. Toxins in the blood due to uremia can cause problems with the normal process of platelet adhesion. There is also a defect that can be seen in some patients where the platelets are not secreted properly. It is estimated between twenty-four and fifty-five percent of patients affected by uremia precipitated from their end-stage renal disease are impacted by bleeding complications.
An unexplained irregular heartbeat can be a symptom that indicates an individual has uremia. The accumulation of uremic toxins in a patient's blood, including p-cresol, PAA, uric acid, indoxyl sulfate, p-cresyl sulfate, and blood urea nitrogen can cause numerous problems in the body involving homeostasis. The heartbeat rhythm is regulated and influenced by signals from the brain, which are a response to changes in the individual's balance of electrolytes, fluids, acid-base status, and blood pressure. Additional problems influencing the regularity of the heartbeat that can be the result of an accumulation of these uremic toxins in the blood include proteinuria, oxidative stress, abnormal metabolism of phosphate and calcium, anemia, increased levels of inflammatory cytokines, and hyperhomocysteinemia.
These issues often cause the heart to beat faster to compensate for their effects on the body. This elevated heart rate over an extended period can cause hypertrophy in the heart or thickening of the heart walls. The long-term tachycardia can also result in myocardial fibrosis or scarring. Both of these factors cause a disruption in the path of electrical signals that tell the muscle when to contract and relax. This mechanism causes an irregularity in the heart rhythm, which is also referred to as an arrhythmia.
Individuals who have uremia may present with symptoms of considerable alterations in mental status, including confusion and memory loss. The mechanism behind these symptoms is closely associated with platelet dysfunction and excessive bleeding seen in individuals with uremia. Poor platelet function puts an individual at a higher risk of experiencing a subdural hematoma. A subdural hematoma occurs when a blood vessel in the brain surface region bursts open, and blood accumulates between the patient's brain tissues and its outer lining.
This medical emergency can be very dangerous because the build-up of blood in this area causes the delicate tissues of the brain to become compressed. When brain tissue is compressed, the patient typically experiences delusions, memory loss, vision changes, and confusion. The exact symptoms that occur tend to vary depending on the part of the brain being pressed and the severity of the compression. Uremic individuals may experience a subdural hematoma with minimal to no noticeable trauma.
An individual affected by uremia may experience pericarditis. The fibroelastic sac that surrounds the heart is called the pericardium. There is usually between fifteen and fifty milliliters of fluid that stays between the pericardium's two layers to lubricate them. Pericarditis occurs when this sac around the heart becomes inflamed and swollen. The uremic toxins in the blood of affected individuals are known to produce a sharp increase in the yield of nitrogenous waste substances. These waste substances can have a pro-inflammatory effect that can contribute to the development of pericarditis.
This inflammatory reaction includes the secretion of the inflammatory markers interleukin 6, interleukin 1, and tumor necrosis factor. This process results in adhesions, deposits of fibrous tissues, and severe inflammation that all cause the pericardium to become damaged. Additionally, pericardial effusion or a buildup of fluid in the pericardium may occur due to a hemorrhage associated with the impaired platelet function in a patient. This disposition of fluid or blood can cause further damage to the pericardium, exacerbating the inflammatory responses that cause pericarditis.
Shortness Of Breath
Shortness of breath may present as a symptom of uremia. A few different mechanisms can contribute to the occurrence of breathlessness in uremia. The renal tubular cells are responsible for regulating the acid-base homeostasis in an individual. Because these cells are not working right, hydrogen ion secretion is decreased while ammonium excretion is disrupted. The result is an accumulation of phosphate, sulfuric acid, hippuric acid, and lactic acid. This buildup disrupts the balance between negatively charged electrolytes and positively charged electrolytes in the body, resulting in metabolic acidosis.
Acidosis in the body causes symptoms such as lethargy and hyperventilation. Hyperventilation is a condition where the lungs are working harder than the body needs. This can make a patient feel like they are short of breath or unable to breathe in enough air. Uremia can also cause anemia, which leads to a lack of oxygen delivery to tissues around the body. The heart and lungs attempt to compensate for this in response. This compensation includes increased heart rate and breathing rate. Furthermore, a buildup of fluid around the lungs or heart as a result of uremia can cause a patient to feel short of breath.