Kidney failure with urinary poisoning (uremia) – causes, symptoms & therapy

Uremia refers to chronic or acute kidney failure , which is accompanied by urinary poisoning. This means that the end stage of the disease has already occurred. The kidneys can no longer clean the blood, so the blood cannot be freed from urea or other toxins. Since the toxic substances are no longer filtered, they can no longer be eliminated.

It is mainly a question of a disturbed excretion of electrolytes and water, whereby the acid-base balance is also disturbed. Such a condition is life-threatening and can leave the patient in a coma (among other things). The breakdown of creatinine and urea is also disturbed. Creatinine is nothing more than a breakdown product that is produced by the muscle tissue. Urea, on the other hand, is considered a waste material that is produced as part of the conversion of protein and urea. Another feature is a hormonal imbalance; this disorder affects the blood, blood pressure and bone formation of the affected person in the further course.

causes

While acute uraemia occurs just a few days after acute kidney failure, the chronic form of the disease develops over several years. Uremia occurs when inadequate therapy – in the context of kidney failure – is applied or no treatment is given at all. Kidney failure (partial or complete) is caused by inflammation , poisoning or a circulatory disorder in the kidneys.Sometimes urinary retention can also be the cause of kidney failure. In many cases, kidney failure is often the result of kidney disease that has been treated inadequately or not at all. In addition, kidney failure is favored by various factors: These are sometimes high blood pressure , incorrectly controlled diabetes or congenital cysts , constantly recurring inflammation of the kidneys or diseases of the kidney blood vessels. Other triggers are years of drug or alcohol abuse .

symptoms and course

Typical symptoms of kidney failure:

• bad breath

• itching

• difficulty concentrating

• fatigue

• jaundice

• muscle cramps

• nausea

Classic symptoms are a urine-like mouth and body odor in the patient. The person concerned complains of severe itching, reports difficulties in concentrating and permanent tiredness. Jaundice can also be a sign of uremia. Other symptoms include cramps, nausea, shortness of breath and poor urination, as well as water retention and unconsciousness.

In some cases, cardiac arrhythmias also occur; often the patient is also “unnaturally pale”. If the uremia is not treated either, the outcome of the disease is fatal. However, if the patient contacts a doctor quickly or if the therapy is started relatively soon (after the diagnosis), the chances of a cure are very good. If chronic uraemia is present, lifelong renal replacement therapy is recommended. Complications such as a high susceptibility to infections or diseases of the cardiovascular system are very common.

Diagnose

If uraemia is suspected, the first step in treatment is a detailed anamnesis . A physical examination is then carried out. The physical examination also includes checking the blood and urine to see whether there are any abnormalities.The standard methods also include ultrasound of the kidneys. Contrast agents are rarely given; The doctor primarily opts for an examination that is gentle on the kidneys. In a few cases, the kidney is punctured so that the doctor can rule out any other diseases.

treatment and therapy

Before the doctor starts treatment, he must first determine whether the uremia is acute or chronic. If the disease is chronic, renal replacement therapy – in the form of dialysis – must be started immediately. Dialysis usually takes place three times a week. The treatment itself lasts between four and five hours. During this time, the toxins are filtered out of the blood; as the disease progresses, the electrolyte and acid-base balance is regulated.

Of course, the underlying disease of the kidneys is also treated. This means that diabetics are “better adjusted” and have to undergo regular medical examinations and controls. The patients also have to adjust their drinking quantity as the process progresses. This means that the amount is adjusted to the excretion capacity of the kidneys.

There is also a change in diet . It is a diet low in potassium and protein , but high in calories. The amount of urea can thus be significantly reduced. It is also advisable to avoid any kind of phosphates. Even if many studies question such dietary changes (mostly American studies), it is still recommended – according to the latest medical knowledge.

prevention

For the most part, uremia can only be prevented if patients suffering from kidney failure have them treated conscientiously and in good time. This means that regular medical check-ups must be carried out. The patient must also take additional precautions and have any changes or symptoms evaluated.