- this is a pathological condition of a diseased kidney, which is no longer able to satisfactorily perform its excretory function, namely the release of water from the body, the constituents of urine, salt, urea and other end products of metabolism, as a result of which they linger and accumulate in the blood.

Therefore, the blood of kidney patients is often not only richer in water than under normal conditions (the specific gravity of the serum can fall from 1030 to 1020 and even lower), but, as numerous studies have shown, in almost all cases where a decrease in urination occurs, it is richer also urea and, probably, to an appropriate extent, other usual constituents of urine or their predecessor products.

This accumulation of urine components in the blood and then, perhaps, also in the tissues themselves causes a number of phenomena that often appear in kidney diseases.

Experimental studies of uremia

Now we must examine a number of other, mainly nervous, symptoms of the disease, which depend on the retention of other components of the sword and are therefore called uremic symptoms. Of course, it is necessary to make a reservation in advance that it is very doubtful whether all the nervous symptoms that arise are real. in kidney diseases, should be considered as uremic in the narrow sense of the word.

However, there is no longer any doubt that uremia should essentially be considered poisoning of the body by metabolic products that have not been excreted.

Many experimental studies have proven that, in animals, removing kidneys or ligating the ureters can cause vomiting, convulsions and hibernation, which are quite reminiscent of the picture of uremia in kidney patients. But if you ask what constituents of urine actually cause uremic phenomena, then the answer will be even more uncertain. For a long time it was thought that urea plays a major role in the origin of uremia.

The results of animal experiments, however, do not support this assumption. A huge amount of urea can be injected into the blood or into the peritoneal cavity of animals without causing the slightest signs of poisoning. Healthy kidneys extremely quickly free the blood from excess urea, and therefore uremic phenomena occur if, by feeding the animal with large quantities of urea, at the same time depriving the animal of water, the excretion of urea is hindered.

But this requires such quantities of urea that are out of the question in uremic renal patients; in addition, simultaneous deprivation of water can interfere with the release of other substances.

Urea released during uremia of the intestinal mucosa is converted in the intestine itself into ammonia carbonate, which plays an important role in the occurrence of uremic enteritis.

Only with ammonia decomposition of urine in the urinary tract and absorption can ammonemia occur. We are thus forced to admit that uremia is caused by some other toxic substance. Some experiments seem to suggest that potassium salts are poisonous; other authors blame mainly extractive substances (creatinine, etc.).

Bouchard tried to explain uremia by special substances similar to alkaloids, supposedly formed during the digestion of proteins and present in all normal urine (urotoxins).

However, the data on which Bushard's theory was based, about a decrease in the toxicity of urine and an increase in the toxicity of blood with uremia, are not always confirmed. Other authors talk about toxic substances formed as a result of the breakdown of kidney tissue (nephrolysins, “nephrotoxins”).

Based on the important observation that urinary retention in healthy kidneys (for example, when the ureters are blocked by stones) is tolerated for many days without the appearance of uremia, they suggested that the breakdown of the renal epithelium releases toxic substances (nephrolysins, nephrotoxins).

Some are absorbed into the blood and cause uremic symptoms. I subscribe to the opinion that an explanation of uremic symptoms is necessary. Look not only for the accumulation of normal metabolic products in the blood due to insufficiency of renal secretion, but also for the general painful nephritic process.

The speed with which severe uremic phenomena develop is often striking; on the other hand, as mentioned above, many days of anuria due to blockage of the ureter with a stone passes without the slightest trace of uremia. In case of sublimate poisoning, 8-10 days of anuria without any uremic phenomena are often observed.

These facts suggest that the general nephritic disease process, caused by special causes, leads to the formation of toxic substances; their accumulation along with normal metabolic products in the blood and tissues causes uremic symptoms. A more detailed study of blood for uremia revealed only some general facts.

We now know that the molecular concentration of the blood is mostly elevated; however, there is no constant parallelism between the severity of the phenomena and the degree of retention of substances in the blood. Electrical conductivity of the blood does not increase with uremia, which suggests that inorganic salts do not play a causative role.

Chemically, the increase in so-called residual nitrogen in the blood, i.e., the nitrogen remaining in the blood after complete precipitation of protein, is especially important, since this makes it likely that nitrogenous protein breakdown products cause uremic poisoning.

The amount of residual nitrogen normally ranges from 20 to 40 mg; with uremia, figures of about 120 mg and even up to 300 mg are found. It was this instability in the amount of residual nitrogen during uremia that served as the main reason for revising the previously existing views on the essence of uremia.

Insufficiency of renal secretion in many uremic patients manifests itself, in addition to an increase in residual nitrogen, in an increase in the content of indican in the blood serum. Based on a chemical study of blood with uremia, one has to think that retained substances accumulate not only in the blood, but also in the tissues.

Not only the chemical nature of toxic substances, but also their mode of action is not yet fully understood. One thing is certain, that with uremia we are dealing almost exclusively with cerebral, and mainly with cortical, disorders. But it is not yet known whether there is direct damage to the nervous elements (which we consider the most likely, taking into account the following nested uremic symptoms), or whether the cause is an effect on the blood vessels (vasoconvulsions), resulting in anemia and malnutrition of certain areas brain.

The more precise nature of uremic intoxication is not yet well understood. In any case, one cannot deny the importance of retention of substances intended for excretion as a cause of nervous disorders in renal diseases.

Clinical observations are quite consistent with the assumption that uremia is caused by retention of the constituents of urine in the body.

In most cases, uremic symptoms occur only when the daily amount of urine has dropped very low or urination has even almost completely stopped for several days. That this greatly reduces the excretion of not only water, but also other components of urine, has been directly proven by special studies.

However, we cannot remain silent that some clinical observations are not entirely in harmony with the view presented. If cases have been reported more than once in which, with nephritis, even with many days of anuria, no uremic symptoms occurred, this does not prove anything, since it is never possible to determine exactly how much substances destined for excretion have accumulated in the blood.

The body, undoubtedly, is able to get rid of the final products of metabolism in other ways besides the kidneys (through the skin, intestines, edematous fluid, in addition, one must take into account what and in what quantities the patient ate, as well as individually very different endurance of the body and, in particular, the nervous system to the action of all kinds of poisons.

It is more difficult, however, to explain those cases that sometimes occur in which uremic phenomena suddenly appear in kidney patients, although before there was no noticeable decrease in urination. We have to assume here that, despite the abundant secretion of water, i.e., despite the normal amount of urine, a retention of solid components nevertheless occurred, albeit insignificant.

By analogy with other poisonings, it is easy to imagine that a long-term retention of even very small quantities of toxic substances can suddenly manifest itself in a number of the most severe phenomena.

With chronic lead or mercury poisoning, the symptoms of the disease also often appear quite suddenly, although the poisoning of the body occurred very slowly and gradually. In the same way, we explain to ourselves the very frequent sudden onset of severe uremic symptoms, especially in patients with a shriveled kidney, in whom, apparently, nothing foreshadowed the impending attack from poisoning.

Sometimes, special circumstances can also contribute to the onset of uremia, for example, weakening of cardiac activity, which causes blood pressure to drop and urination becomes difficult. Further, in some cases it is observed that the onset of uremia coincides with the disappearance of existing edema.

This is explained by the fact that simultaneously with the rapid absorption of the edematous fluid, the toxic metabolic products contained in it, which are not excreted, enter the blood in relatively large quantities.

Nevertheless, observations of sudden onset uremic phenomena without visible preceding disorders of renal secretion, as well as the mentioned fluctuations in the content of residual nitrogen in the blood, raise the question of searching for other explanations for uremia.

The most important was the theory of Traube, created by him in 1861. Traube was the first to argue that uremic phenomena depend on the rapidly developing cerebral edema and the resulting swelling of the brain and its anemia.

Uremic symptoms

This theory cannot be considered universal, explaining all cases of uremia. Nevertheless, at present, we tend to see the onset of cerebral edema as the cause of at least one group of uremias. At one time, some uremic symptoms are clearly focal, cerebral in nature, such as:

  • uremic
  • hemiplegia
  • monoplegia
  • partial epileptiform seizures
  • hemianopsia
  • amaurosis
  • aphasia, etc., which suggests a focal brain lesion.

It is now known that with nephritis, acute inflammation can suddenly occur in the internal organs; inflammation in the retina, which consists of nerve elements, is a common phenomenon. Finally, it has already been mentioned that nephritic edema in some places has a pronounced local inflammatory nature. Localized nervous disorders in nephritics can be fully explained by similar acute inflammatory-edematous changes in the brain.

The theory explaining uremic phenomena by cerebral edema is contradicted by the fact that during autopsies of those who died from uremia, cerebral edema is not always found (although it often occurs). In addition, the occurrence of cerebral edema itself requires an explanation, which must be sought either in the influence of retained table salt or other metabolic products.

Thus, the boundary between the retention theory and the theory of cerebral edema has been smoothed out, although undoubtedly the distinction between cases accompanied by retention of urine constituents (increased residual nitrogen) from cases without such a delay (i.e. without increased residual nitrogen) represents a significant achievement. However, it must be remembered that this division is one-sided; it is based on taking into account the content of residual nitrogen and does not take into account the possibility of retention of other metabolic products, which can occur regardless of the height of residual nitrogen.

Chronic urination

If now, without touching on the issue of the causes of uremia, we dwell on its clinical manifestations, then we must first of all note that uremia represents all sorts of transitions from the mildest, barely perceptible to the most severe, sometimes directly leading to death, nervous symptoms.

Sometimes severe forms of urinary bleeding, occurring with coma and convulsions, occur completely suddenly, but in other cases they are preceded for a long time by milder uremic phenomena, which are then called precursors.

Sometimes very severe symptoms do not develop at all and only the mildest symptoms persist for a more or less long time; this condition is called chronic urination or chronic kidney failure (see below).

Symptoms of chronic urination

Chronic uremic diseases, which either turn out to be independent, or harbingers or consequences of severe urinary bleeding, consist of

  • headache
  • drowsiness
  • mental confusion
  • sometimes associated with rapid breathing
  • quite often in nausea
  • convulsive belching and repeated vomiting.
  • The phenomena of motor irritation, especially short muscle twitching or prolonged tonic spasms of the limbs or face, etc., are very characteristic of uremic poisoning.
  • Sensitive irritation, goose bumps and a feeling of numbness in the fingers are also common.
  • painful and prolonged itching of the skin. For the general clinical picture of this milder form of urinary bleeding, in addition to vomiting, the peculiar anxiety and pre-cardiac melancholy of the patients often seemed especially characteristic. Therefore, people often talk about asthma uraemicum.
The most characteristic symptom of acute severe urinary bleeding is a uremic attack of convulsions.

Epilepsy attack

In its details, the attack of convulsions almost completely corresponds to an attack of epilepsy; it begins, often without a cry, with a brief tonic initial period, with the whole body stretched opisthotonically, followed by a series of clinical twitches in the face and limbs.

The face turns blue, bloody foam appears from the mouth, the pupils usually dilate and do not react to light, breathing is accelerated, and at times it stops completely due to the onset of convulsions of the respiratory muscles, the pulse is small and frequent, but in many cases it turns out to be unusually tense, on the radial artery barely noticeable, body temperature sometimes rises.

In other cases, seizures begin with short, intermittent jerks in one limb, e.g. in the upper, and then move on to the muscles of the trunk, face and lower extremities. Quite often, one half of the body takes a greater part in the attack than the other.

Usually the convulsions gradually stop after a few minutes, giving way to deep hibernation, often lasting several hours or more with deep snoring or Cheyne-Stokes breathing. Before a seizure and for some time after it, the Babinski reflex can be evoked.

Rarely is it limited to just one attack of convulsions. For the most part, attacks are repeated at larger or smaller intervals, so that sometimes there are up to 20 or more of them per day. If a spinal puncture is made at this time, an increase in cerebrospinal fluid pressure is almost always found.

Complete loss of consciousness remains throughout this time. But in longer intervals between individual attacks, consciousness may fully or partially return. Often also severe attacks, quite reminiscent of epilepsy, alternate with weaker convulsions and.

In addition to seizures, some other uremic symptoms, partly touched upon by us already in passing, deserve somewhat more detailed consideration.

Uremic amaurosis

Occasionally occurring uremic, amaurosis deserves special attention. Usually it remains after a successfully endured convulsion; only occasionally it precedes attacks of convulsions or appears independently of them. In such cases, it always develops quite quickly, so that the initial visual impairment soon develops into complete blindness. In this case, the reaction of the pupils to light is almost always preserved, and the retina, examined with an eye mirror, turns out to be completely normal.

It is not yet known where the lesion is located in the visual apparatus. Some researchers suggest swelling of the optic nerve sheath; others (including us) consider it more likely to be a disorder of the brain's visual centers, especially the occipital cortex.

The prognosis for uremic amaurosis is generally favorable, since the visual disturbance completely passes, mostly after 1 - 2 days, sometimes after a longer period. In other nerves, changes were observed less frequently; comparatively most often - uremic hearing loss or even complete deafness.

Mental symptoms

Movement disorders other than jerks and seizures are rare. Hemiplegic or monoplegic paralysis, contractures, trembling movements, etc. were observed only in isolated cases. Psychiatric symptoms are more common. It was necessary to repeatedly observe in uremics a long-lasting state of confusion, with a sharp weakening of the ability to remember, similar to the so-called Korsakov psychosis.

Confusion of consciousness is manifested in a lack of orientation in time and space (incorrect answers about the duration of the illness, about the time of day and year). Severe delirium, manic or in other cases melancholic states accompany coma, and sometimes precede it.

Uremic vomiting

Of great interest are those urinary phenomena that should be considered as a kind of self-help on the part of the body, since they often entail the vicarious release of urea, and perhaps other metabolic products. This includes primarily uremic vomiting.

This is a frequent and sometimes “extremely persistent” symptom in both acute and, especially, chronic urinary tract infections. In many cases it is of central origin and can be identified with vomiting, which so often accompanies various diseases of the brain.

But, in addition, it is often caused by the irritation that the released urea, or rather the ammonia carbonate formed from it, has on the gastric mucosa. Ammonia carbonate is always formed from urea only in the stomach itself, and in the vomiting eruptions of uremic patients one can discover the presence of significant quantities of partly still undecomposed urea, partly of ammonia carbonate.

If you boil vomit with a small amount of soda lye and bring a stick moistened with hydrochloric acid to it, a cloud of ammonium chloride will form. The same thing can sometimes be obtained with the air exhaled by uremic patients. Sometimes, along with vomiting, there is quite severe hiccups.

Uremic diarrhea

Of equal importance with urinary vomiting is uremic vomiting, which is undoubtedly caused by ammonia carbonate formed from urea in the intestines. Often, ammonia carbonate causes quite severe catarrhal, sometimes even necrotizing, dysentery-like inflammation of the intestinal mucosa.

Cholera urine

Another way in which the body sometimes seeks to free itself from the amounts of urea accumulated in it is through the sweat glands. Schottin was the first to describe a remarkable case of cholera urination, where urea deposits were found on the skin, and this observation was then repeatedly confirmed in other cases of urination.

Most often, deposits occur on the face, especially on both sides of the nose, where, after the sticky sweat evaporates, scales with a matte sheen remain, which turn out to be urea upon chemical examination. Much less frequently, urea is released in other areas of the skin. It is possible, however, that the sometimes observed severe uremic itching of the skin depends on irritation of the skin nerves by the excreted constituents of urine

Other organs, except the skin and the digestive apparatus, only rarely play the role of accomplices in the vicarious secretion of urea. Fleischer, however, once managed to discover a fairly significant amount of urea in the saliva and sputum of a urinary patient.

Status of pulse, body temperature and respiration during urination

Finally, one should consider the state of pulse, body temperature and respiration during urination. Often, even before the onset of severe symptoms, the pulse is already clearly slowed, sometimes up to 48 - 40 beats; at the same time, he is almost always tense and hard. Blood pressure appears high. A moderate slowing of the pulse is also often found with chronic urinary incontinence.

With the onset of uremic convulsions, the pulse usually becomes, on the contrary, small and very frequent, especially in cases with an unfavorable outcome. Body temperature with severe urination rarely remains unchanged. When convulsions are present, it usually rises by several degrees, reaching even 41-42°C in severe cases.

We have observed such high temperatures, especially as final increases in unfavorable outcomes, although in such cases sometimes improvement can still occur. On the other hand, there are also strong drops in temperature, up to 35° and 34° C., most often again as the final temperatures of collapse in cases that end in death in a deep coma without noticeable phenomena of motor irritation.

Breathing in uremic patients is sometimes strikingly accelerated and especially deepened, a phenomenon reminiscent of a kind of breathing during a coma. Some severe attacks of shortness of breath in renal patients are described under the name "uremic dyspnea or asthma uraemicum" for the most part, however, it is difficult to decide whether this is really a neuro-uremic symptom, since such sudden onset of shortness of breath may depend on simultaneous heart damage and left ventricular failure, from sclerosis of the coronary arteries and aorta, or from edema and inflammatory damage to the lungs.

Regarding the duration of urinary phenomena and regarding the way in which individual uremic symptoms add up to the overall picture of the disease, several more additions must be made. The above division of urinary bleeding into acute and chronic forms is not without significance for practice. In the first form, we mostly deal with severe uremic phenomena, especially urinary convulsions and uremic coma.

Along with this, uremic vomiting, amaurosis and other symptoms are often observed. This severe acute uremia occurs in, especially, scarlet nephritis, and also in some forms of shriveled kidney. Severe acute uremia, as has been said, can sometimes occur almost suddenly.

More often, however, milder uremic symptoms appear first (headache, vomiting, general anxiety, weak twitching of individual muscles, etc.), which are then immediately followed by attacks of uremic convulsions or other severe urinary symptoms.

Chronic renal failure

We see something different in cases of uremia, which are more chronic and are called chronic renal failure. The picture of the disease develops gradually and is very typical. Here is a list of some symptoms:

  • Weakness and exhaustion
  • Mild headache and malaise
  • Consciousness is often unclear and confused. They confuse time and place.
  • Drowsiness, finally falling into a prolonged half-asleep or even deep soporosis state.
  • Insomnia
  • Lack of appetite
  • The tongue is dry, coated with a stain. Excruciating thirst is often observed.
  • Urinary odor from the mouth.
  • Sometimes severe stomatitis develops.
  • Belching, nausea and vomiting.
  • small twitching in the muscles (tendon jumping).
  • Breathing in most cases is deep and rapid, in severe cases it is irregular.
  • Often patients cannot lie down and must sit on a bed or in a chair all the time. Itchy skin that interferes with sleep. Scratching can cause various skin lesions.

The outcome of urine in severe cases always seems doubtful, but not always unfavorable. This applies mainly to acute uremic seizures. Uremic symptoms can completely disappear even after a multi-day coma with severe, frequently recurring attacks of convulsions; but, on the other hand, urinary bleeding is by no means rarely the cause of death in a wide variety of acute and chronic kidney diseases.

When assessing each case of acute uremia, special attention must be paid to the state of the pulse, respiration and body temperature, and it goes without saying that the state of urination and mainly other phenomena depending on the underlying suffering must also be taken into account. Severe chronic uremic conditions associated with renal failure generally carry a poor prognosis. Only occasionally is it possible to restore kidney and circulatory function again.

Volhard Franz on uremia

It has already been mentioned that Volhard Franz and other researchers tried to divide the collective concept of uremia, which embraces various painful phenomena, into two groups, according to the characteristics of their occurrence. This division is based on the fact that in one form of uremia, in particular in acute convulsive uremia, manifested by epileptiform seizures and coma, there is no increase in residual nitrogen in the blood.

Volhard Franz does not consider these conditions to be true uremia, but explains them as cerebral edema; edema, indeed, occurs in the section and is manifested during life by an increase in cerebrospinal fluid pressure during a lumbar puncture. In contrast to these acute eclamptic forms, in the chronic uremia (renal failure) described above, characterized by

  • general weakness
  • confusion
  • nausea
  • deep breathing
  • individual muscle twitches,

Almost always a significant increase in residual dose in the blood is found. Here we are talking about true retention uremia in the literal sense of the word (azotemic uremia).

This division is a step forward in the study of uremia. However, it is difficult to imagine that such a strict distinction could be maintained; there are transitions between both forms; in addition, it has already been mentioned that in order to explain cerebral edema, it is necessary to assume the retention of metabolic products (according to Vidal, the retention of sodium chloride in the brain).

It is also necessary to take into account that with chronic uremia, a significant chemically easily demonstrable accumulation of metabolic products can occur more easily than with acute, sudden onset.

It is possible that with the latter, there are such small amounts of toxic substances in the blood that they do not have a noticeable effect on the residual nitrogen numbers. On the other hand, there are cases with a high content of residual nitrogen without the slightest symptoms of uremia (for example, in one case of sublimate poisoning in our clinic, 220 mg was found). Various uremic symptoms apparently depend on various types of toxic substances retained in the blood.

In conclusion, it should be noted that nervous phenomena in renal patients may depend on a number of other reasons. High blood pressure, congestion due to heart failure, the simultaneous existence of arteriosclerosis with its many consequences, angiospastic phenomena can cause a variety of nervous disorders, sometimes associated with true uremic symptoms. In view of this, each individual case deserves careful study.

Due to impaired renal function, uremia develops - autointoxication syndrome, which can be acute or chronic. The mechanism of its development is quite complex: uremic disorders occur with renal failure, which is associated with self-poisoning of the body with products of protein metabolism and toxic substances.

Uremia is accompanied by homeostasis disorders, hormonal disorders, and malfunction of all internal organs. This condition is an emergency and requires immediate attention to specialists. Normally, harmful compounds are neutralized and excreted along with urine. With uremia, there is a delay in protein breakdown products, which has a pronounced toxic effect on the human body.

The main causes of uremia:

  • bacterial, viral infections;
  • acute or chronic kidney disease;
  • intoxication of the body;
  • damage to the pelvic organs;
  • blockage of renal vessels;
  • alcoholism, drug addiction;
  • benign, malignant tumors of the urinary organs;
  • urolithiasis disease;
  • chronic prostatitis, prostate hyperplasia, prostate tumors in men.

Many kidney diseases occur with uremia, which can develop acutely or gradually. Metabolic products accumulate in the body. The level of urea in the blood increases. The concentration of organic substances changes, most of which are highly toxic, damage internal structures, and disrupt the normal course of important processes.

In addition to urea, other substances also accumulate:

  • ammonia;
  • pyridine derivatives;
  • aliphatic amines;
  • phenols;
  • acetone;
  • oxalic acid;
  • hormonal substances;
  • lipochromes;
  • creatinine;
  • indole


Acute uremia most often develops due to kidney disease and other chronic pathologies: interstitial nephritis, glomerulonephritis, pyelonephritis, polycystic condition, prostate adenoma, urolithiasis, diabetes mellitus. In men, symptoms of uremic coma are more common. This is due to the widespread prevalence of urological diseases, including infectious ones.

Metabolic products destroy cells and contribute to tissue damage of internal organs, including the heart muscle. This leads to cardiovascular disorders and depression of the central nervous system. Azotemic uremia is accompanied by an increase in creatinine in the blood, intestinal atony and can result in intestinal obstruction.

Chronic uremia develops at the last stage of diffuse kidney damage and renal failure. This condition threatens human life. If timely medical assistance is not provided, death is possible.

Due to the increased load on the kidneys and compression of the urinary organs by the uterus, uremia is often diagnosed in the last stages of pregnancy in women. Patients complain of difficulty urinating, stagnation of urine. During an ultrasound examination, specialists detect deposits of mineral salts in the kidney structures. Elevated urea in tests confirms the diagnosis. After the birth of the child, the woman’s condition usually normalizes, but medical supervision and preventive diagnostics are required.

Additional signs

Uremia usually progresses gradually. Patients complain of decreased appetite, increased thirst and increasing weakness. Later other symptoms appear:

  • headache;
  • vomiting, nausea;
  • memory impairment;
  • decrease in body temperature;
  • puffiness of the face;
  • voluntary muscle twitching;
  • physical weakness, lethargy;
  • dry skin, brittle hair and nails;
  • pale face;
  • decreased vision and hearing;
  • the appearance of a characteristic white coating on the skin due to excess urea;
  • tendency to bleed;
  • the appearance of ammonia odor from the mouth;
  • breathing disorders;
  • decrease in blood pressure.


Due to impaired kidney function, toxins begin to be released through the gastrointestinal tract, which is accompanied by repeated vomiting and prolonged diarrhea. Nitrogen metabolites accumulate in tissues and begin to be released through the mucous membranes and skin, causing an inflammatory process. Due to irritation of the membranes of internal organs, complications develop in the form of colitis, uremic gastritis, and pericarditis. Intoxication syndrome disables the liver and leads to severe anemia. Patients may be in a state of lethargy for a long time, and then begin to behave nervously, excitedly, or even aggressively.

Due to an increase in the concentration of uric acid and ammonia, unbearable skin itching occurs. When scratching, tissues are injured and a secondary infection may occur. In advanced forms of uremia, ulcerative defects occur. This condition can be accompanied by a dangerous infectious process, which for people with diabetes and weakened immunity often ends in death or bleeding - both external and internal.

Against the background of uremia, the fragility of blood vessels increases, and the function of hematopoiesis may be inhibited. Toxic compounds begin to be released through the salivary glands, the mucous membrane of the respiratory tract, and provoke the development of infectious diseases: tracheitis, laryngitis, stomatitis, bronchitis. The terminal stage is accompanied by a decrease in blood pressure.

Survey

Experts make the diagnosis based on examination data, patient complaints and examination results. If the development of uremia is suspected, the following studies are prescribed:

  • laboratory diagnostics of blood and urine;
  • Ultrasound of the kidneys and other urinary organs;
  • CT, MRI of internal organs;
  • immunological blood tests;
  • Reberg-Tareev test;
  • study of excretory function of the kidneys;
  • kidney biopsy.


Diagnostics is extremely important for assessing the severity of the patient’s condition and planning further treatment. You should not refuse a comprehensive examination and procedures recommended by your doctor. It is necessary to begin treatment as soon as possible to stop the progression of uremic disorders and to cleanse the body of accumulated poisons.

Making a diagnosis does not cause difficulties if the patient has a history of chronic glomerulonephritis, pyelonephritis and the detection of corresponding changes in research results.

Laboratory diagnostics make it possible to determine the characteristic changes characteristic of renal failure and other kidney pathologies. In a general analysis, specialists detect signs of a decrease in the amount of hemoglobin, as well as red blood cells. The number of leukocytes in the blood increases, while the number of lymphocytes and platelets decreases. Possible increase in ESR. In the leukocyte formula, a neutrophil shift to the left is observed.

The detection of polyuria and nocturia in urine tests indicates the initial stage of renal failure. Subsequently, specialists detect anuria. Protein, red blood cells, and signs of cylindruria appear in the urine. At the same time, glomerular filtration is reduced, as is urine osmolarity.

The severity of renal failure can be determined by the level of creatinine and urea. Signs of azotemia gradually increase, the amount of sodium and calcium decreases, while the concentration of peptides, phosphorus, magnesium and potassium increases, and the amount of indican increases, which indicates the progression of a severe form of chronic renal failure.

Nutrition and treatment

Therapeutic nutrition plays a key role in the course of chronic renal failure and uremia. The diet allows you to maintain a satisfactory condition of the patient and inhibits the development of the disease. Even with long-term kidney diseases, diet therapy can improve the prognosis and delay the onset of renal failure.

Diet requirements:

  • restrictions in the protein diet while preserving foods rich in essential amino acids;
  • introduction of a sufficient amount of vegetables, fruits, herbs;
  • limiting salt, spices, excessively fatty and fried foods, smoked foods;
  • a sufficient amount of vitamins, minerals and other nutrients;
  • high daily calorie content due to carbohydrates and fats, which prevents the breakdown of its own protein and the appearance of severe intoxication.

Treatment of uremia is symptomatic, aimed at combating pathological signs (bleeding, increased blood pressure, pain in joints and muscles, decreased vision, hearing, neurological manifestations, purulent-septic complications). Specialists are doing everything to achieve long-term remission.

Therapeutic actions are aimed at combating the underlying disease. It is important to avoid or delay the onset of uremic coma, which often ends in the death of the patient. Specialists monitor the concentration function of the kidneys, vascular patency, creatinine and urea levels. To restore homeostasis, the water-salt balance of the blood and azotemia are corrected using sodium bicarbonate. For oliguria, diuretics are prescribed under the control of diuresis. Antihypertensive drugs help normalize blood pressure and avoid vascular complications.

In the terminal stage, hemodialysis is performed - a procedure to cleanse the blood outside the kidneys. If signs of bleeding are observed, specialists use calcium supplements, aminocaproic acid and vitamin K. To restore protein metabolism, patients are prescribed anabolic hormones. They are taken in a course of 10–20 days under blood pressure monitoring. Such drugs can increase arterial hypertension and lead to fluid retention. If the patient's condition worsens, specialists reduce or cancel anabolic steroids. Severe anemia is an indication for the prescription of cobalt and preparations containing iron.

Prevention

Prevention may include measures aimed at preventing the development of kidney disease or reducing the number of relapses. Uremia develops mainly against the background of infectious and inflammatory processes in the renal tissue. To prevent their occurrence, it is recommended to monitor your own health, regularly treat urological diseases, preventing the infection from penetrating from the bladder and urethra through the ureters to the kidneys.

In the presence of pyelonephritis, glomerulonephritis, regular drug therapy is carried out. The earlier you start treatment, the less the disease affects the functionality of the kidneys and the entire urinary system.

Basic principles of prevention:

  • try to avoid hypothermia, especially the legs and lumbar region;
  • promptly treat urogenital infections, inflammation of the bladder and urethra;
  • give up tight trousers, jeans and underwear made of synthetic compressive materials, which impair blood circulation in the pelvic area and lead to congestion;
  • do not hold back urination so that urine does not stagnate in the bladder for a long time;
  • drink 2–3 liters of purified water daily;
  • do not refuse antibiotic therapy if infections of the kidneys and other urinary organs are detected;
  • Perform ultrasound diagnostics regularly if you are predisposed to developing kidney disease or have chronic diseases.

Preventive visits to a urologist and other specialized specialists are mandatory if you are prone to uremia and inflammatory and infectious diseases. The doctor can detect signs of illness and deterioration in health at an early stage and prevent relapse or severe complications. Be sure to follow a diet that will help maintain kidney function. It is recommended to limit animal protein, especially processed meats. They promote the formation of uric acid and stone deposition.

Salt your food less. Sufficient amounts of salt are found in regular foods and even in drinking water. There is no need to use salt in large quantities. It can be completely excluded from the diet so as not to provoke the appearance of edema and fluid accumulation in the tissues.

Try to eat natural foods and eat boiled or baked low-fat fish several times a week. Replace animal fats with vegetable fats. This will reduce the number of free radicals that cause cancer, including in the urinary system. Kidney diseases and uremic disorders greatly suppress the activity of the immune system. Be sure to include fresh vegetables, fruits and herbs, ginger, and citrus fruits in your diet. Replace simple carbohydrates (baked goods, sweets) with complex ones - cereals, fiber. Take vitamin complexes and anti-inflammatory preparations in courses (as agreed with your doctor).


Watch your drinking regime. Insufficient fluid has a negative effect on kidney function. The adrenal glands cease to perform their basic functions and maintain good hematopoiesis. The main signs of a lack of fluid are dry mouth and a regular feeling of thirst. When there is a lack of water, urine acquires a pungent odor, becomes concentrated, and single or multiple stones begin to form. Urolithiasis often provokes blockage of the renal arteries and veins, causing acute uremic disorders.

Plants for healing and treating kidneys

Traditional treatment of kidney pathologies and uremic disorders can only be used in combination with drug therapy and diet. Medical prescriptions must be carried out with maximum accuracy. Drug therapy can be used as a prophylactic agent to prevent the development of infectious diseases and frequent relapses of inflammatory processes in the kidneys.

To cleanse the body of toxins, you can use decoctions and infusions of herbs with a diuretic effect: angelica, horsetail, bearberry. These plants also normalize blood flow to the pelvic organs, so they can be used for other urological and gynecological diseases. Chamomile, St. John's wort and mint can be used to suppress the inflammatory process, destroy germs and bacteria that enter the urethral mucosa. If you are not allergic, eat a teaspoon of natural honey every day on an empty stomach, which contains active substances that inhibit the development of infection.

Goals of herbal medicine for kidney diseases and uremia:

  • stop or slow down the progression of the underlying disease;
  • reduce the number of relapses per year;
  • prevent complications;
  • enhance the therapeutic effect of the use of medications and medical procedures;
  • improve the patient’s quality of life;
  • improve general condition, strengthen immunity;
  • avoid accumulation of toxins.

It is recommended to prepare medicinal raw materials yourself or buy only from trusted pharmacies. Some plants that grow near the road accumulate toxic compounds and can make you feel worse. For kidney pathologies, especially infectious diseases, it is useful to use bearberry, which has antiseptic and anti-inflammatory properties. Its leaves help cope with pyelonephritis and make it possible to limit the amount of antibiotics used.

Uremia is a pathological condition that occurs due to the accumulation of protein metabolic products in the blood, which should normally be excreted in the urine.

Symptoms of uremia

At the initial stages of the disease, uremia is characterized by general clinical symptoms, such as weakness, fatigue, and headache. When examining blood, an increased content of nitrogenous wastes is found in it: residual nitrogen, urea, creatinine.

In a later period, urea and other nitrogen-containing substances accumulating in the blood begin to be intensely secreted by the skin (“uremic powder” or “frost” on the skin), mucous and serous membranes, irritating them. As a result, symptoms of uremic gastritis (anorexia, nausea, vomiting), colitis (diarrhea), laryngotracheitis, pleurisy, pericarditis (usually already in the terminal period) appear.

Due to intoxication, the functions of the liver and bone marrow are impaired, anemia and thrombocytopenia increase, a tendency to bleeding appears, and vision is impaired (uremic neuroretinitis).

Appearance of a patient with uremia (uremic powder on the skin)

Causes of uremia

The immediate cause of uremia is acute or chronic renal failure. That is, all the reasons that lead to the above pathologies are factors in the development of uremia.

It is necessary to start with kidney cancer, since they are the most often causative factors of uremia. As a result of the cancerous process, the blood-uremic barrier may be destroyed, and urinary toxins, which are normally excreted in the urine, enter the blood, causing this clinical condition.

The next group of causes of uremia can be considered inflammatory processes of the kidneys. They are divided into purulent and autoimmune. If we talk about purulent processes, then it is necessary to recall diseases such as pyelonephritis with subsequent kidney abscess. In addition to nonspecific clinical symptoms, they will experience complaints of pain in the kidney area and increased body temperature. If we are talking about autoimmune diseases, such as glomerulonephritis, then in addition to general clinical symptoms, an increase in blood pressure may be observed.

Very often, uremia can be caused by various forms of urolithiasis. Most often it develops with complete blockage of the ureter in its different parts. At the same time, urine accumulates in the pelvis, increasing intrarenal pressure, which leads to the destruction of the glomerular membranes and the release of kidney toxins into the blood. Patients with this disease are bothered by sharp pain in the lumbar region, which, as a rule, is not constant, but paroxysmal in nature. Characteristic renal colic makes it possible to make the correct diagnosis.

Very often, the causes of uremia are not nephrological, but systemic diseases. For example, kidney damage due to diabetes, hypertension or tuberculosis can also cause destruction of the structure of the renal tubules, resulting in a uremic state. In order to identify such diseases, it is necessary, first of all, to pay attention to general blood and urine tests.

Another group of causes of uremia, which occur mainly through acute renal failure, are various poisonings and intoxications. As for poisoning, in our region the most common is damage from toxins from poisonous mushrooms. Therefore, you need to be extremely careful when preparing mushrooms, especially those that you collect yourself.

As for chemical systemic intoxications, medical practitioners most often have to deal with poisoning from alcohol surrogates.

Clinical diagnosis of uremia

First of all, if uremia is suspected, it is necessary to perform a biochemical blood test to determine the level of urea and creatinine. These indicators are direct markers of uremia. Since these substances are products of protein metabolism, in case of uremia it is necessary to determine the level of total protein in the blood.

After uremia is determined through biochemical tests, it is necessary to conduct a whole list of laboratory and instrumental examinations in order to find out the cause of this clinical condition. First of all, it is necessary to conduct a general urine test. Quite often, only based on the results of this study, it is already possible to determine the cause of uremia. For example, if a large amount of salts is detected in a general urine test, this makes it possible to assume that the patient has urolithiasis. With an increased number of bacteria in the patient’s urine, we can talk about complicated pyelonephritis.

If a general urine test makes it possible to only assume the presence of a particular disease, then to verify an accurate diagnosis it is necessary to carry out a wide range of laboratory and instrumental research methods. Typically, urologists start with ultrasound because it is inexpensive and covers a wide range of kidney diseases. Using ultrasound, you can diagnose pathologies such as urolithiasis, kidney tumor and abscess of this organ.

Ultrasound of the kidneys is a mandatory method of examination for uremia

If ultrasound does not provide an accurate answer regarding the underlying disease, then other, more specific research methods must be used. To determine the functional state of the kidneys, excretory urography is used. It makes it possible not only to make a diagnosis of urolithiasis, but also to determine how much the stone blocks the lumen of the ureter. Computed tomography with contrast of the urinary tract can be used for the same purpose.

Careful laboratory diagnosis is more important in cases where the cause of uremia is not organic kidney pathology, but systemic diseases such as tuberculosis, diabetes mellitus or hypertension. In these cases, it is very important to conduct a clinical blood test for sugar and bacteriological examination of biological fluids for Mycobacterium tuberculosis.

Syndromic treatment of uremia

In fact, uremia is a syndrome that includes a huge number of symptoms, so syndromic rather than symptomatic treatment is used to correct it. It may consist of drug or device therapy.

As for the drug treatment of uremia, it consists of rehydration and detoxification therapy. For this purpose, patients are prescribed intravenous infusions of saline, glucose, rheosorbilact and rheopolyglucin. The number of drugs is determined by the severity of the patient’s general condition. As a rule, the prescription of such drugs reduces clinical symptoms, which resume soon after their discontinuation. At the same time, quite often there are situations where symptomatic treatment of uremia remains the patient’s only hope, since pathogenetic and etiological therapy no longer makes any sense.

Drug treatment of uremia is the method of choice only in the initial stages of the disease or when it is not possible to use modern, more serious methods of treatment. Today, hematological dialysis should be considered the priority treatment method for uremia. To carry it out, a special device is used, which among a wide range of people has the trivial name “artificial kidney”. In fact, the device is a kind of hemodialysis membrane through which human blood is passed and at the same time all pathological metabolic products are removed from it.

There is a popular belief that an “artificial kidney” can be addictive, so many patients are simply afraid to go to medical institutions for such help. In fact, this information has absolutely no scientific meaning. As practice shows, for diseases such as obstruction of the ureter by a calculus, the use of hemodialysis is a single episode in a person’s life. After using this device, the patient’s normal general condition is restored, doctors begin etiological treatment aimed at the primary cause of the pathology.

As for treatment with folk remedies, it is not recommended for such pathology. The fact is that delay in acute or chronic renal failure can result in an unfavorable outcome for the patient, so such patients must immediately contact specialized medical institutions.

Complications of uremia

In principle, uremia itself is already a complication of renal failure, but it should be noted that it is not the final link in the development of one pathological process. In the absence of normal treatment, urinary toxins, which are found in large quantities in the blood, begin to pass through the blood-brain barrier, where they affect the nerve structures of the brain. Patients develop a condition called renal encephalopathy. At this time, the above symptoms are accompanied by complaints of severe headache, tremors of the limbs, memory loss and periodic loss of consciousness. Over time, patients become inhibited, react poorly to others and do not understand where they are. This clinical condition is called stupor.

If at this stage the patient is not hospitalized in the intensive care unit, then stupor will slowly turn into renal or uremic coma. The patient loses consciousness, noisy deep breathing occurs (Kussmaul breathing), Cheyne-Stokes type breathing is less common, a strong odor of ammonia emanates from the patient, the pupils are constricted. In such a condition, the patient, except for pulse and breathing, no longer exhibits any signs of life. The main problem is that even with adequate treatment at this stage it is simply impossible to assess the patient’s future prognosis. Moreover, even if a person manages to emerge from a state of uremic coma, in the future one must be wary of intellectual failure. In addition, it is necessary to remember that with renal coma there is a fairly high mortality rate.

Which doctor should I contact if I have signs of uremia?

As has already become clear, seeing a doctor for uremia is not only mandatory, but simply vital. But in order not to waste time, which in any case will affect the patient’s condition, he needs to correctly navigate which specialist to contact first.

If a patient has symptoms of uremia, which complement the symptoms of urolithiasis, then such a patient needs to consult a urologist. Only he will be able to correctly diagnose and determine further treatment tactics.

In the case when the symptoms of uremia are accompanied by complaints that may be associated with oncological pathology, the primary specialist is an oncologist, whose task is to choose the correct tactics for managing the patient.

If a patient has chronic systemic diseases, such as atherosclerosis or diabetes mellitus, before consulting a urologist, he needs to contact his local physician so that he can adjust the treatment regimen or refer him to a specialist.

Ed. urologist, sexologist-andrologist A.N. Plotnikov

Uremia is one of the serious diseases associated with poisoning of the body by products of protein metabolism due to impaired kidney function. As a result, their functionality rapidly decreases, causing the deposition of waste and changes in the chemical composition of the body.
What is uremia? What symptoms accompany it, and what treatment is required?

It is customary to distinguish acute and chronic forms of uremia. Each of them is accompanied by characteristic symptoms.

Signs of an acute form of uremia are a decrease in the volume of urine excreted. This is due to damage to parts of the nephron by poisons. There are signs of severe renal dysfunction, to which are added disturbances in the body’s vital functions.

Laboratory tests reveal azotemia with an increased concentration in the blood of nitrogenous products of protein metabolism:

  • creatinine;
  • indicana;
  • urea;
  • ammonia.

At the same time, changes in the level of electrolytes in the blood are detected, acidosis and fluid retention are recorded.

In addition, the acute form of uremia causes dysfunction of internal organs, which is accompanied by symptoms such as heart rhythm disturbances, pulmonary edema, digestive and nervous system disorders.

An attack of acute uremia lasts from 5 to 10 days, but sometimes it drags on for up to a month or more. Full recovery and restoration of working capacity in most cases takes up to a year.

Chronic uremia is the outcome of many severe kidney diseases. Patients become drowsy, apathetic and easily excitable. Their skin condition worsens, their hearing decreases, and bleeding appears. The disease leads to irreversible damage to the kidney.

Main signs of the disease

Uremia is indicated by increasing symptoms of poisoning. The primary sign of the disease is lightened urine, the excretion of which increases. Laboratory tests performed during this period show a decrease in the urine content of chlorides and urea retained by the body. Gradually, the volume of diuresis decreases, and the retention of nitrogenous waste provokes an increase in the level of nitrogen in the blood.

intoxication of the body

The precomatose state lasts for weeks or months and often ends in uremic coma. Primary symptoms are observed in the stomach and intestines:

  • lack of appetite;
  • unquenchable thirst;
  • bitter taste and odor from the mouth.

Uremia is accompanied by the accumulation of urea not only in the blood, but also in saliva. Therefore, the patient develops a bitter taste in the mouth. Saliva is exposed to bacteria, causing a person's mouth to smell bad. Urea penetrates the gastric juice and accumulates there causing:

  • gastritis;
  • colitis;
  • nausea;
  • vomiting after eating.

The digestive system begins to suffer due to poisoning of its walls with ammonia salts. The patient refuses to eat, but over time, vomiting appears on an empty stomach. Some patients experience bloody diarrhea.

At some point, new symptoms appear, already from the CNS (central nervous system):

  • apathy;
  • stiffness of movements;
  • lethargy;
  • severe fatigue;
  • feeling of heaviness in the head;
  • insomnia;
  • calf muscle cramps;
  • fainting.

With the onset of uremic coma, the respiratory system begins to suffer. Breathing becomes noisy, and the patient's deep inhalation is followed by a short exhalation. With the onset of the final stage, the ability to breathe disappears completely.

Symptoms of uremia also manifest themselves in changes in the skin, such as:

  • plaque on the skin;
  • dryness and flabbiness;
  • trophic ulcers.

Therapy methods

Treatment of uremia is symptomatic. To relieve signs of poisoning and related problems, the following methods are used:

  1. Washing the stomach and intestines.
  2. Diet.
  3. Bleeding.
  4. Use of drugs.
  5. Hemodialysis.

As part of the treatment, the patient is given a lavage of the gastrointestinal tract, removing nitrogenous products of protein metabolism. To do this, use enemas and saline laxatives. The patient is prescribed a special diet with limited protein foods - primarily meat and dairy products. Treatment is accompanied by intravenous injections of a 40% glucose solution. Bloodletting is performed to remove toxins and also reduce blood pressure.

Drug treatment for uremia includes injections of sodium chloride into a vein, since vomiting removes chlorine from the body. For the same purpose, increase your daily salt intake. If cardiac dysfunction is present, the patient is prescribed Strophanthin. Sodium bromide is used to eliminate itching on the skin, and seizures are stopped with calcium chloride.

The choice of specific drugs and their dosages depends on the severity of symptoms. Drug treatment is used for stage I uremia, when more serious methods are contraindicated.

"Artificial kidney"

In the later stages of uremia, hemodialysis (also called an “artificial kidney”) may be used. The procedure involves using a special apparatus through which the blood is pumped, removing urea, toxic substances and excess fluid. As a result, a person’s electrolyte and acid-base balances are normalized, and blood pressure is restored. When the patient's condition improves, the underlying cause of the disease is treated.

It is important for people with kidney failure to know what uremia is, since they have an increased risk of developing this pathology. The disease leads to severe poisoning of the body, which damages all internal organs and systems. Patients require treatment in the form of hemodialysis and medications, otherwise the person may die.

The term Uremia refers to the poisoning process of various protein products.

This condition may be the result of a serious disorder.

Sometimes the popular name “urine self-poisoning” is used, which accurately reflects the essence of the problem.

The disease is characterized by quite severe damage to the regulation of the human body and extremely complex pathogenesis.

Basic information about the disease

From a scientific point of view, this is not a disease. Uremia is a clinical syndrome that develops against the background of dysfunction of the urinary system.

As a result, toxins accumulate in the blood, causing poisoning of the body, called autointoxication. Uremic intoxication syndrome can be acute or sluggish chronic.

The acute form occurs suddenly and develops rapidly. It causes severe impairment of kidney function. Various disorders occur in the tissues of the body.

The concentration of toxic substances in the blood is growing rapidly. Such toxins are c, ammonia, and other nitrogenous compounds.

The acid-base balance is disturbed. Therefore, the earlier treatment is started, the less likely complications will occur.

Chronic uremia is more dangerous due to changes in the structures of the renal tissues. This disease disrupts the functioning of the kidneys, which leads to the most dangerous consequences:

  • water and salt metabolism are disrupted;
  • control over osmotic pressure is lost;
  • Dystrophic and metabolic processes intensify.

Causes of illness

Various reasons lead to uremia. Acute pathology is caused by:

  • allergic, nervous or painful shock;
  • rapid hemolysis of red cells in the blood;
  • prolonged tissue compression;
  • allergies accompanied by cell destruction.

The chronic form of uremic disorder results from long-term effects on the kidneys during chronic:

  • glomerulonephritis or pyelonephritis;
  • polycystic ovarian disease or gynecological diseases;
  • diabetes, especially;
  • prostate adenoma or prostatitis;
  • stone disease of the urinary tract and kidney tissue.

This pathology can affect anyone who has diseases that provoke it. The risk group for developing pathology includes women during menopause or during pregnancy.

Uremia may also occur in cases of excessive sexual activity.

Manifestation of the clinical picture

Symptoms of uremia can be recognized by disorders of the gastrointestinal tract. Urea, which accumulates in the stomach, leads to uremic colitis and gastritis.

Then there are attacks of vomiting after eating, and blood in the stool. Stiffness of movement, sleep disturbances, weakness, and fatigue may also occur.

As the disease progresses, twitching of the eye and facial muscles and breathing problems are observed. During the terminal stage, breathing periodically completely disappears.

Body temperature drops to 35 degrees. Itching occurs, foci of inflammation and trophic ulcers appear. The skin becomes dry.

With a sluggish process, the work of the renal tissues is slowly disrupted. This allows the patient to choose the treatment method. But this form of the disease is dangerous because the symptoms do not appear as pronounced as in the case of an acute course.

Symptoms of uremic coma

Signs of increasing coma:

  • puffy face;
  • pastiness of the hands and feet;
  • pallor, dry skin;
  • severe itching of the skin with traces of scratching on it.

Sometimes a powdery white coating appears on the skin of the sick person. These stand out. Traces of internal hemorrhages also appear on the body.

Diagnostic methods

Uremia is diagnosed taking into account previous renal pathologies, laboratory tests, and hardware examinations.

The main thing for the study is a blood bioanalysis. As the study progresses, the amount of nitrogenous substances with urea and acid, as well as creatinine, is determined.

The analysis shows the concentration of electrolytes. The blood is examined to determine the content of fat, glucose and protein, thereby determining the degree of metabolic disorder. These indicators are considered markers of uremic disorder.

After a biochemical study of the analysis, if it shows uremia, a series of further examinations are carried out. The necessary analysis is a general urine test.

It is also important to conduct a blood test for sugar, a test for.

A general urine test is required.

In case of renal disorders leading to uremia, the urine is usually yellow in color, contains little urea, and has a small amount of urine.

Based on the results of these studies, the cause of the disease can be determined. For example, a lot of salts in the urine suggests that the patient has stone disease. And the presence of microorganisms gives rise to suspicion of pyelonephritis.

Often, studies such as or are prescribed to confirm the diagnosis. Tomography with urography allows you to determine the degree of blockage of the lumen of the ureter.

Methods of therapy

When treating uremia, a method such as is used. In some cases it is done. Or removal, if the second organ is working more or less normally.

Treatment of coma

If a patient has a uremic coma, it is necessary to reduce the level of intoxication as quickly as possible by washing the stomach and intestines with a solution of sodium bicarbonate, and also perform a couple of alkaline enemas.

To correct water and electrolyte balance, infusions of glucose and sodium chloride solutions are necessary.

The amount of fluid administered is 2-3 liters, but if the patient has edema, the amount of fluid is reduced and prescribed.

Acidosis is neutralized by infusion of sodium bicarbonate solution, and hyperkalemia with calcium gluconate or calcium chloride, which is also administered intravenously.

High blood pressure is reduced by pentamine, which is added to saline solution, administered with a dropper, as well as a solution of aminophylline by intravenous injection or dibazole.

If a patient experiences convulsions, Seduxen or its analogues are usually used intramuscularly. If pericarditis develops, prednisolone is prescribed.

The only way to prolong the life of a patient in the stage of uremic coma and at the initial stage is hemodialysis. The difference lies in the dosage of drugs.

Application of hemodialysis

This treatment is carried out for acute or chronic forms of uremia.

This method involves purifying blood through a special filter.

The device used for this is called an “artificial kidney.”

After this method of cleansing, toxins are removed from the blood, water metabolism is normalized, and electrolytic balance is normalized.

The device used to purify the blood is connected to the patient’s body via a venous method.

In this case, the blood, passing through the filters, returns to the vessels of the body after complete cleansing.

The cleansing procedure lasts 3-4 hours. The number of cleansing procedures depends on the severity of the disease. Sessions range from 10 to 50.

But it should be remembered that this method is unacceptable for the treatment of patients with malignant tumors and mental disorders. The use of hemodialysis is also contraindicated for those who suffer from bleeding tendencies, hemophilia, or failure of one of the limbs.

Traditional methods of treatment for uremic intoxication are not recommended. After all, traditional medicine works slowly, and this can turn out disastrously for the sick person. Even death is possible. That’s why experts recommend going to the hospital.

Kidney transplant

This operation is performed as a last resort if hemodialysis does not lead to a positive result. Doctors have no other way to save the patient. The transplant operation prolongs the patient's life by several years.

When treating children, this treatment method is the main one for the reason that hemodialysis delays mental and physical development.

It is more advisable to do a transplant between the ages of 15 and 45 years. For children under 15 years of age, kidney transplantation is performed only for health reasons.

But for patients over 45 years of age, such treatment is dangerous, since there is a high probability of complications in the form of blood clots, diabetes, and the development of a heart attack.

To preserve the transplanted organ, the patient must receive periodic courses of immunosuppressive therapy throughout his life.

Dietary requirements

Hemodialysis is combined with dietary nutrition, which helps restore the balance of substances in the tissues of the body.

The diet should contain a sufficient amount of animal meat containing proteins. Sausage, smoked meats, and canned food should not be consumed.

It is necessary to limit potassium-containing products.

It is present in raisins and bananas, all citrus fruits, oatmeal and greens. Potassium is also present in dried apricots, various nuts and chocolate.

The daily volume of liquid consumed is also limited, including not only water and tea, but also liquid first courses.

More than 8 g of salt per day is unacceptable, and it is better to avoid it completely. If the patient is in serious condition, it is better to feed him pureed vegetables, fruits, and cereals cooked in milk.

The same menu should be available after kidney transplantation or kidney transplantation.

Preventive measures

To prevent the development of uremia, it is necessary to avoid the causes that provoke its development. To do this, it is necessary to monitor the general condition of the kidneys and avoid hypothermia.

Be examined every 6 months. In addition, in case of disturbances in the functioning of the renal system, even minor ones, it is necessary not only to follow all the recommendations of doctors, but also to eat right and drink plenty of fluids.

It is preferable to drink non-carbonated mineral water. You can also drink natural juices, green teas, herbal infusions or decoctions.

If such a misfortune happens to someone close to you, you need to be patient and support the patient.

The patient requires hygienic baths to cleanse the skin of secreted toxins and prevent inflammation.

Bed linen also needs to be changed more often, and your face should be wiped several times during the day with a napkin soaked in a solution of baking soda. Cleansing procedures for the stomach and intestines are also carried out.

Possible consequences

Uremia causes great harm to brain tissue. The patient experiences disturbances in memory and sleep patterns, and concentration is weakened.

Progressive pathology entails the development of encephalopathy. Speech disturbance or absence is often observed.

The sick person loses his appetite. His urine volume is gradually decreasing, his limbs are severely swollen, his liver is working intermittently, and the functioning of his bone marrow is deteriorating. This leads to pathologies such as anemia or thrombocytopenia. The functioning of the organs of vision and hearing is greatly deteriorated.

A dangerous consequence of uremia is coma if the patient is not provided with timely assistance by specialists.

Uremia is still an incurable pathology, despite progress in this area. This is a very dangerous disease. Poisoning entails disturbances in myocardial tissue, brain cells and liver, which is very dangerous. Therefore, it is necessary to begin its treatment in a timely manner.