Uremia

The word comes from the Greek uremia and refers to the occurrence of uric substances in the blood above the normal values ​​and the clinical picture is evolving, uremia, ie poisoning by so-called uremic toxins, which in advanced kidney failure, a so-called renal failure, occur.

The full clinical picture of uremia can ( over years developing ) be acute (5-10 days after acute renal failure) or chronic.

Symptoms

Clinically, in the foreground are a therapy-resistant pruritus and signs of enterocolitis. It is often associated with problems of the gastrointestinal tract such as nausea, vomiting, and bleeding due to inflammation of the stomach ( gastritis) and inflammation of the bowel (colitis). At the heart can cause pericardial inflammation with the stethoscope hear a clearly audible pericardium rubbing uremia. As a complication may in turn result in heart failure. In the further course of the disease may result in a potassium excess, resulting in cardiac arrhythmias. Pulmonary edema ( " water in the lungs " ) with shortness of breath and bluish discoloration of the central violet to skin, mucous membranes, lips and / or fingernails occurs in some cases. Since urea can damage nerves in higher concentrations, it can cause neurological disorders such as uremic pathological changes in the brain, which can range up to coma of personality changes, sleep disturbances, agitation conditions, slowing down. Also, peripheral nerves can be disrupted, which is clinically manifested as a disease of the entire outer nervous system. Also blood formation is disturbed, leading to anemia. Striking is also the smell of the breath after urine ( fetor uraemicus ) - but only occurs when ureasehaltige bacteria are located in the mouth.

Therapy

A uremia as a clinical picture usually consists of stage IV chronic renal failure patients whose treatment is the improvement of uremia. Therapeutically, the improvement of renal function in the foreground. In chronic renal AT1 antagonists and other antihypertensive drugs such as calcium antagonists and beta-blockers are ACE inhibitors used. Also known as hemodialysis popularly dialysis is a treatment option for advanced kidney disease and is moored to creatinine value, the urea concentration in serum, the serum potassium, calcium and phosphate, and clinical symptoms. In addition, so far a strict diet was prescribed to avoid, for example, too high a protein, potassium ( by fruit juices, fruit) and phosphorus intake ( by Coke, pizza). But recent studies provide both the value of a strict restriction of protein intake as well as the value of a low-phosphate diet in question.