Disease uremia: what is it, symptoms, treatment
Uremia is a disease that develops in humans by reducing the functional activity of the kidneys. Paired organs no longer fully filter the blood from metabolic products, with the result that it accumulated a large quantity of urea and non-nitrogen. Uremia can be attributed to clinical syndromes, characteristic for certain diseases. The collection of symptoms allows you to quickly diagnose the pathology and provide treatment at an early stage. Nephrologists also produce uremia as one of the stages of renal failure. The absence of drug therapy leads to development of serious complications and death.
As the disease evolves
Uremia in humans is a result of the diseases, which in most cases affect the urinary system. Calyx, tubules and pelvis of the kidneys do not completely purify the blood of toxins, toxins and products of disintegration of fats, proteins, carbohydrates. Their concentration increases, causing self-poisoning of the body.
Clinical syndrome develops gradually. The severity of signs of toxicity depends on the chemical composition of the substance whose concentration in blood is the highest. Pathogenesis of uremia consists of several stages:
- In the bloodstream accumulated a significant amount of urea, blood pH shifts to the acid side on the background of decrease of specific weight of urine.
- Increased concentration of metabolites provokes the intoxication of internal organs, especially the liver and kidneys.
In the blood accumulate compounds that in a healthy person are displayed at each emptying of the bladder:
- oxalic and uric acid;
Urea under the influence of water hydrolyses to tiantou that are toxic to the human body compounds. They disrupt the membrane permeability of cardiac muscle to cause disorder of the cardiovascular system. The increased content of urea in the blood, depresses the Central nervous system. In humans, there is emotional instability, tremor of the extremities and fatigue.
Digestive disorders in uremia is associated with excessive concentration of creatinine in the blood. Nephrologists diagnose ezotericheskoe development of gastritis, which could grow in the intestinal and intestinal obstruction.
Intoxication is accompanied by a violation of hematopoiesis. A person develops iron deficiency anaemia, damages the renal parenchyma. This leads to the appearance of fresh blood or blood clots in the urine. In the absence of medical intervention in the body begin to Deposit mineral compounds, which contributes to the development of dehydration, less urination with small volume of allocated urine.
The causes of pathology
The main cause of uremia is always acute or chronic renal failure. In the structural elements of paired organs by various injuries does not fully filter the blood. Treatment of renal failure is aimed at the elimination of uremia, which in turn provokes the development of the salt diathesis and urolithiasis.
The clinical syndrome occurs irrespective of sex. Uremia is diagnosed as infants with congenital anomalies of the kidney and the elderly.
The most common causes of pathology are:
- injury of pelvic organs through prolonged or severe compression injury;
- poisoning poisons of plant and animal origin, heavy metals, caustic alkalis and acids, of pharmacological preparations;
- chronic alcoholism, drug addiction, toxicomania;
- viral and bacterial infections;
- intrauterine hypoxia of fetus;
- fluid and electrolyte imbalance.
Uremia precipitating factor is hypertension. High pressure accompanied by damage to blood vessels in the kidneys. This reduces their functional activity and impairs blood filtration. The same negative effect on blood vessels endocrine diseases such as hyperthyroidism and diabetes.
All diseases of urinary system can cause uremia, especially in the acute stage. These include:
- acute and chronic pyelonephritis, glomerulonephritis, haemorrhagic cystitis;
- prostatic hyperplasia;
- nephritic and nephrotic syndromes under various diseases;
- kidney stones and salt diathesis kidneys;
- malignant and benign tumors in the bladder, the ureters, urethra, kidneys and adrenal glands.
Uremic poisoning is often diagnosed in the third trimester of pregnancy. The growing uterus compresses the kidneys, and the urethra. This leads to the urination disorder, stagnation of urine and deposition of mineral compounds in the tubules, the cups and the pelvis. After the baby is born the mother quickly restored the work of the urinary system.
Types of clinical syndrome
Uremia is classified depending on the severity of the clinical syndrome:
- acute uremia;
- chronic uremia.
Pathology of the acute form develops with a sharp decrease in the functional activity of the kidneys. Blood quickly increases the concentration ofnitrogen, acetone, uric acid and its metabolites. Occurring acid-base imbalance, change the contents of electrolytes. Disrupted all vital systems. The duration of acute uremia varies depending on the disease or injury that caused the self-poisoning of the body.
Ezoterichesky chronic uremia inevitably occurs in chronic pathologies of the urogenital system. Patients diagnosed negative changes in the heart, blood vessels, bone and muscle tissues. Especially dangerous in the end-stage of chronic uremia, when it is not possible complete recovery of glomerular filtration.
Symptoms of uremia
As this clinical syndrome affects all systems of human activity, it is difficult to find a symptom that there wouldn't be uremia. What are the signs of intoxication a person will have, impossible to predict. It all depends on the immune status, sex, age, presence of diseases in the body. Nephrologists are the following symptoms of uremia:
- change the color and smell of urine the presence of blood, pus, flocculent sediment;
- frequent emptying of the bladder with the safe drinking mode;
- dragging pain in the abdomen and lumbar region radiating to the flanks.
As a rule, these signs of uremia develop in the initial stage of the pathological process. Increase in the bloodstream urea, acetone and nitrogen leads to more serious and dangerous symptoms:
- deteriorating appetite, reduced body weight;
- disrupted gastrointestinal tract: nausea, vomiting, flatulence, sour belching, heartburn, diarrhea or chronic constipation;
- urination negligible amount of urine, and this amount is constantly decreasing;
- there is a weakness, lethargy, drowsiness, confusion;
- develops hypothermia, the accompanying reduction in motor activity due to loss of strength;
- diarrhea in stool found streaks of blood or fresh blood;
- in the vomit, you also receive the blood, and cause this extremely dangerous stomach bleeding;
- vomiting most often occur in the absence of food in the stomach.
The main symptoms of uremia include a change of smell. From the skin and hair of a man in dire smell of ammonia from accumulated in the tissues of the urea. An unpleasant smell is felt even from the exhaled vapor.
Increasing the concentration of free ammonia and uric acid in the blood causes severe itching. Man can not long hold back and starts to brush the skin. On the resulting small wounds and scratches quickly associated bacterial infection. Inflammation is constantly enlarging, often become ulcers.
If man was not given medical assistance, there is damage to the muscle tissue. Develops tremor of upper and lower extremities, alternating with cramps. At the last stage of the pathology occurs uremic coma is the result of extensive self-poisoning of the body.
Diagnosis of the disease
At the initial stage of diagnosis of the nephrologist is to examine the patient, listens to complaints, is studying the disease in history. As the main cause of uremia is more likely to be inflammation in the genitourinary system, it is assigned to carry out extended biochemical analyses of urine and blood. These studies are informative, especially revealing the interpretation of the values of daily urine. What you can learn:
- if in urine significantly increased the concentration of mineral salts, the nephrologist suggests the presence of a saline diathesis and urolithiasis;
- the increase in the blood content of urea directly points to the development of uremia, the decrease in the concentration of red blood cells, platelets, and hemoglobin indicates that an inflammatory process.
Technicians always perform seeding biological sample in the culture medium. It is necessary to determine the type of pathogen, which could cause pyelonephritis, glomerulonephritis, kidney failure.
Patients displayed differential diagnosis at suspicion on presence of tumors in one of the departments of the urinary system:
- computed tomography;
- x-ray examination;
- magnetic resonance imaging;
The patient is the removal of a small piece of tissue for cytological and histological examination. This will help to determine the kind of the tumor is formed.
Therapy of acute and chronic uremia
Treatment clinical syndrome is aimed at eliminating the symptoms of uremia and is carried out in stationary conditions. For removal of urea, acetone and unbound nitrogen is used:
- hemodialysis or artificial kidney;
The blood is passed through a special device equipped with a membrane, and separated into plasma and healthy blood cells. Plasma with dissolved urea is removed and the platelets and red blood cells is placed back in the human body. For complete cleansing of blood is performed the procedures necessary to restore a time period.
But, as it is often not used in hemodialysis and plasmapheresis, urea and nitrogen continueto accumulate in the blood, while not resolved the main cause of uremia – a disease that caused the development of the pathological process.
Therapy clinical syndrome includes a complex of medical actions:
- bed rest;
- adhering to a balanced sparing diet;
- therapy using pharmacological drugs.
Excrete toxic compounds help solutions for parenteral administration. Their active ingredients bind to harmful compounds and evacuated from the body each time emptying of the bladder. The number of solutions depends on the state of human health, discovered toxins and their concentration in the blood of the patient. These medications are shown only at the initial stage of uremia. With worsening of the disease require a hard treatment.
In addition to the introduction of parenteral pharmaceutical preparations, the patient is assigned to lavage of the stomach and intestines. During the procedure are removed from the body of nitrogenous wastes. For the prevention of uremic encephalopathy practiced intravenous glucose. Their diet of the patient completely eliminated foods high in protein include meat and milk.
Differential diagnosis is sometimes carried out to assess the state of healthy kidneys, if necessary, removal of the second, causing the uremia. If the functional activity of the second body is confirmed, the patient shows a nephrectomy, or surgical removal of the contracted kidney. In the subsequent treatment is routine hemodialysis or transplant human donor kidney.
Complications of uremia
In acute or chronic poisoning of the body of uric and oxalic acids, urea, ammonia changes the composition of the blood. Red blood cells lose their ability to bind molecular oxygen and deliver it to the cells. As a result of a pathological process the most affected brain. In the absence of oxygen, begin to deteriorate and die neurons, upset the regulation of all vital systems.
If the concentration of toxic substances in the blood exceeds the norm, the person may experience auditory and visual hallucinations. The progression of the clinical syndrome becomes a cause of uremic encephalopathy. Its main symptoms include: disorders of speech and sensitivity, nervous excitability, unsteadiness of gait.
Uremia in the blood, there is a higher concentration of phenolic compounds. In this state, lack of medical care leading to gradual intoxication. Man withdraws deterioration of health on food poisoning, viral or bacterial infection, fatigue and postpones the visit to the doctor. At this time his kidneys are gradually destroyed, irreversible damage to their cells and tissues. The person are unable to remove fluid from the body – the amount of urination is reduced, and under the eyes and ankles edema. At the next stage of poisoning urea and ammonia develop stupor and coma.
Primary prevention of uremia – early treatment of diseases. This primarily refers to diseases of the genitourinary system. Even innocuous cystitis in the absence of medical therapy can be reborn in a chronic pyelonephritis or glomerulonephritis. These diseases are against the background of extensive inflammation, which often becomes the cause of renal failure and uremia.