Uremia - Causes, Symptoms and Treatment .MF .
uremia - a pathological condition which is caused by the accumulation of protein in the blood of metabolic products, which normally should be allocated with urine.
symptoms of uremia
In the initial stages of the disease is characterized by uremia common clinical symptoms, such as weakness, fatigue, headache.When a blood test show high content of nitrogenous wastes in it: the residual nitrogen, urea, creatinine.
In the later period, urea and other nitrogen-containing substances that accumulate in the blood begin to intensively allocated 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 in the terminal period).
violated due to intoxication of the liver, bone marrow, increases anemia, thrombocytopenia, there is a tendency to bleeding, impaired vision (uremic neyroretinit).
Exterior patients with uremia (uremic
immediate cause of uremia is an acute or chronic renal failure.That is, all the reasons which lead to the above pathologies, and are factors in the development of uremia.
Start necessary with oncological diseases of the kidneys, because they are most often the causal factors of uremia.Because cancerous process can degrade gematouremichesky barrier urinary and toxins that are normally excreted in the urine into the blood, causing said clinical condition.
Another group of causes of uremia may be considered inflammation of the kidneys.They are divided into purulent and autoimmunity.Speaking of purulent processes, it is necessary to remember diseases such as pyelonephritis with subsequent kidney abscess.In addition to non-specific clinical symptoms, when they will be observed complaints of pain in the kidneys and increased body temperature.If we talk about autoimmune diseases, such as glomerulonephritis, when they rise in blood pressure can occur in addition to general clinical symptoms.
Very often uremia may be caused by different forms of urolithiasis.Most often it develops in a full blockade ureter in its different departments.Thus, the urine accumulates in the pelvis, intrarenal increasing pressure, which leads to the destruction of the membranes of the glomeruli and renal toxins from entering the bloodstream.Patients with this disease bother sharp pain in the lumbar region, which, as a rule, do not have a permanent and paroxysmal in nature.The typical renal colic make it possible to put the correct diagnosis.
Very often causes uremia are not nephrology and systemic diseases.For example, kidney damage in diabetes, hypertension or tuberculosis can also cause the destruction of the structure of the renal tubules that ends uremic state.In order to detect such diseases, it is necessary, first of all, pay attention to the common blood and urine tests.
Another group causes uremia, which are implemented basically by acute renal failure, and are different poisoning toxicity.As for the poisoning, in our region, the most common is the defeat toxins of poisonous mushrooms.Therefore you must be very careful in the preparation of mushrooms, especially those that are gathered independently.
With regard to chemical intoxication system, the medical practitioners, most often have to deal with poisoning alcohol substitutes.
Clinical diagnosis in uremia
First of all, in cases of suspected uremia need to perform biochemical analysis of blood to determine the level of urea and creatinine.These indicators are direct markers of uremia.Because these substances are the products of protein metabolism, then in uremia it is imperative to determine the level of total protein in the blood.
Once through biochemical analyzes will be determined uremia, necessary to thwart a laboratory and instrumental examinations to determine the cause of this clinical condition.Primarily, it is necessary to hold common to urinalysis.Quite often, only on the results of this study, it is already possible to identify the cause of uremia.For example, if a total analysis of urine is determined by a large number of salts, it allows the patient to assume the presence of urolithiasis.With an increased amount of bacteria in the urine of the patient can talk about complicated pyelonephritis.
If urinalysis allows only assume the presence of a particular disease, to verify the exact diagnosis is necessary to conduct a wide range of laboratory and instrumental methods.As a rule, urologists begin with ultrasound diagnosis, since it is inexpensive and covers a wide range of kidney diseases.Using ultrasound to diagnose such diseases like kidney stones, kidney tumor, and abscess of the body.
renal ultrasound - a mandatory method of research in uremia
If ultrasound does not give a precise answer about the underlying disease, then it is necessary to use other, more specific research methods.To determine the functional state of the kidney excretory urography is used.It provides an opportunity not only to put the diagnosis of urolithiasis, but also determine how calculus covers the lumen of the ureter.With the same purpose may be used CT scan with contrast of the urinary tract.
Meticulous laboratory diagnostics is more important in cases where the cause of uremia is not organic renal failure, and systemic diseases such as tuberculosis, diabetes, or hypertension.In these cases it is important to conduct a clinical blood test for sugar and bacteriological examination of biological fluids for Mycobacterium tuberculosis.
syndromic treatment of uremia
fact, uremia - a syndrome that includes a huge number of symptoms, so its correction is used not symptomatic, and syndromic management.It may lie in the hardware or drug therapy.
With regard to medical treatment uremia, it is rehydration and detoxification therapy.For this purpose, patients received intravenous infusions of saline, glucose, and reosorbilakta reopoliglyukina.Number of drugs is determined by the severity of the patient's general condition.As a general rule, the purpose of these drugs reduces the clinical symptoms, which, soon after their withdrawal resumed again.At the same time, quite often observed a situation where the symptomatic treatment of uremia patient remains the only hope, as pathogenetic and etiological therapy has no sense.
Drug treatment of uremia is the method of choice only in the initial stages of the disease, or when there is no possibility to apply modern, more serious treatments.To date, the priority treatment of uremia should be considered as hematological dialysis.For its use of a special device, which among a wide range of people is the common name "artificial kidney".In fact, such a device is currently gemodializiruyuschey membrane, through which passes the blood of man and at the same time it is removed from all pathological metabolic products.
The people are of the opinion that the "artificial kidney" is able to be addictive, so many patients simply afraid to go to health institutions for such assistance.In fact, this information is devoid of absolutely no scientific meaning.As practice shows, in diseases such as obstructive ureteral calculi use of hemodialysis it is a single episode in a person's life.After using this machine will be restored a normal general state of the patient, the doctors begin to etiological treatment aimed at primary cause of pathology.
As for the treatment of folk remedies, it is not recommended for this pathology.The fact that the delay in acute or chronic renal failure can result in a poor outcome for the patient, therefore such patients should immediately contact the specialized medical institutions.
complications of uremia
Basically, uremia itself is already a complication of kidney failure, but it should be noted that it is not the final stage in the development of a pathological process.In the absence of a normal treatment, urinary toxins that are found in large quantities in the blood begin to pass through the blood-brain barrier, which affect nervous structures of the brain.In patients developing the condition, which is called renal encephalopathy.At this time, the above symptoms align complaints of severe headache, tremor of the limbs, loss of memory and occasional loss of consciousness.Over time, patients are inhibited, respond 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 department, the stupor slowly go into a renal or uremic coma.The patient loses consciousness, there is a noisy deep breathing (Kussmaul breathing), rarely observed type of breathing Cheyne-Stokes, the patient comes a strong smell of ammonia, pupils contracted.In this state of the patient, in addition to heart rate and respiration, are not there any more signs of life.The main problem is that even if adequate treatment at this stage is simply impossible to further evaluate the outlook for the patient.However, even if a person is and be able to emerge from uremic coma, in the future we need to be afraid of intellectual bankruptcy.In addition, you must remember that in renal coma observed quite a high percentage of mortality.
Which doctor contact when signs of uremia
As has become clear, access to a doctor when uremia is not something optional, but simply vital.But in order not to lose time, that in any case affect the patient's condition, he needs to properly orient to what expert to address in the first place.
If the patient has marked symptoms of uremia, which complement the symptoms of kidney stones, then such a patient should consult a urologist.Only he will be able to properly diagnose and determine further treatment strategy.
In that case, when the symptoms of uremia accompanied by complaints that may be associated with cancer pathology, the priority is the specialist oncologist, whose task is to choose the correct tactics of the patient.
If a patient has chronic systemic diseases, such as atherosclerosis or diabetes, it is, before consulting a urologist, you should contact your district physician to the treatment regimen corrected or sent him to a specialist.
Ed.urologist, sexologist-andrologist Plotnikov AN