uremia

For more information on uremia, visit Britannica.com.

The presence of urinary components in the circulating blood and the resultant symptoms. Manifestations include weakness, headache, confusion, vomiting, and coma, and in terminal chronic renal disease, purpura and epistaxis may be present. Uremia is caused by insufficient urinary excretion for any reason. See also stomatitis, uremic.

1. an excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acid metabolism; more correctly referred to as azotemia.
2. in current usage, the syndrome of chronic renal failure. As the glomerular filtration rate falls in either acute tubular necrosis or chronic renal failure, serum urea (usually expressed as blood urea nitrogen content, BUN) and creatinine rise to very high levels. However, BUN and creatinine measurements are only roughly correlated with the clinical signs of uremia. Other nitrogenous compounds present in small amounts may produce most of the toxic effects. Some uremic signs are due to losses of kidney function that do not involve azotemia.
Uremia is a syndrome that occurs as the end-stage in renal insufficiency. The pathology includes stomatitis, pneumonopathy, endocarditis and gastritis. In the dog and cat there is vomiting, diarrhea, anemia and sometimes ulcerative stomatitis. In horses there is depression and chronic diarrhea. Cattle show somnolence, depression and recumbency. Chickens develop visceral gout. Called also kidney failure.

• prerenal u. — see azotemia.

Uremia
Classification and external resources
Urea
ICD-10	N19., R39.2
ICD-9	585-586, 788.9
DiseasesDB	26060
eMedicine	med/2341
MeSH	[1]

Uremia or uraemia (see spelling differences) is a term used to loosely describe the illness accompanying kidney failure (also called renal failure), in particular the nitrogenous waste products associated with the failure of this organ.^[1]

In kidney failure, urea and other waste products, which are normally excreted into the urine, are retained in the blood. Early symptoms include anorexia and lethargy, and late symptoms can include decreased mental acuity and coma. It is usually diagnosed in kidney dialysis patients when the glomerular filtration rate, a measure of kidney function, is below 50% of normal.^[2]

Azotemia is another word that refers to high levels of urea, but is used primarily when the abnormality can be measured chemically but is not yet so severe as to produce symptoms. Uremia can also result in fibrinous pericarditis. There are many dysfunctions caused by uremia affecting many systems of the body, such as blood (lower levels of erythropoietin), sex (lower levels of testosterone/estrogen) and bones (osteoporosis and metastatic calcifications).

Causes

Besides renal failure, the level of urea in the blood can also be increased by:

• increased production of urea in the liver, due to:
  • high protein diet
  • increased protein breakdown (surgery, infection, trauma, cancer)
  • gastrointestinal bleeding
  • drugs (e.g. tetracyclines and corticosteroids)

• decreased elimination of urea, due to:
  • decreased blood flow through kidney (e.g. hypotension, cardiac failure)
  • urinary outflow obstruction

• dehydration
• chronic infection of the kidney such as chronic pyelonephritis

References

1. ^ uremia at Dorland's Medical Dictionary
2. ^ Meyer TW and Hostetter, TH (2007). "Uremia". N Engl J Med 357 (13): 1316. doi:10.1056/NEJMra071313. PMID 17898101. 

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v • d • e Symptoms and signs: urinary system/reproductive system (R30-R39, 788) Pain Renal colic · Dysuria · Vesical tenesmus Other urination disorders Urinary incontinence/Enuresis · Urinary retention Oliguria/Anuria · Polyuria Nocturia Extravasation of urine · Extrarenal uremia urinary system navs: anat/physio/dev, noncongen/acid+base/congen/neoplasia, symptoms+signs/eponymous, proc reproductive system navs: anat female,male/physio/dev, noncongen/congen/neoplasia, symptoms+signs/eponymous, proc

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