The following signs and symptoms are seen in patients with uremia:

• Peripheral neuropathy
• Muscular fatigue
• Seizures 
• Anorexia and nausea
• Perennial cramping
• Sleep disturbances
• Coma
• Sexual dysfunction
• Bone problems
• Muscle wasting
• Pruritus
• Hiccups
• Bleeding problems
• Pallor

• Fatigue

  Symptoms associated with uremia include nausea, vomiting, fatigue, appetite loss, weight loss, itching, muscle cramps, thirst, visual disturbances, and changes in mental status. [medicinenet.com]

  The symptoms of uremia are Fatigue, lassitude, and a loss of mental concentration may be among the first signs. [longdom.org]

  The thyroid and parathyroid panels will help work up any symptoms of fatigue, as well as determine calcium abnormalities as they relate to uremia vs longstanding or unrelated illness of calcium metabolism. [en.wikipedia.org]

• Weight Loss

  Uremic syndrome may affect any part of the body and can cause: Nausea, vomiting, loss of appetite, and weight loss. Changes in mental status, such as confusion, reduced awareness, agitation, psychosis, seizures, and coma. [healthlinkbc.ca]

  Symptoms associated with uremia include nausea, vomiting, fatigue, appetite loss, weight loss, itching, muscle cramps, thirst, visual disturbances, and changes in mental status. [medicinenet.com]

  However, we also mentioned some of the indications of starting HD in patients with progressive, severe chronic kidney disease: - Refractory Hypertension despite multiple meds - Persistent nausea/vomiting - Signs of malnutrition and weight loss - low albumin [errolozdalga.com]

• Weakness

  […] voice Reluctance to speak Sweating with little or no exertion Insomnia Dry skin Dry hair Poor memory Scanty periods Chills Cold limbs Inability to get warm Spontaneous sweating Lassitude T: Pale or Pale, thin and dry C: Thin and white P: Weak or Thin [americandragon.com]

  A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. [ncbi.nlm.nih.gov]

  Manifestations of this include fatigue, weakness, nausea, poor appetite, reduced concentration, confusion and lethargy. There is not a specific BUN number after which symptoms start to develop. It varies amongst different individuals. [thekidneydr.com]

  […] hypertension Subdural hematoma 10 times more likely than in general population Platelet dysfunction Headache, focal neurologic deficits, seizure, coma Peripheral neuropathy Occurs in 60-100% of dialysis patients Paresthesias, impaired proprioception, weakness [wikem.org]

  Symptoms of uremia include confusion, loss of consciousness, low urine production, dry mouth, fatigue, weakness, pale skin or pallor, bleeding problems, rapid heart rate (tachycardia), edema (swelling), and excessive thirst. [healthgrades.com]

• Malnutrition

  We conclude that cellular malnutrition occurs in apparently stabilized adult uremics without clinical signs of malnutrition. CAPD seems to improve many cell bioactivities, and therefore, cellular malnutrition in uremics. [nature.com]

  Metabolic acidosis blocks the first two responses and hence contributes to malnutrition in patients with chronic uremia. [ncbi.nlm.nih.gov]

  Thus, it is important that dialysis be initiated prior to the occurrence of significant malnutrition. [emedicine.com]

• Falling

  Uremic symptoms clinically manifests when the glomerular filtration rate (GFR) of the kidneys fall below 60 ml per minute per 1.73 meter squared of body area. [symptoma.com]

  As the glomerular filtration rate falls in either acute tubular necrosis or chronic renal failure, serum urea (usually expressed as blood urea nitrogen content or BUN) and creatinine rise to very high levels. [medical-dictionary.thefreedictionary.com]

  With declining GFR, the kidneys capacity to excrete acids falls below their metabolic production, resulting in metabolic acidosis. Secondary Hyperparathyroidism See the secondary hyperparathyroidism page for pathogenesis and clinical consequences. [pathwaymedicine.org]

  If kidney function falls low enough, you might need dialysis or a kidney transplant. Infections. People with nephrotic syndrome have an increased risk of infections. [mayoclinic.org]

• Dyspnea

  Most common during increased catabolism (trauma, sepsis) or missed dialysis sessions Constitutional symptoms, such as fever, are more common than in uremic pericarditis Treatment Dialysis Tamponade Presents with altered mental status, hypotension, dyspnea [wikem.org]

  Evaluate presence of peripheral edema, vascular congestion and reports of dyspnea. S3 and S4 heart sounds with muffled tones, tachycardia, irregular heart rate, tachypnea, dyspnea, crackles, wheezes,edema and jugular distension suggest HF. [nurseslabs.com]

  Case Report A 66-year-old man was transferred to our hospital because of confusion, severe general fatigue, and dyspnea of 1-week duration. The patient had chronic kidney disease related to diabetic nephropathy. [hindawi.com]

  Points Clinical Manifestations Chills and fever or Fever with no thirst Swollen eyes, limbs abdomen or genitals Achiness Stiff neck and shoulders Anhidrosis Headache Stabbing joint pain Itchy throat Cough Asthma Aversion to Cold Maybe frozen shoulder Dyspnea [americandragon.com]

  Ventricular filling pressures increase, caused by retention of fluids, resulting in symptoms connected with HF such as dyspnea, jugular venous distension, hepatic congestion, peripheral edema and orthopnea. [intechopen.com]

• Vomiting

  Uremic syndrome may affect any part of the body and can cause: Nausea, vomiting, loss of appetite, and weight loss. Changes in mental status, such as confusion, reduced awareness, agitation, psychosis, seizures, and coma. [healthlinkbc.ca]

  if the condition is tonified before the Wind is expelled Urinary retention if the conditiong is reduced before the Wind is expelled Shortness of breath Mild or severe gasping Hiccups Fullness in chest Vomiting Heaviness of the body Edema Dysuria Maybe [americandragon.com]

  Vomiting and diarrhea however can cause excessive sodium and chloride loss. Such states will further depress urine formation and lead to more severe azotemia. Careful... [mdedge.com]

  Symptoms associated with uremia include nausea, vomiting, fatigue, appetite loss, weight loss, itching, muscle cramps, thirst, visual disturbances, and changes in mental status. [medicinenet.com]

  Although the symptoms and findings may be multiple and variable, the clinical picture usually includes varying degrees of headache, vomiting, pericarditis, gastrointestinal symptoms, and, finally, coma and death in the late stages. [jamanetwork.com]

• Nausea

  Uremic syndrome may affect any part of the body and can cause: Nausea, vomiting, loss of appetite, and weight loss. Changes in mental status, such as confusion, reduced awareness, agitation, psychosis, seizures, and coma. [healthlinkbc.ca]

  Symptoms associated with uremia include nausea, vomiting, fatigue, appetite loss, weight loss, itching, muscle cramps, thirst, visual disturbances, and changes in mental status. [medicinenet.com]

  A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. [ncbi.nlm.nih.gov]

  Loss of appetite progresses to nausea and vomiting; episodes of diarrhea and constipation may occur. [longdom.org]

  Symptoms include fatigue, nausea, loss of appetite, a metallic taste in the mouth and mental confusion. Treatment includes dialysis or a kidney transplant. [toppr.com]

• Diarrhea

  Vomiting and diarrhea however can cause excessive sodium and chloride loss. Such states will further depress urine formation and lead to more severe azotemia. Careful... [mdedge.com]

  Loss of appetite progresses to nausea and vomiting; episodes of diarrhea and constipation may occur. [longdom.org]

  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. [medical-dictionary.thefreedictionary.com]

  […] chronic diarrhea, rectal prolapse and Vanquished Yang : + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence : moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea : moxa or moxa needle DU-20, KI-3, [americandragon.com]

  Symptoms of uremia often initially include fatigue, loss of appetite, edema, excessive thirst, and decreased concentration, and progression of the condition may lead to a rapid pulse, anemia, diarrhea, convulsions, discoloration of the skin, coma, and [microscopyu.com]

• Hiccup

  Other associated symptoms and signs can include low urine output, confusion, hiccups, and high blood pressure. [medicinenet.com]

  Arrythmias, LVH, Increased predisposition to MI and SCD, Accelerated atherosclerosis and coronary calcification, Volume overload, Pericardial effusions and pericarditis -Pulm - pulmonary edema due to volume overload -GI - nausea/vomiting, anorexia, hiccups [errolozdalga.com]

  The following signs and symptoms are seen in patients with uremia: Peripheral neuropathy Muscular fatigue Seizures Anorexia and nausea Perennial cramping Sleep disturbances Coma Sexual dysfunction Bone problems Muscle wasting Pruritus Hiccups Bleeding [symptoma.com]

  […] as if intoxicated Frequent belching Progressive motor dysfunction occurring over hours to days Development of facial asymmetry Heat and pain of the brain Mental confusion with moments of lucidity Inability to fully recover after loss of consciousness Hiccups [americandragon.com]

  […] arrhythmia); nervous manifestations (alterations in the sensitivities of the hands and feet and neuropathies); endocrine manifestations (secondary hyperparathyroidism); bone manifestations (renal osteodystrophy); and gastrointestinal manifestations (nausea, hiccuping [tandfonline.com]

• Constipation

  Loss of appetite progresses to nausea and vomiting; episodes of diarrhea and constipation may occur. [longdom.org]

  […] of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation [americandragon.com]

  - Preventing constipation, including the use of laxatives, as decreasing the duration of protein transit in the large intestine reduces the metabolism of amino acids to potentially toxic uremic compounds. - Sorbent therapy. [karger.com]

• Heart Failure

  ‘Did he have diabetes, ascites, uraemia, anasarca, or heart failure?’ Origin Mid 19th century: modern Latin, from Greek ouron ‘urine’ + haima ‘blood’. Pronunciation uremia /yo͝oˈrēmēə/ /jʊˈrimiə/ [en.oxforddictionaries.com]

  In uremia, metabolic acidemia may contribute to other clinical abnormalities, such as hyperventilation, anorexia, stupor, decreased cardiac response (congestive heart failure), and muscle weakness. [emedicine.com]

  The mortality usually happens in the form of heart failure, myocardial infarction and sudden cardiac failure. [intechopen.com]

• Metallic Taste

  The patient may experience persistent itching sensations, along with muscle twitching. dry and flaky skin. dry mouth with metallic taste, breath has a distinct ammonia like odour. [longdom.org]

  Symptoms include fatigue, nausea, loss of appetite, a metallic taste in the mouth and mental confusion. Treatment includes dialysis or a kidney transplant. [toppr.com]

  taste in the mouth, a characteristic odor of the breath, pruritus, urea frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [medicine.academic.ru]

  Uremic symptoms include but are not limited to a uriniferous breath smell, metallic taste in the mouth, muscle cramps, changes in mentation, fatigue, itching of the skin, and anemia. Early stages of kidney disease are typically asymptomatic. [atlasofscience.org]

• Halitosis

  Patients with CRF associated with high levels of urea nitrogen in the blood and salivary production31 report more severe halitosis when the blood urea levels are >55 mg/dL. [tandfonline.com]

  May progress to seizures and coma Dusky yellow-tan or gray skin Uremic halitosis, uremic frost - patient will have urine-smelling breath and skin due to inability to clear waste products from the kidney بی اشتهایی، دلبدی، استفراغ، اسهال، ممکن منتج به [slideus.org]

  May progress to seizures and coma • Dusky yellow-tan or gray skin • Uremic halitosis, uremic frost - patient will have urine-smelling breath and skin due to inability to clear waste products from the kidney • بی اشتهایی، دلبدی، استفراغ، اسهال، ممکن منتج [slideserve.com]

• Muscle Cramp

  Symptoms associated with uremia include nausea, vomiting, fatigue, appetite loss, weight loss, itching, muscle cramps, thirst, visual disturbances, and changes in mental status. [medicinenet.com]

  Severe malnutrition can contribute to muscle wasting, while electrolyte abnormalities may cause muscle cramping, cardiac arrhythmias, and mental status changes. [emedicine.medscape.com]

  Uremic symptoms include but are not limited to a uriniferous breath smell, metallic taste in the mouth, muscle cramps, changes in mentation, fatigue, itching of the skin, and anemia. Early stages of kidney disease are typically asymptomatic. [atlasofscience.org]

  cramps, tremor, and asterixis.3 In more severe uremia, muscle fasciculations and myoclonus may appear.3 The combination of asterixis and myoclonus may be severe and has been termed uremic twitching.3,5 Chorea and athetosis are sometimes confused with [epilepsy.com]

  Uremia is detected with low amounts, and accompanying signs may be nausea, vomiting, excessive thirst, fatigue, vision problems, muscle cramps, and confusion. [doctorshealthpress.com]

• Muscle Weakness

  […] increased fracture susceptibility Treatment = phosphate binding gels, vitamin D3 replacement Vitamin D3 deficiency and aluminum intoxication (osteomalacia) Leads to osteomalacia (defect in bone calcification) Symptoms similar to hyperparathyroidism (muscle [wikem.org]

  In uremia, metabolic acidemia may contribute to other clinical abnormalities, such as hyperventilation, anorexia, stupor, decreased cardiac response (congestive heart failure), and muscle weakness. [emedicine.com]

  Arch Surg 97:283 PubMed CAS Google Scholar Lazaro RP, Kirshner HS (1980) Proximal muscle weakness in uremia. Case reports and review of the literature. [link.springer.com]

• Muscle Twitch

  The patient may experience persistent itching sensations, along with muscle twitching. dry and flaky skin. dry mouth with metallic taste, breath has a distinct ammonia like odour. [longdom.org]

  According to Puschmann, Lundborg distinguished 3 stages of the disorder: Stage 1 began in childhood or early adolescence and consisted of nocturnal attacks of involuntary symmetric muscle twitches, which often were painful, caused anxiety, and reminded [medlink.com]

• Leg Cramp

  Uremia symptoms may include: Drowsiness or fatigue Leg cramps Loss of appetite Headache Nausea or vomiting Trouble concentrating Tremors Irritability Treatment Options If you have developed uremia, your kidneys are extremely damaged. [templehealth.org]

  If the AV site is located on a leg, the patient should avoid sitting for lengthy periods, as venous drainage may be obstructed. [en.wikipedia.org]

• Bone Pain

  Bone pain: As kidney failure progresses, the body’s calcium and phosphorus balance is affected, resulting in changes in the bones. Symptoms include bone pain, back pain and arthralgia. [treat-kidney.blogspot.com]

  Other symptoms include fatigue, nausea, vomiting, cold, bone pain, itch, shortness of breath, and seizures. [educalingo.com]

  […] to hyperparathyroidism (muscle weakness, bone pain) Treatment = desferrioxamine Amyloidosis Common in patients >50yo who have received dialysis for >10yr Complications: GI perforation, bone cysts with pathologic fracture, arthropathies Anion Gap Metabolic [wikem.org]

  COMPLICATIONS OF LONGTERM CALCIUM AND PHOSPHORUS IMBALANCE Tertiary hyperparathyroidism Renal osteodystrophy Demineralization Bone pain Fractures Systemic toxicity Cutaneous - Calciphylaxis Cardiovascular, accelerated vascular calcification 46. [slideshare.net]

• Tinnitus

  Clinical Manifestations Oliguria Dizziness Vertigo A feeling of distention in the eyes Tinnitus Feverish sensation in the head Irritability Flushed face as if intoxicated Frequent belching Progressive motor dysfunction occurring over hours to days Development [americandragon.com]

  (pseudotumor cerebri) is a condition characterized by increased intracranial pressure. [1] PTS is classically the disease of middleaged obese women and presented with the increased intracranial pressure symptoms such as headache, diplopia, pulsatile tinnitus [sjkdt.org]

• Pruritus

  Thus, if pruritus is not adequately treated, hemodialysis patients may be at risk for prolonged sleep deprivation: indeed, lack of sleep may well be a key variable linking uremic pruritus and a higher mortality risk, the authors note. [medscape.com]

  Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges. Int J Nephrol Renovasc Dis. 2017. 10:11-26. [Medline]. [Full Text]. Mettang T, Kremer AE. Uremic pruritus. Kidney Int. 2015 Apr. 87 (4):685-91. [emedicine.medscape.com]

  All rights reserved. uremia Prerenal azotemia, renal underperfusion Nephrology A constellation of Sx caused by the retention of urea and other products of protein catabolism due to inadequate kidney function in advanced renal failure Clinical N&V, pruritus [medical-dictionary.thefreedictionary.com]

  * ure·mia (u-reґme-ə) [ur- + -emia] 1. azotemia. 2. in current usage, the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting, anorexia, a metallic taste in the mouth, a characteristic odor of the breath, pruritus [medicine.academic.ru]

• Uremia

  [G. ouron, urine, + haima, blood] Farlex Partner Medical Dictionary © Farlex 2012 uremia also uraemia (yo͝o-rē′mē-ə) n. [medical-dictionary.thefreedictionary.com]

  Link/Cite Link to this page Cite this page MLA Style "Uremia." YourDictionary. LoveToKnow. www.yourdictionary.com/UREMIA. APA Style Uremia. (n.d.). In YourDictionary. [yourdictionary.com]

  Etymology dictionary uremia — s. f. [medicine.academic.ru]

  […] degree of uremia in a patient. [symptoma.com]

• Kidney Failure

  This stage of kidney failure is also known as Stage 5 Chronic Kidney Disease (CKD). [atlasofscience.org]

  Some will need a kidney transplant. Kidney failure may also damage other organs, so untreated uremia can result in liver or heart failure. Causes High blood pressure may cause kidney issues, which may cause uremia. [medicalnewstoday.com]

  […] acute kidney failure. which help for medical students who like to remember, even for medical board exams. [youtube.com]

  Mild levels of azotemia may show no symptoms but when the kidney failure prolongs the symptoms start to emerge. When kidney failure has enough degree to cause symptoms, it is known as Uremia. [byjus.com]

• Renal Insufficiency

  It is usually the result of RENAL INSUFFICIENCY. Most uremic toxins are end products of protein or nitrogen CATABOLISM, such as UREA or CREATININE. [ebi.ac.uk]

  insufficiency, and their severity correlates with the severity of renal insufficiency.3 Early movement disorders include muscle cramps, tremor, and asterixis.3 In more severe uremia, muscle fasciculations and myoclonus may appear.3 The combination of [epilepsy.com]

  Uremi Engelsk definition A clinical syndrome associated with the retention of renal waste products or uremic toxins in the blood. It is usually the result of RENAL INSUFFICIENCY. [mesh.kib.ki.se]

  A clinical syndrome associated with the retention of renal waste products or uremic toxins in the blood. It is usually the result of RENAL INSUFFICIENCY. [profiles.umassmed.edu]

• Oliguria

  Clinical Manifestations Oliguria Dizziness Vertigo A feeling of distention in the eyes Tinnitus Feverish sensation in the head Irritability Flushed face as if intoxicated Frequent belching Progressive motor dysfunction occurring over hours to days Development [americandragon.com]

  Control of Fluids and Electrolytes Unfortunately many patients with oliguria and acute uremia are over-treated with water and saline in the hope that diuresis will occur, but no amount of fluid will induce urine formation if the uremia is due to parenchymal [mdedge.com]

  Acute renal failure is usually associated with oliguria or anuria, hyperkalemia, and pulmonary edema. Chronic renal failure is irreversible and requires hemodialysis. [icd9data.com]

  Pathophysiology Acute renal failure Prerenal, renal or post-renal azotemia → decreased glomerular filtration → oliguria → retention of waste products → toxemia/uremia. [vetstream.com]

  پروسه های نرسنگ را در مورد یک مریض عدم کفایه کلیوی بحث نمایید.Acute Renal Failure عدم کفایه حاد کلیه کلیه حالب مثانه Acute Renal Failure عدم کفایه حاد کلیه Inability of the kidneys to remove wastes, concentrate urine and absorb or secrete electrolytes Oliguria [slideus.org]

• Renal Injury

  A recent study demonstrated higher levels of carotid artery calcification in patients with renal injuries that are accompanied by changes in triglyceride and potassium levels that can be diagnosed via panoramic radiography.35 Zhao et al.36 evaluating [tandfonline.com]

  A renal biopsy may be helpful in determining reversibility or treatability of the renal injury, and may ultimately be required to make an accurate diagnosis of acute kidney injury or chronic kidney disease. [statpearls.com]

  It is highly expressed in kidney following ischemic and nephrotoxic injury. Plasma/serum and urine NGAL is used as an early marker of acute kidney injury (AKI) in several renal diseases. [intechopen.com]

• Confusion

  Changes in mental status, such as confusion, reduced awareness, agitation, psychosis, seizures, and coma. Abnormal bleeding, such as bleeding spontaneously or profusely from a very minor injury. [healthlinkbc.ca]

  Other associated symptoms and signs can include low urine output, confusion, hiccups, and high blood pressure. [medicinenet.com]

  In this report, we have presented a diabetic patient with uremia, in which acute Parkinsonism occurred, coupled with acute mental confusion, after a sudden increase in blood urea nitrogen and serum creatinin levels. [ncbi.nlm.nih.gov]

  Symptoms include low urine output, confusion, loss of consciousness, and excessive thirst. [healthgrades.com]

  Symptoms include fatigue, nausea, loss of appetite, a metallic taste in the mouth and mental confusion. Treatment includes dialysis or a kidney transplant. [toppr.com]

• Headache

  He reported a remarkable improvement of his headache but would still have an occasional mild to moderate headache. [jmedicalcasereports.biomedcentral.com]

  The clinical course of the disease is generally good, but it can sometimes cause chronic visual disturbances and headaches. [sjkdt.org]

  A 28-year-old man was admitted to our hospital with nausea, headache and weakness of the left hand. He had severe uremia without hypertension due to recurrent/chronic pyelonephritis. [ncbi.nlm.nih.gov]

  Although the symptoms and findings may be multiple and variable, the clinical picture usually includes varying degrees of headache, vomiting, pericarditis, gastrointestinal symptoms, and, finally, coma and death in the late stages. [jamanetwork.com]

• Stupor

  Chronic bladder pain R39.83 Unilateral non-palpable testicle R39.84 Bilateral non-palpable testicles R39.89 Other symptoms and signs involving the genitourinary system R39.9 Unspecified symptoms and signs involving the genitourinary system R40 Somnolence, stupor [icd10data.com]

  In uremia, metabolic acidemia may contribute to other clinical abnormalities, such as hyperventilation, anorexia, stupor, decreased cardiac response (congestive heart failure), and muscle weakness. [emedicine.com]

• Insomnia

  […] the brain Mental confusion with moments of lucidity Inability to fully recover after loss of consciousness Hiccups Irritable Heat in the Heart Tremors Limited mobility of the limbs Persistent high fever Restlessness Twitching Spasms of the extremities Insomnia [americandragon.com]

  Most commonly, subtle symptoms such as insomnia, restless leg syndrome, decreased memory and concentration, fatigue -CV - Hypertension, Arrythmias, LVH, Increased predisposition to MI and SCD, Accelerated atherosclerosis and coronary calcification, Volume [errolozdalga.com]

  Bangkokerz / Getty Images Symptoms: Skin and Nervous System The toxicity caused by uremia can result in nervous system symptoms such as peripheral neuropathy, cognitive decline, seizures, sensory dysfunction, insomnia, and muscle cramps. [facty.com]

  Clinical features of uremia[3][4][5] Area affected Signs and symptoms Central nervous system diurnal somnolence, night insomnia, memory and concentration disorders, asthenia, headache, confusion, fatigue, seizures, coma, encephalopathy, decreased taste [en.wikipedia.org]

• Forgetful

  Forget about low quality plagiarised papers filled with mistakes. Use the help of true academic experts and get the service you deserve! [codep35badminton.fr]

  ST-44 Clinical Manifestations Facial complexion pale and sallow Both cheeks slightly red Headache Dizziness Dry, rough eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis ( Wei syndrome), Weakness Fatigue Tinnitus Deafness Forgetfulness [americandragon.com]

The following diagnostic tests and modalities are used to work up patients suffering from uremia:

• Isotope clearance: The radioisotope iothalamate is utilized to accurately measure the actual glomerular filtration rate to determine the degree of uremia in a patient.
• Complete blood count (CBC): This routine laboratory test is used to determine the level of hemoglobin and hematocrit and diagnose anemia of uremia. 
• Kidney ultrasound: Renal sonograms are used to determine the presence of hydronephrosis and obstruction among patients with signs of uremia. The scan will also measure the relative size of the kidneys. 
• Computed tomography (CT scan): This radiologic imaging modality can be helpful in identifying hematomas in the kidney due to trauma. 
• Magnetic resonance imaging (MRI): MRI is sensitive in detecting the presence of vascular stenosis in the kidneys as a cause of uremia.
• Renal biopsy: Histopathologic studies of the kidney will reveal glomerulosclerosis in cases of long standing renal failure.

• Hyponatremia

  His blood pressure was 201/113 mmHg, and laboratory findings revealed renal failure and hyponatremia. On physical examination, disorientation and dysarthria were observed. Hemodialysis was performed the same day. [ncbi.nlm.nih.gov]

  […] photoconvulsive responses to photic stimulation may occur.3 When seizures occur in the context of renal insufficiency, it is necessary to rule out a number of complications other than uremia:3 electrolyte imbalance (water intoxication, hypocalcemia, hyponatremia [epilepsy.com]

  Other conditions associated with CRF that can cause headache include severe anemia, hyponatremia, severe hypertension, and dialysis. Dialysis headaches are frontal, start within a few hours of the procedure, and are not persistent [1, 4]. [jmedicalcasereports.biomedcentral.com]

  Hyponatremia (I) c. Hyperkalemia (I) d. Hyperphosphatemia (I) (I) improves with an optimal program of dialysis and related therapy; (P) persist or even progress, despite an optimal program; (D) develops only after initiation of dialysis therapy. 30. [slideshare.net]

  Hyponatremia and reduced urine volume may also occur. [uspharmacist.com]

The following treatment modalities are available for the management of uremic diseases:

• Dialysis: The use of peritoneal and hemodialysis are also implored to treat uremic states in patients. Peritoneal dialysis is usually indicated among patients with other cardiovascular conditions [7]. Hemodialysis are used for other cases but may require an arterio-venous access [8]. 
• Intravenous calcium gluconate: The infusion of calcium gluconate in the venous system active controls the hyperkalemic state that causes cardiac disturbances among uremic patients.
• Erythropoietic stimulating agents (ESA): These agents are arbitrarily given to promote the production of red blood cells in the bone marrows.
• Parathyroid hormone (PTH) replacement therapy: A PTH level of 150-600 pg/ml is targeted to correct the conditions of parathyroidism among ESRD patients with uremia [9].
• Oral calcium supplements: Exogenous calcium and phosphates are given to correct varying degrees of hypocalcemia and hypophosphatemia among patients with uremia.
• Diet: Studies have shown that the administration of a low protein diet among patients with uremia can lower the rate of nephron death and subsequently delay the progression to ESRD [10]. 
• Renal transplant: This surgical option is the definitive treatment of choice of ESRD patients with severe signs of uremia.

In general, uremia among ESRD patients has a very poor prognosis unless hemodialysis or renal transplantation is done promptly. However, uremia brought about by acute renal insufficiency from reversible causes like thrombocytopenic purpura, Wegener disease, and Goodpasture syndrome can have a better prognosis if diagnosed and treated early in the course of the disease. Uremic disease carries a high morbidity rating in almost all patients with concomitant diseases like diabetes mellitus and hypertension.

Uremia usually results from chronic renal diseases caused by the following illnesses [3]:

• Polycystic kidney disease
• IgA nephropathy
• Multiple myeloma
• Uncontrolled hypertension
• Hemolytic uremic syndrome
• Goodpasture syndrome
• Thrombocytopenic purpura
• Diabetes mellitus
• Systemic lupus erythematosus
• Amyloidosis

Acute cases of renal diseases can also lead to uremia when there is a rapid rise in creatinine or urea concentrations in the blood.

The actual prevalence of uremia is hard to determine because the expression of the signs and symptoms of the disease varies in some disease conditions. In normal individuals, uremic signs starts to appear at creatinine clearance level of less than 10ml/min while diabetics can have the onset of symptoms in as early as 15ml/min of creatinine clearance. Concurrently, uremia exists in patients treated as end stage renal disease (ESRD).

Almost 58% of the world’s ESRD populace resides in Brazil, Japan, Germany, USA, and Italy. The white race has higher predisposition for ESRD representing almost 60% of cases. ESRD has a slight predilection in males than their female counterparts. Mean age of onset is usually on the late adulthood stage. Patients beyond 70 years old are least likely to tolerate any delays in renal treatment for uremic signs compared to their younger counterparts.

Uremia generally develops as a complication of renal failure in most patients. There is a progressive decline in the kidney functioning during this phase where its capacity to produce adequate vital hormones, fluid and electrolyte regulation, water elimination, and acid-base homeostasis is significantly impaired. When creatinine levels go beyond 2mg/dl, the peritubular cells of the kidney fail to secrete erythropoietin that induces red blood cell formation leading to progressive anemia. By statistics, 39% of patients presenting with anemia has an associated renal dysfunction at hand [4].

The gradual accumulation of uremic toxins hampers the adhesion capacity of the thrombocytes. This impairment leads to bleeding diasthesis making ESRD patients on oral coagulopathy susceptible to pathologic bleeding in the face of uremia [5]. The breakdown in the acid-base balance by the kidney leads to the failure in the secretion of hydrogen ions and excretion of ammonium from the serum resulting to metabolic acidosis. The decreasing serum pH leads to compensatory respiration presenting as tachypnea. The accumulation of potassium secondary to tubular acidosis leads to hyperkalemia.

This is an offshoot in uremic states especially when the creatinine clearance falls below 20 mL/min. There is an imbalance in the calcium and phosphate metabolism due to the uncontrolled secretion of parathyroid hormones caused by uremia. The calcium and phosphate accumulation in the serum leads to abnormal deposition of calcium plaques in the skin, blood vessels, and other tissues in the body [6]. The uremic state will also lead to abnormal carbohydrate metabolism, sexual hormone release, and thyroid hormone secretions.

Patients with diagnosed diabetes and hypertension should comply religiously with their maintenance medications to prevent renal complications in the future. High risk patients should avoid nephrotoxic drugs like ibuprofen and naproxen to prevent nephrotoxicity and uremia.

Uremia is a medical illness that accompanies renal failure caused by the abnormal accumulation of organic waste products normally excreted by the kidneys. Uremic symptoms clinically manifests when the glomerular filtration rate (GFR) of the kidneys fall below 60 ml per minute per 1.73 meter squared of body area [1]. Early uremic signs are usually constitutional and non-specific, thus mild uremia is oftentimes underdiagnosed. Severe uremia is corrected by renal transplant; however, the supply of kidney donors is almost always eclipsed by the demand for kidney transplant. Because of this, hemodialysis is the leading modality utilized to control and subvert this medical illness [2].

• Definition: Uremia is a medical condition associated with renal failure causing an abnormal accumulation of organic waste products normally excreted by the kidneys.
• Cause: Uremia can typically arise from any etiologic conditions that results in renal failure like diabetes, hypertension, multiple myeloma and SLE.
• Symptoms: Uremia will present with muscular fatigue, seizure, numbness, anorexia, and sleep disturbances.
• Diagnosis: Isotope clearance, anemia work-up, and imaging studies are diagnostic tests and modalities used in the work up of patients with uremia.
• Treatment and follow-up: Uremia can effectively be treated with dialysis and kidney transplantation. 

1. Coresh J, Byrd-Holt D, Astor BC, et al. Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000. J Am Soc Nephrol 2005; 16:180-188.
2. USRDS 2006 annual data report: atlas of end-stage renal disease in the United States. Bethesda, MD: U.S. Renal Data System, 2006.
3. Fakhouri F, Roumenina L, Provot F, et al. Pregnancy-Associated Hemolytic Uremic Syndrome Revisited in the Era of Complement Gene Mutations. J Am Soc Nephrol. Mar 4 2010.
4. Almoznino-Sarafian D, Shteinshnaider M, Tzur I, et al. Anemia in diabetic patients at an internal medicine ward: Clinical correlates and prognostic significance. Eur J Intern Med. Apr 2010; 21(2):91-96.
5. Boccardo P et al. (2004) Platelet dysfunction in renal failure. Semin Thromb Hemost 30: 579–589.
6. Schlieper G, Aretz A, Verberckmoes SC, et al. Ultrastructural Analysis of Vascular Calcifications in Uremia.J Am Soc Nephrol. Mar 4 2010.
7. Chuang YW, Shu KH, Yu TM, et al. Hypokalaemia: an independent risk factor of Enterobacteriaceae peritonitis in CAPD patients. Nephrol Dial Transplant. May 2009; 24(5):1603-8.
8. Vinsonneau C, Camus C, Combes A, et al. Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial. Lancet2006; 368:379-385.
9. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. Aug 2009; S1-130.
10. Fouque D, Laville M. Low protein diets for chronic kidney disease in non-diabetic adults. Cochrane Database Syst Rev. Jul 8 2009; CD001892.