Uraemia

Uraemia is a harmful disorder that takes place when waste products build up in the blood. The waste product build-up happens due to reduced kidney function. So, uraemia, by definition, simply means the presence of urine in the blood. In short, we can say that uraemia occurs due to waste product accumulation. 

Uraemia impacts the entire body. The biggest cause for this condition is chronic kidney disease (CKD). It can lead to acute kidney injury and failure. Some serious health complications may result from this condition, like metabolic problems, hormonal problems, electrolyte problems, and fluid accumulation. Let us discuss the condition of uraemia further.

Who is at risk of uraemia?

People with the following disorders or diseases are at the highest risk for this condition. 

• Diabetes mellitus- A group of diseases that impacts the way the body uses glucose.
• High blood pressure- Blood’s force against the artery walls is higher than normal.
• Glomerulonephritis (GN) – Damaged kidney filters 
• Polycystic kidney disease (PKD) – It happens due to the formation of fluid-filled sacs or cysts in the kidneys or around them. 

What causes uraemia?

Kidneys are responsible for filtering waste materials and fluids from the body. This process results in the formation of urine. If the kidneys are healthy, they help in the maintenance of the normal levels of erythropoietin (EPO), Vitamin D, and acid electrolytes. 

Kidneys that are not healthy or are damaged will cause the building up of toxins in the blood. Dialysis is required if the kidney function reduces 10% below normal. If kidney function goes down by 15%, individuals may start feeling extremely sick. This could be an indication of uraemia. Following are the various chemicals that are elevated in such a condition: 

• Creatinine- A waste product whose production takes place in muscles because of dietary protein
• Urea- A waste product whose formation takes place in the liver with the breaking down of proteins 

What are the symptoms of uraemia?

The various symptoms of this condition are as follows:

• Fatigue
• Itchiness
• Shortness of breath due to the accumulation of fluid
• Loss of appetite
• Muscle cramps
• Nausea and vomiting
• Weight loss that cannot be explained
• Cognitive dysfunction leading to thinking, memorising, and remembering problems in an individual

In very severe cases, symptoms may be the following:

• Uremic fetor- Experiencing urine-like breath odour or metallic taste in the mouth
• Uremic frost-  Formation of yellow-white crystals on the skin because of the presence of urea in sweat

What are the complications of uraemia?

Uraemia can cause dangerous health complications if its treatment does not take place in a timely manner. In the presence of this condition, accumulation of electrolyte imbalances, excessive acid or hormones takes place in the body. These accumulations can negatively impact the heart.

These accumulations also impact the body’s metabolism system. Consequently, the body’s ability to convert food to energy shall be affected. 

Blood vessels may harden due to the building up of toxins in the blood. This hardening leads to various disorders or problems of blood vessels, heart, muscle, and bones.  

Other complications of this condition are as follows:

• High blood pressure
• Acidosis- Presence of excessive acid in your blood
• Hyperparathyroidism- Presence of excessive calcium and phosphorus in the blood resulting in bone abnormalities and abnormal parathyroid hormone levels
• Anaemia- Deficiency of healthy red blood cells in the body
• Malnutrition- Lack of body nutrients
• Hyperkalemia- Presence of excessive potassium in the blood
• Hypothyroidism- Underactive thyroid
• Infertility- Inability to attain pregnancy

Treatment of uraemia

The most common treatment for this condition is a procedure known as dialysis. This procedure facilitates the cleaning of the blood. Peritoneal dialysis and Hemodialysis are the two types of dialysis that are conducted. In Peritoneal dialysis, filtering of the blood takes place using a special fluid and the belly’s lining. In Hemodialysis, filtering of the blood takes place by using a machine outside the body. 

A kidney transplant may be required if uraemia happens due to end-stage renal (kidney) failure. In this condition, the kidney becomes ineffective in filtering the blood. Hence, there is no other option other than to transplant the severely damaged kidney. 

In a kidney transplant, the failed kidney is replaced with a donor’s kidney. This donor kidney could come from either a dead person or a living person.

Iron supplementation for anaemia may be recommended by the doctor. In the case of hyperparathyroidism, the doctor may recommend the replacement of phosphorus binder, Vitamin D, calcium, and EPO to prevent bone loss. 

Prevention of uraemia

Regular dialysis is required for patients who suffer from end-stage kidney disease due to this condition. For such patients, regular dialysis helps in keeping the toxins under control. Below are the various preventive measures for this condition:

•     Avoiding smoking
•     Proper control and management of blood pressure
•     Proper control and management of diabetes
•     Maintenance of healthy body weight
•     Consuming a healthy diet on a regular basis
•     Consuming the prescribed medications in a timely manner
•     Avoiding medications that are likely to cause damage to the kidneys
•     Exercising or physical work-out

Conclusion

Uraemia can be defined as a dangerous condition that takes place due to the building up of waste products in the blood. These waste products can reduce the effective functioning of the kidneys. This is a dangerous condition that can lead to permanent kidney damage or death if treatment is not provided in a timely manner. While discussing uraemia, it is necessary to understand its risk factors, its causes, its symptoms, its complications, its treatment, and its prevention.