Acute kidney failure can trigger what is known as uremia , urinary poisoning. This occurs when urine builds up in the urinary tract and triggers various symptoms. Treatment of the underlying disease promises good chances of recovery, but dialysis may still be necessary.
What is uremia?
Acute or chronic kidney failure with urinary poisoning, medically called uraemia, is the final stage of kidney failure. The kidneys are no longer able to fulfill their task of cleaning the blood from endogenous, urinary substances, such as urea, and exogenous toxins, such as medicines. See etaizhou for What does KSS Mean.
These substances can no longer be filtered and excreted. The concrete characteristics of uremia are disturbed excretion of water and electrolytes, combined with a disturbance of the acid-base balance. The life-threatening effects of such a disorder are, for example, dizziness or coma.
Furthermore, the breakdown of urea and creatinine is disturbed. Creatinine is a breakdown product of muscle tissue, urea is a waste product from the conversion of urea and protein. Hormone imbalance is the third feature affecting blood pressure, boils and blood formation.
The difference between acute and chronic uraemia lies in the point in time at which it occurs: chronic uraemia develops over years, while acute uraemia occurs five to a maximum of ten days after acute kidney failure.
The causes of kidney failure with urinary poisoning are therefore insufficient or non-existent therapy for kidney failure. Complete or partial kidney failure is caused by [[poisoning]en, inflammation, insufficient blood flow to the kidneys or urinary stasis. Kidney failure itself is usually the result of poorly treated kidney disease.
These are triggered by various factors, including poorly controlled diabetes, years of high blood pressure, repeated kidney infections, congenital cysts and diseases of the kidney blood vessels. Alcohol and drug abuse can also cause kidney disease and subsequent uremia.
Symptoms, Ailments & Signs
Uremia is a very serious kidney disease that causes a variety of symptoms. It is an acute or chronic kidney failure caused by urinary poisoning. In addition to therapy -resistant itching all over the body, the main symptoms are intestinal inflammation. This causes nausea, vomiting and often bleeding from the stomach and intestines.
In addition, inflammation of the pericardium can develop, which later often leads to severe cardiac insufficiency. In addition, cardiac arrhythmias are possible, which in turn arise on the basis of hyperkalemia. Sometimes pulmonary edema with severe breathing problems and cyanosis is also observed. A build-up of fluid in the abdomen (ascites or abdominal dropsy) can also occur.
Furthermore, disorders of the immune system and anemia also occur. Breath may smell of urine (ammonia). However, this is only the case if there are urea-degrading bacteria in the patient’s mouth. The increased concentration of urea in the blood also leads to neurological problems because urea can damage nerves depending on the concentration.
Personality changes, agitation, amnesia, abnormal sleepiness or even coma can occur. Peripheral nerves are also often damaged. As a result, polyneuropathy can develop with increasing sensory disturbances, gait disturbances, signs of paralysis and skin changes. In addition, muscle twitches in entire muscles or muscle groups such as the core and extremity muscles are also possible.
Diagnosis & History
If uremia is suspected, the medical diagnosis includes a detailed anamnesis and a thorough physical examination. This includes the analysis of urine and blood for abnormalities, such as the amount or the substances contained.
A kidney ultrasound is also one of the standard methods. Imaging procedures with administration of contrast medium are only carried out in exceptional cases to protect the kidneys. In some cases, a kidney puncture may be necessary.
If left untreated, kidney failure with urinary poisoning is fatal. The prognosis of acute uraemia is good if medical help is sought in good time and the underlying disease that caused it can be treated well. Chronic uraemia, on the other hand, requires long-term renal replacement therapy. Complications such as cardiovascular disease and high susceptibility to infection are common.
If left untreated, kidney failure with urinary poisoning leads to the death of the patient. Chronic uraemia requires renal replacement therapy using dialysis. Patients usually find this treatment method very stressful. Dialysis usually involves three treatments per week, each lasting four to five hours.
As part of the treatment, the blood is cleaned of toxic substances and excess fluids and the acid-base and electrolyte balance is normalized again. A number of complications can occur during or as a result of dialysis. Circulatory problems are particularly common. By removing water as part of the blood wash, the blood volume decreases and the blood pressure, i.e. the fluid pressure in the vessels, decreases.
If the lack of liquid in the bloodstream can no longer be compensated for, this usually results in a very sharp drop in blood pressure, which can lead to unconsciousness. Even with less extreme reactions, the drop in blood pressure is associated with a number of uncomfortable symptoms for the patient, including nausea, vomiting, severe dizziness and temporary visual disturbances.
In addition, dialysis patients often experience infections of the shunt, i.e. the surgically placed vascular access, or tunnel infections of the catheter permanently anchored in the abdominal wall.
When should you go to the doctor?
If the person concerned suffers from symptoms such as nausea, vomiting or a strong feeling of illness, a doctor should be consulted. In case of bleeding, pain or a general feeling of being unwell, medical attention is needed. Since the affected person may die prematurely without adequate medical care, a doctor’s visit is recommended as soon as the first irregularities appear. Inflammation, fever, a loss of performance, or persistent itching need to be evaluated and treated. If the symptoms spread or increase in intensity, a doctor should be consulted.
Disorders of cardiac activity, dizziness or abnormal sensations must be clarified. Excessive sensitivity, numbness or an inner turmoil are causes for concern. Increased tiredness, interruptions in sleep or unsteady gait are further indications of an existing disease. A doctor must be consulted because the symptoms indicate a progression of the disease that needs to be treated. In the event of paralysis or unstoppable twitching of the muscle fibers, there is a need for action.
If there is a change in consciousness or an acute health-threatening situation, an emergency service must be alerted. General functional disorders, irregularities in the gastrointestinal tract or cramps should be presented to a doctor. If there are changes in the complexion, abnormal behavior or persistent excitement, a doctor’s visit is necessary. If the personality of the affected person is perceived as unusual by people in the immediate vicinity, a doctor should be consulted.
Treatment & Therapy
In the treatment, a distinction is made between chronic and acute uraemia. Chronic uraemia requires renal replacement therapy using dialysis. This usually takes place three times a week. During the four to five-hour treatment, toxins and excess fluid are filtered out of the blood and disturbances in the acid-base and electrolyte balance are balanced. Concomitant diseases must be treated accordingly.
In addition, one uses the conservative measures that are used in acute uraemia. This includes treating the underlying disease of the kidneys, for example improving blood sugar control in diabetics. Regular medical check-ups are also a matter of course. The intake of diuretics, which serve to support the excretion of electrolytes and urea, takes place after careful consideration of the risks and side effects.
Patients must adjust the amount they drink to the elimination capabilities of their kidneys. A change in diet is also recommended: the amount of urea is reduced with a diet low in protein and potassium but high in calories. Avoiding phosphates is also recommended. Although current studies in the USA question the success of a change in diet, it is still state of the art.
Outlook & Forecast
Kidney failure with urinary poisoning poses a potential threat to human life. Without immediate professional medical care, the affected person is at risk of sudden death. If medical care is provided as quickly as possible, the patient’s survival can be ensured. Therapies are initiated immediately, which lead to a stabilization of the functionality of the organism. However, the treatment approaches are very stressful for the patient and their social environment. In addition, side effects can occur that are difficult for many to cope with.
In most cases, regular dialysis is required to ensure survival. This method leads to a severe limitation in coping with everyday life. In the event of an unfavorable course, there is a risk of a psychological sequelae due to the emotional stress experienced. This significantly worsens the well-being of the person concerned and can in turn also have a negative effect on the further physical condition.
A large number of patients require a donor organ to permanently relieve their symptoms and improve their quality of life. Although an organ transplant is associated with numerous complications and side effects, it is often the last and only resort. If the surgical procedure can be carried out without further complications, a significantly improved health situation can be expected afterwards.
To prevent uremia, patients with kidney failure should have it treated. If kidney weakness is already present, regular medical examinations and compliance with special precautionary measures, in particular self-observation, are essential. Patients at risk should check their weight every day, observe urine excretion and urine volume, avoid drugs and substances that damage the kidneys, support the immune system and follow prescribed measures.
In relation to the symptoms of the disease, those affected should give their follow-up care a high priority. Finally, organ failure must be treated in intensive care. With follow-up care that is consistently tailored to the patient, the patient can learn to deal with the accompanying symptoms. The self-responsible measures are based a priori on regular examinations, dialysis appointments and the rehabilitation measures and self-help groups that are used if possible.
Sharing with like-minded people or in the context of psychotherapeutic sessions can help to find courage and to understand the complexity of the illness and to maintain one’s standard of living. Patients with uraemia receive an intensive exchange of information during their medical treatment and should not be afraid to address open questions and other treatment options in addition to the medication.
Many patients perceive the change in diet in particular as a turning point. Some sufferers find this vital circumstance easier than others. However, knowing that you are on a high-calorie but low-fat, low-protein, low-potassium and phosphate-free diet is a big step towards accepting the disease.
At the same time, the amount you drink must be adapted to the capacity of the kidneys and the body weight must be checked and recorded daily. In the lifelong aftercare process, it should be important to the person concerned to deal with their symptoms as positively as possible, to be enthusiastic about nice hobbies in order to maintain a stable mental life.
You can do that yourself
With this state of health, there are hardly any possibilities of self-help. Organ failure requires intensive medical care. Therefore, the sufferer should, under all circumstances, seek the help and support of medical professionals. There are no self-responsible measures that could alleviate the symptoms. It is a life-threatening condition in which the person affected usually has little room for manoeuvre.
A sufficient exchange of information about the possibility of kidney failure with urinary poisoning should take place in advance. Normally, the patient is already receiving medical treatment due to a diagnosed kidney disease. In this meeting, open questions, upcoming changes and a possible further course of the disease should be discussed. In addition, open questions can be answered by researching medical specialist literature, special forums on the Internet or participation in self-help groups. In many cases, the exchange with other affected people is perceived as supportive and strengthening.
Despite all the adversities, a fundamentally positive attitude towards life is helpful in overcoming the existing symptoms. As far as possible, relatives should give the sick person courage, be there for them and promote joie de vivre. A stable and healthy psyche is elementary in dealing with the overall situation. Talking, laughing together and humor have a positive effect.