Causes and symptoms of chronic uremia
Chronic uremia
Chronic uremia manifests itself as a strong intoxication of the body, due to renal failure. With uremia, metabolism is disturbed, acidosis occurs. Toxins accumulate in the body, from which various organs and systems suffer.
Causes of chronic uremia
Most of the symptoms of chronic uremia are based on dehydration and a shift in acid-base balance, acidosis. Uremia can develop against the background of impaired renal function, when the outflow of urine is difficult. The cause of urinary tract disorders can be prostate diseases, kidney and ureteral stones, urethral strictures. All of these factors cause a gradual increase in the symptoms of uremia, as urinary excretion slows down more and more over time. Chronic uremia can also be caused by kidney diseases occurring in a chronic diffuse form: glomerulonephritis, pyelonephritis, atherosclerotic wrinkled kidney syndrome against a background of hypertension.
Symptoms of chronic uremia
Among the first symptoms of chronic uremia can be noted the appearance of weakness, lethargy, apathy. The patient complains of headaches, his sleep is disturbed, his memory suffers. A blood test shows a high content of residual nitrogen, urea and creatinine. Later, nitrogenous toxins begin to be released through the skin, mucous membranes and serous membranes, causing their irritation, which causes the development of uremic gastritis, colitis, laryngotracheitis, pleurisy, pericarditis. Intoxication disrupts liver function, affects bone marrow function, causes anemia and thrombocytopenia. Patients have a tendency to bleed, weakened or lost vision.
In extremely severe cases, a uremic coma occurs, which is accompanied by loss of consciousness and deep noisy breathing (Kussmaul), in some cases, pathological breathing of the Cheyne-Stokes type develops. The patient's pupils are constricted, the smell of ammonia is felt next to his bed. When diagnosing, uremic coma should be distinguished from diabetic, hepatic, etc.
Chronic uremia becomes the cause of irreversible changes in the kidneys. It can last for years, and often patients do not feel serious discomfort, their condition remains relatively satisfactory for a long time.
Treatment of chronic uremia
Treatment of chronic uremia is reduced to the elimination of obstacles to the excretion of urine from the body, diet therapy (maximum exclusion of protein foods from the diet), restoration of acid-base balance (alkalis are used to combat acidosis). Patients undergo bloodletting with the simultaneous administration of a solution of glucose (5%) or sodium chloride (0.9%).
To get rid of toxins that constantly accumulate in the stomach and intestines, daily washing and enemas help. Also, peritoneal dialysis is performed using slightly alkaline solutions, the basis of the beneficial effect of which is the ability of the peritoneum to rapidly absorb and excrete fluid in large volumes.
In severe cases, therapy using the "artificial kidney" apparatus is indicated. It helps to effectively cleanse the blood of toxins.
In case of chronic uremia, it is recommended to follow a fat-carbohydrate diet with a restriction of the daily dose of table salt to 4 g, protein to 22 g. If there is no risk of edema, large amounts of fluid are beneficial. In some cases, the diet is selected individually, based on the specifics of metabolic disorders. Patients with chronic uremia also need B vitamins (the most important B1 and B6) and ascorbic acid. To combat putrefactive bacteria, in addition to antibiotic therapy with tetracycline and olettrin, the use of lactic acid products is recommended.
Patients with chronic uremia also need symptomatic therapy. High blood pressure is reduced with reserpine, iron supplements are prescribed for anemia, and red blood cell transfusion is indicated for progressive anemia. With extreme caution, heart failure is treated with cardiac glucoside preparations. It is necessary to take into account the delayed excretion of these drugs from the body by the kidneys, the excretory functions of which are impaired. With an exacerbation of chronic kidney disease, which caused uremia, appropriate treatment is prescribed.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
