Acute Kidney failure can be a so-called Uremia trigger a 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
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The acute or chronic Kidney failure with urinary poisoning, medical Uremia called, is the end stage of kidney failure. The kidneys are no longer able to perform their task of cleaning the blood from the body's own urinary substances, such as urea, and toxins foreign to the body, such as drugs.
These substances can no longer be filtered and excreted. The specific characteristics of uremia are impaired excretion of water and electrolytes, combined with a disruption of the acid-base balance. The life-threatening effects of such a disorder are, for example, dizziness or coma.
The breakdown of urea and creatinine is also disturbed. Creatinine is a breakdown product of muscle substances, urea is a waste product from the transformation of urea and protein. Hormonal disruption is the third trait that affects blood pressure, boil and blood formation.
causes
The difference between acute and chronic Uremia is at the time of occurrence: chronic uremia develops over years, the acute occurs five to a maximum of ten days after acute kidney failure.
The causes of kidney failure with urinary poisoning therefore lie in inadequate or absent therapy for kidney failure. Complete or partial kidney failure is triggered by [[poisoning], inflammation, insufficient blood flow to the kidneys or urinary congestion. The kidney failure itself is mostly the result of inadequately 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 consequently uremia.
Symptoms, ailments & signs
Uremia is a very serious kidney disease that leads to a variety of symptoms. It is an acute or chronic kidney failure due to urinary poisoning. In addition to therapy-resistant itching all over the body, the main symptoms are intestinal inflammation. This leads to nausea, vomiting and often bleeding from the stomach and intestines.
Furthermore, an inflammation of the pericardium can develop, which later often leads to severe heart failure. Cardiac arrhythmias are also possible, which in turn arise on the basis of hyperkalemia. Pulmonary edema with severe breathing problems and cyanosis is also sometimes observed. An accumulation of water in the abdomen (ascites or ascites) can also occur.
Furthermore, disorders of the immune system and anemia occur. The 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 urea concentration in the blood also leads to neurological complaints, because depending on the concentration, urea can damage nerves.
Personality changes, states of agitation, amnesia, abnormal sleepiness or even coma can occur. In addition, peripheral nerves are often damaged. As a result, a polyneuropathy with increasing sensitivity disorders, gait disorders, paralysis and skin changes can develop. Muscle twitches in whole muscles or muscle groups such as the trunk and extremity muscles are also possible.
Diagnosis & course
The medical diagnosis includes Uremia- Suspected a detailed medical history and thorough physical examination. This includes the analysis of urine and blood for abnormalities, for example the amount or the substances contained.
A kidney ultrasound is also one of the standard methods. Imaging procedures with contrast agent administration are only carried out in exceptional cases to protect the kidneys. In some cases, the kidney may need to be punctured.
If left untreated, kidney failure with urinary poisoning is fatal. The prognosis of acute uremia is good if medical help is sought in good time and the underlying disease that causes it can be treated well. Chronic uremia, on the other hand, requires permanent renal replacement therapy. Complications such as cardiovascular diseases and a high susceptibility to infection are common.
Complications
If left untreated, kidney failure with urinary poisoning leads to death of the patient. Chronic uremia requires renal replacement therapy using dialysis. This treatment method is usually perceived as very stressful by the patients. Dialysis usually includes 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. The withdrawal of water in the course of blood washing reduces the blood volume, the blood pressure, i.e. the fluid pressure in the vessels, drops.
If the lack of fluid 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 unpleasant symptoms for the patient, in particular nausea, vomiting, severe dizziness and temporary visual disturbances.
In addition, dialysis patients often get infections of the shunt, i.e. the surgically placed vascular access, or tunnel infections on the catheter that is 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. If there is bleeding, pain or general discomfort, medical help is needed. Since there is a risk of premature death without adequate medical care, a visit to the doctor is recommended as soon as the first irregularities occur. Inflammation, fever, loss of performance, or persistent itching should be investigated and treated. If the symptoms spread or if they intensify, a doctor should be consulted.
Cardiac disorders, dizziness or abnormal sensations must be clarified. Excessive sensitivity, numbness, or agitation are a cause for concern. Increased tiredness, interruptions to sleep or unsteady gait are further indications of an existing illness. A doctor must be consulted as the symptoms indicate the progression of the disease and require treatment. Action is required in the event of paralysis or unstoppable twitching of the muscle fibers.
If there is a change in the state of consciousness or an acute health-threatening situation, an emergency service must be alerted. General malfunctions, gastrointestinal irregularities, or cramps should be presented to a doctor. A doctor's visit is necessary in the event of changes in the appearance of the skin, abnormal behavior or persistent excitement. If the person concerned is perceived as unusual by people in their immediate vicinity, a doctor should be consulted.
Treatment & Therapy
The treatment is between chronic and acute Uremia distinguished. Chronic uremia 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 illnesses must be treated accordingly.
In addition, the conservative measures that are used in acute uremia are used. This includes the treatment of the underlying disease of the kidneys, for example the better control of blood sugar in diabetics. Regular medical checks are also a matter of course. The intake of diuretics, which serve to support the elimination of electrolytes and urea, takes place after careful consideration of the risks and side effects.
Patients have to adjust the amount they drink according to the elimination abilities of their kidneys. A change in diet is also recommended: a diet low in protein and potassium but high in calories reduces the amount of urea. Avoiding phosphates is also recommended. Current studies in the USA question the success of a change in diet, but it is still state of the art.
Outlook & forecast
Kidney failure with urinary poisoning represents a potential threat to human life. Without immediate professional medical care, there is a risk of sudden death. If medical care is provided as quickly as possible, the patient's survival can be ensured. Therapies are initiated immediately that stabilize the functioning of the organism. However, the treatment approaches are very stressful for the patient and his social environment. In addition, side effects can occur that are difficult for many to cope with.
In most cases, regular dialysis is needed to ensure survival. This method leads to severe restrictions in coping with everyday life. If the outcome is unfavorable, there is a risk of psychological secondary illnesses due to the emotional stress experienced. This significantly worsens the well-being of the person concerned and can in turn have a negative effect on the further physical condition.
For a large number of patients, a donor organ is needed to permanently alleviate symptoms and improve quality of life. Although an organ transplant is associated with numerous complications and side effects, it is often the last and only solution. If the surgical procedure can be carried out without further complications, a considerably improved health situation can be expected afterwards.
prevention
To one Uremia To prevent this, patients with kidney failure should seek treatment. If you already have kidney weakness, regular medical examinations and the observance of special precautionary measures, in particular self-observation, are essential. Risk patients should check their weight every day, observe urine excretion and the amount of urine, avoid drugs and substances that damage the kidneys, support the immune system and follow prescribed measures.
Aftercare
With regard to the symptoms of the disease, those affected should attach great importance to their aftercare. Finally, the organ failure has to be looked after by intensive medical care. With follow-up care that is consistently tailored to the patient, he or she can learn to deal with the accompanying symptoms. The self-responsible measures are a priori based on regular examinations, dialysis appointments and the rehabilitation measures that are used wherever possible, as well as self-help groups.
Exchanging ideas with like-minded people or during psychotherapeutic sessions can help to find courage, to understand the complexity of the disease and to maintain one's standard of living. Patients with uremia receive an intensive exchange of information in their medical treatment and should not be afraid to address open questions and other treatment options in addition to medication.
Many patients find the change in diet in particular to be a major turning point. Some people affected find this vital circumstance easier than others. However, knowing that you are subject to a high-calorie, low-fat, low-protein, low-potassium and phosphate-free diet is a major step towards acceptance of the disease.
At the same time, the amount of water you drink must be adjusted to the ability of the kidneys and your body weight must be monitored and recorded daily. In the lifelong aftercare process, it should be a concern of the person affected to deal with their symptoms as positively as possible, to be enthusiastic about beautiful hobbies, in order to maintain a stable mental life.
You can do that yourself
With this state of health there are hardly any possibilities for self-help. Organ failure needs intensive medical care. Therefore, the person concerned should under all circumstances seek the help and support of medical professionals. There are no independent measures that could alleviate the symptoms. It is a life-threatening condition in which the person affected usually does not have much room for maneuver.
Sufficient information should be exchanged in advance about the possibility of kidney failure with urinary poisoning. Usually, the sick person is already undergoing medical treatment due to a diagnosed kidney disease. In this, open questions, upcoming changes and a possible further course of the disease should be discussed. In addition, open questions can be answered through research in medical specialist literature, special forums on the Internet or participation in self-help groups. The exchange with other affected persons is perceived as supportive and strengthening in many cases.
Despite all the adversities, a generally positive attitude towards life is helpful in coping with existing complaints. As far as possible, relatives should encourage the sick person, be there for him and promote the joy of life. A stable and healthy psyche is elementary when dealing with the overall situation. Conversations, mutual laughter and humor all have a positive effect.
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