How to diagnose uremia

Written by Zhou Qi
Nephrology
Updated on September 12, 2024
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Uremia is the final state of chronic renal failure. This disease cannot be diagnosed through physical examination and medical history inquiry alone. Diagnosis requires testing, combined with the patient's physical examination and medical history, to comprehensively determine the diagnosis. Patients with uremia first need to have a blood test to check kidney function, with blood creatinine levels needing to exceed 707μmol/L. Secondly, they should undergo an ultrasound of the urinary system. Typically, the kidney size in such patients is reduced, which can be detected by the ultrasound. These two diagnostic methods used together can diagnose uremia. Patients also need to be checked for potential complications caused by uremia, such as measuring blood pressure and performing a complete blood count to check for renal anemia, among others.

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Precursors of uremia

The kidneys have a very strong compensatory ability. When kidney function is slightly impaired, they can generally still handle the basic physiological functions of the human body through compensation, so patients may feel that everything is normal. Despite the fact that the occurrence and development of uremia is a long and gradually worsening process, which can sometimes be very severe, it is still possible to detect early signs of uremia if one actively seeks them out early on. Early indications of uremia can be identified in time by going to the hospital for urine and blood tests. The early signs of uremia often manifest as general fatigue, which is the symptom most easily overlooked. Other symptoms of early uremia include edema, especially noticeable swelling of the eyelids and facial area after waking up in the morning. If it develops into systemic or persistent edema, the condition is already very serious. Additionally, early-stage uremia patients may also experience an increase in the frequency of nocturnal urination and more foam in the urine, as well as increased blood pressure, and even dizziness, headaches, and a lack of appetite. These are all early signs of uremia.

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What causes uremia?

Uremia is very common in clinical practice. It is mainly caused by abnormal kidney functions, leading to abnormalities in glomerular filtration, as well as in the reabsorption and secretion functions of the renal tubules, which results in a series of symptoms. Once uremia occurs, it can disrupt the internal environment of the body, cause electrolyte abnormalities, and even lead to life-threatening arrhythmias. Uremia is very dangerous in clinical practice and often requires regular hemodialysis treatment. Therefore, once uremia occurs, medical attention must be sought promptly.

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Can uremia be cured?

First, it is necessary to clarify the cause and the severity, so it is important to visit the nephrology department for comprehensive tests. Once the cause is determined, the next steps can be planned based on the results, and dialysis may be necessary if required. If there is no improvement, treatments such as kidney transplantation can be considered. It is also crucial to rest, avoid fatigue, reduce activities, especially strenuous activities, maintain a positive mood, adjust your mentality, and have regular follow-ups. Therefore, this issue needs to be actively addressed, as it can be very troublesome to manage and the prognosis may be very poor if not taken seriously.

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Is high creatinine uremia?

High creatinine levels do not necessarily indicate uremia, but during uremia, creatinine levels will certainly increase. Clinically, we consider creatinine levels above 707 as uremia. Once uremia is diagnosed, treatment mainly involves renal replacement therapy or transplantation. Renal replacement therapy mainly includes hemodialysis and peritoneal dialysis, each with its own advantages and disadvantages, and the choice should be based on the patient's individual condition. Renal transplantation is currently the best treatment option, which can be done through relatives or donations. After a kidney transplant, one can live and work like a normal person, but long-term oral immunosuppressive medication is required.

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What should I do about tinnitus caused by uremia?

Tinnitus in uremia requires further consultation at the ENT department of a formal public hospital. Tinnitus is not a typical symptom of uremia and may not necessarily be related to kidney disease or caused by uremia. Some patients may experience tinnitus due to severe anemia, which leads to insufficient blood supply in the skull, or due to persistently high blood pressure caused by uremia, which can also potentially cause tinnitus. However, the probability of these scenarios is generally low, and it is still recommended that patients seek further consultation at an ENT department to clarify potential causes, such as infections or tumors in the inner ear system.