The precursors of uremia

Written by Zhou Qi
Nephrology
Updated on February 27, 2025
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The so-called uremia refers to the end result of chronic kidney disease causing long-term damage to the kidneys in patients. Patients with uremia often have long-standing conditions, as it takes time to progress from mild kidney failure to uremia. Before the onset of uremia, patients may experience symptoms related to kidney failure, such as swelling of the limbs and face, reduced urine output, proteinuria which leads to foamy urine, and visible blood in the urine due to hematuria. Patients are also prone to developing high blood pressure. These symptoms can be precursors to uremia, although other diseases can also cause similar symptoms.

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Written by Zhou Qi
Nephrology
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What tests are involved in checking for uremia?

Uremia refers to the final stage of chronic renal failure, also known as end-stage kidney disease. Therefore, the first step in examining a patient with uremia is to check renal function. The patient's blood creatinine level must reach a certain level to diagnose uremia. Secondly, it is necessary to examine the urinary system through color Doppler ultrasound, and to conduct blood tests for routine blood indicators, electrolytes, parathyroid hormone, etc. The color Doppler ultrasound shows a reduction in kidney size, which provides evidence for the diagnosis of uremia. Patients with uremia often also suffer from various complications, including anemia, electrolyte disorders, hyperparathyroidism, and so on. Therefore, such patients also need to undergo examinations for routine blood parameters, electrolytes, and parathyroid hormone levels, among other indicators.

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Written by Li Liu Sheng
Nephrology
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Causes of Uremia

Uremia is a syndrome caused by the progressive development of various chronic kidney diseases that ultimately leads to bilateral renal failure in patients, unable to timely remove excess water, electrolytes, and various toxins from the body. The causes of uremia are many and complex. Common causes include chronic nephritis, diabetic nephropathy, and hypertensive nephropathy. Other diseases such as chronic interstitial nephritis, chronic pyelonephritis, uric acid nephropathy, chronic obstructive nephropathy, renal vascular diseases, and hereditary nephritis can also lead to uremia. Once uremia occurs, patients often exhibit symptoms of general discomfort and may need to choose dialysis treatment, which can be either hemodialysis or peritoneal dialysis, depending on individual circumstances.

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Written by Li Liu Sheng
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Symptoms of Uremia

Once diagnosed with uremia, patients exhibit numerous clinical symptoms, though these symptoms are not completely identical across different individuals. Typically, the primary symptoms of uremia include nausea, vomiting, loss of appetite, with these symptoms becoming more pronounced after eating. There might even be diarrhea, an increase in the frequency of bowel movements, and gastrointestinal bleeding. Additionally, patients show signs of edema, particularly around the eyelids and face, with very noticeable swelling in the lower limbs. Severe cases may also present with pleural effusion and ascites, accompanied by a reduction in urine output. Patients may also experience dizziness, headache, elevated blood pressure, and even exhibit pallor, anemia, itchy skin, bone pain, and intolerance to cold, among various other clinical symptoms.

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Does uremia hurt?

The so-called uremia refers to patients whose kidney function has been lost by more than 90%, and the vast majority of kidney tissue has been destroyed. Although the condition of these patients is very serious, they do not experience pain symptoms. In patients with uremia, the kidney tissue has hardened, and in most of the causes leading to uremia, pain is not induced. Even though the kidneys have severe problems, there are no nerves in the kidneys to sense pain, as there are no sensory nerves, so the kidneys do not feel pain. Causes that can lead to uremia include diabetes, hypertension, chronic nephritis, urinary system stones, tumors, and more. Painful conditions are mainly caused by urinary system stones, while other causes generally do not entail pain.

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Written by Zhou Qi
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Is uremia hereditary?

Uremia is not actually an independent disease, so it's difficult to say that uremia is hereditary. Uremia refers to a condition where the kidneys are 90% damaged. However, there are many reasons that can cause more than 90% of kidney tissue damage; among these, some are genetic diseases, but most are not hereditary. Common causes of hereditary uremia include diabetes, as well as primary chronic glomerulonephritis, hypertension, urinary system stones, and even prostate tumors, allergic purpura, etc., which can all cause kidney damage. These factors are generally not genetic diseases. However, there are very few causes of uremia that are genetic diseases, mainly including autosomal dominant polycystic kidney disease.