Is uremia serious in the early stages?

Written by Li Liu Sheng
Nephrology
Updated on May 11, 2025
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In the early stages of uremia, although the condition is not as severe as in full-blown uremia, the patient will still experience many uncomfortable symptoms. For example, after getting up in the morning, the patient may notice swelling in the eyelids on both sides, feel nauseous and have a significant decrease in appetite. They may also feel fatigued and tired after physical activity. Additionally, changes in the volume of urine occur, such as an increase in the frequency of nighttime urination to three to five times. Patients may also experience varying degrees of dizziness, headaches, and gradually increasing blood pressure that is difficult to control. Other symptoms include itchy skin and muscle soreness, among other clinical signs. Therefore, timely treatment in the early stages of uremia is necessary to slow the rapid progression of chronic kidney disease to the uremic stage.

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Written by Li Liu Sheng
Nephrology
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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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Nephrology
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How to diagnose uremia

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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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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Nephrology
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How is uremia caused?

Uremia, also known as end-stage renal disease, is actually the late stage of chronic renal failure development, capable of causing long-term chronic damage to the kidneys. There are many reasons for this, and if these causes persist over a long period, continuously harming the kidneys without effective removal or control, it could eventually lead to severe renal failure, ultimately causing uremia. The causes that can chronically harm the kidneys mainly include diabetes, hypertension, chronic nephritis, polycystic kidney, urinary system stones, tumors, and other such conditions.

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Does uremia cause blood in urine?

Patients with uremia may experience hematuria, but not all patients will do so. Uremia refers to a condition where over 90% of the patient's kidney tissue has been damaged. Due to the destruction of kidney tissue, when blood passes through the kidneys, it is indeed possible that red blood cells will leak from the glomeruli into the urine. Therefore, patients with uremia may exhibit signs of hematuria, especially those caused by primary chronic glomerulonephritis. If the uremia is caused by tumors or kidney stones leading to urinary obstruction, this situation can cause bleeding in the ureters or bladder, also resulting in hematuria. However, most patients with uremia have a very low chance of experiencing hematuria because the vast majority of their kidney tissue has been destroyed, even up to 100%, leaving no urine production, and thus no blood in the urine. If an anuric patient exhibits hematuria, the possibility of stones, tumors, or urinary tract infections should be considered.