From the Guidelines
Uremia is primarily caused by kidney failure, which can result from acute kidney injury (AKI) or chronic kidney disease (CKD), with the latter being a more common cause of uremia in the long term. The main causes of kidney failure leading to uremia include CKD, which can result from conditions like diabetes, hypertension, glomerulonephritis, polycystic kidney disease, and recurrent kidney infections 1. AKI, on the other hand, can cause uremia due to severe dehydration, blood loss, sepsis, certain medications, contrast dyes used in imaging studies, and urinary tract obstructions such as kidney stones or enlarged prostate. Some key points to consider in the causes of uremia include:
- Prerenal factors, such as impaired blood flow from any cause including hypotension, hypovolemia, decreased cardiac output, or renal artery occlusion, can contribute to AKI and subsequently uremia 1.
- Renal causes, including any disease that damages renal parenchyma, such as vasculitis, acute tubular necrosis, glomerulonephritis, interstitial nephritis, renal infection or infiltration, drugs, and toxins, are also significant contributors to AKI and uremia 1.
- Postrenal AKI, resulting from ureteral, bladder, or urethral obstruction, is less common but can also lead to uremia 1. Uremia develops when kidney function declines to the point where waste products like urea, creatinine, and other nitrogenous compounds accumulate in the bloodstream, leading to symptoms such as nausea, fatigue, confusion, itching, and in severe cases, seizures or coma. Treatment typically involves addressing the underlying cause, managing complications, and in advanced cases, renal replacement therapy such as dialysis or kidney transplantation, with the goal of improving morbidity, mortality, and quality of life for patients with uremia.
From the Research
Causes of Uremia
- Uremia is a chemical, toxic, potentially fatal condition that can be produced by hundreds of diseases, both kidney and systemic (e.g., diabetes) 2.
- The condition ultimately kills almost every cell in the body and can range from acute and catastrophic to slowly and moderately progressive 2.
- Uremia is associated with end-stage renal disease (ESRD), which affects approximately 745,000 individuals in the United States 3.
- ESRD is diagnosed when kidney function is no longer adequate for long-term survival without kidney transplantation or dialysis 4.
Related Conditions
- Hyperkalemia, hypervolemia, metabolic acidosis, anemia, mineral and bone disorders, and protein-calorie malnutrition are common complications of ESRD 3.
- Pain, nonpain symptoms, and fatigue are also common in patients with ESRD and can affect quality of life 5.
- Uremia-associated nausea and pruritus can be managed with medications such as ondansetron, naltrexone, and phosphate binders 5.