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Understanding Uremia

Uremic syndrome involves the impairment of several biochemical and physiological functions associated with deteriorating renal function. Uremia presents as a broad array of symptoms and is characterized by an accumulation of toxins, which are classified based on size and protein binding. Dialysis is the mainstay of toxin removal, although kidney transplantation may be necessary in severe cases. Clinical effects of uremic toxins are proposed based on surrogate mechanisms of oxidative, endothelial, and erythrocyte damage. Currently, drug therapy targeting uremic symptoms is anecdotal. Uremic bleeding is the most well-described symptom in the literature, and viable therapeutic options for management…

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Articles of Interest

Chronic Renal Failure & the Uremic Syndrome

Patients are usually asymptomatic until kidney failure is advanced. When the GFR falls to approximately 10–15 mL/minute, nonspecific symptoms such as general malaise, weakness, insomnia, inability to concentrate, and nausea and vomiting begin to appear. Eventually other symptoms and signs that reflect generalized organ dysfunction develop as part of the uremic syndrome

Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease

Patients with chronic kidney disease and end-stage renal disease are at 5- to 10-fold higher risk for developing cardiovascular disease (CVD) than age-matched controls. Clinically, CVD in this population manifests as coronary artery disease, arrhythmias, stroke, or congestive heart failure.

Neurologic conditions and disorders of uremic syndrome of chronic kidney disease: presentations, causes, and treatment strategies

Uremic syndrome of chronic kidney disease (CKD) is a term used to describe clinical, metabolic, and hormonal abnormalities associated with progressive kidney failure. It is a rapidly growing public health problem worldwide. Nervous system complications occur in every patient with uremic syndrome of CKD.

The Link Between Chronic Kidney Disease and Uremia

In a Pharmacy Times® interview, Despoina Manousaki, MD, PhD, pediatric endocrinologist and assistant professor at CHU Sainte-Justine Research Centre, spoke about her 2021 ASN Kidney Week presentation on genetic determinants of vitamin D metabolism and the impact of uremia. In this video, she discusses the connection between chronic kidney disease and uremia.

The quest for a better understanding of chronic kidney disease complications: an update on uremic toxins

Chronic kidney disease is characterized by a progressive reduction of glomerular filtration rate and/or the appearance of proteinuria, and subsequently the progressive retention of organic waste compounds called uremic toxins (UT). Over the last decades, a large number of such compounds have been identified and their effects on organs and tissues, especially the cardiovascular system, has been demonstrated.

Uremia, a complication of chronic kidney disease: Causes, symptoms, treatment, and diet

Uremia or uremic syndrome is a condition that develops when your kidneys become too damaged to filter out harmful substances from the body, particularly urea and creatinine. Instead, increased levels of these substances build up in the blood, leading to the manifestation of dangerous side effects that may eventually become life-threatening.

Uremic Cardiomyopathy: A New Piece in the Chronic Kidney Disease-Mineral and Bone Disorder Puzzle

Cardiovascular diseases are the main cause of death in chronic kidney disease (CKD) patients. In dialysis patients, sudden cardiac death accounts for 40% of all deaths. In these patients, sudden cardiac death is usually secondary to an underlying cardiomyopathy, which is clinically identified by the high prevalence of left ventricular hypertrophy and the resultant mechanical and electrical dysfunction. CKD-related cardiomyopathy has a multifactorial pathophysiology.

Uremic syndrome of chronic kidney disease: altered remote sensing and signaling

Uremic syndrome (also known as uraemic syndrome) in patients with advanced chronic kidney disease involves the accumulation in plasma of small-molecule uremic solutes and uremic toxins (also known as uraemic toxins), dysfunction of multiple organs and dysbiosis of the gut microbiota. As such, uremic syndrome can be viewed as a disease of perturbed inter-organ and inter-organism (host–microbiota) communication.

Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets

Chronic kidney disease (CKD) is a progressive loss of renal function. The gradual decline in kidney function leads to an accumulation of toxins normally cleared by the kidneys, resulting in uremia. Uremic toxins are classified into three categories: free water-soluble low-molecular-weight solutes, protein-bound solutes, and middle molecules.

What Hiding Under the Uremia...

Considering that renal disease and uncontrolled hypertension often co-exist together, it is important to have a high index of suspicion for PRES (Posterior Reversible Encephalopathy Syndrome) in patients being treated for uremic encephalopathy.

What Is Uremia?

Putative uremic toxins include parathyroid hormone, macroglobulin, advanced glycosylation end products, and beta2 microglobulin, though no specific uremic toxin has been identified as responsible for all clinical manifestations of uremia. There are many symptoms of uremia that occur as kidney function declines. Before severe uremia develops, treatments such as dialysis and transplantation are usually needed. The timing of dialysis will depend on your symptoms and varies from person to person.

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StatPearls

Uremia is a clinical condition associated with worsening renal function. It is characterized by fluid, electrolyte, hormonal, and metabolic abnormalities. Uremia most commonly occurs in the setting of chronic and end-stage renal disease but may also occur due to acute kidney injury.