TO THE layman, the term “uremia” may sound Latin and does not know anything about it. However, to health professionals- doctors, nurses, medical technologists- uremia is a word that implies an impending terminal kidney failure, or a chronic kidney disease (CKD) or end-stage renal disease (ESRD). Obviously, it is a serious medical condition which requires close monitoring and immediate aggressive management.
Uremia is a complex syndrome (combination of signs and symptoms) caused by kidney failure characterized by variable biochemical as well as clinical abnormalities. There is an inability of kidneys to excrete waste products which when accumulated in excess, could potentially harm the other organs in the body; there is also the inability to reabsorb and conserve needed substances, which sadly, are flushed out into the urine.
Clinically, the alarming manifestations of uremia include central nervous system symptoms which could range from mild headaches, twitching, convulsive seizures and coma, a variety of gastrointestinal symptoms like nausea, vomiting, profuse diarrhea, although some patients have constipation instead, changes in the eye grounds that induce visual disturbances,; cardiovascular involvement particularly pericarditis which limits the effective contraction of the heart; respiratory difficulties like dyspnea, easy fatigability.
Uremic patients have a sallow, pale skin due to the anemia- remember that the source of stimulation for red blood cell in the bone marrow is secreted by the kidneys-the sallow nature is a light yellow shade due to the pigment urochrome.
There are many causes of uremia, but most of them have something in common- the chronicity or how long the clinical condition has not been adequately managed- examples would be a high blood pressure which the patient took for granted, that if ever medicines were taken, they were under dosed, taken on and off and worse, not taken at all, short of the patient having a stroke; also there is the poorly controlled blood sugar of the diabetic; or those whose urinary tract infection- pyelonephritis- has been on and off treated but not fully cured. In older men whose enlarged prostate may already been causing obstruction of urine flow, there may be retrograde backflow of urine which may reach the kidneys and becomes a culture medium for bacterial growth.
The message our column to our dear readers is to be aware and appreciative of the role played by the kidneys in our over-all health, not just our concern and fear for a heart attack or a stroke, now called brain attack.
In other words, symptoms referable to the kidneys like flank pains or backside pains, dysuria-painful urination, frequency of urinating voluminous amounts of urine-polyuria, or a lab finding of high blood sugar or uric acid, see and consult your family physician immediately.
As they say, “an ounce of prevention is better than a pound of cure.”
Again, it must be stressed that when the kidneys would have reached a point of “irreversible defect” meaning kidney failure, the only remedy would be periodic dialysis until hopefully, a suitable kidney donor is found. Love your kidneys!