Late symptoms of uremia

In the early clinical uremia only primary disease symptoms can be seen only in the examination creatinine clearance rate. These uremic patients with decompensated often under stress , the sudden deterioration of renal function , and the emergence of symptoms of uremia , clinically known as reversible uremia ; once the stress factor is removed to restore kidney function is often compensated . If the progression of the disease to the " healthy survival" renal unit can not meet the minimum requirements of the body , even in the absence of stress factors , uremic symptoms will gradually manifested . Late symptoms may exhibit the following points:

1 . Hematopoietic system performance : Anemia is uremic patients must have symptoms. Anemia reasons: ① kidney patients erythropoietin decreased. ② retention metabolites ( e.g., methyl , guanidine succinic acid , etc.) inhibition of erythrocyte and mature red cell membrane damage , shortening its life . The presence of toxic substances ( such as erythropoietin inhibitor ) inhibited the activity of erythropoietin ③ blood. Anorexia, diarrhea, and easy bleeding and other causes of iron deficiency when ④ uremia , folic acid deficiency and protein deficiency , the urine protein loss ( especially transferrin loss ) , is also one cause of anemia. Because anemia are many reasons , it is difficult to correct , response to treatment is poor in general . In addition to anemia, as well as easy bleeding, such as ecchymosis , epistaxis , gingival bleeding, black stools , etc. ; This is because uremia , platelet function is poor, can easily be destroyed , together with acidosis increases capillary fragility and other reasons year. In addition , in the nephrotic syndrome, especially when the adrenal cortex hormone therapy, and may be due to inhibition of coagulation factor higher multiple coagulation factor activity weakened , hypoalbuminemia lead to blood concentration, blood is hypercoagulable state can be easily vascular thrombosis .

2 . Mental , neurological manifestations: mental wilt Mi , fatigue, dizziness , headache , memory loss , insomnia , may have limbs tingling, burning , and hand-foot skin itching, itching unbearable even lower limbs must move frequently , you can not stop and so on. Can occur late lethargy , irritability , delirium , muscle tremors or twitching , convulsions, coma. Causes of mental, neurological symptoms , probably metabolite retention, a common result of water , electrolyte imbalance , metabolic acidosis, and high blood pressure, nervous system effects , and peripheral neuropathy may be associated with " the molecules ' retention related.

3 . Metabolic disorders : uremic patients have varying degrees of metabolic disorders. Due to malnutrition, reduced protein synthesis , coupled with the loss of protein in the urine , so many patients have significant hypoproteinemia and weight loss, lower blood levels of essential amino acids , essential amino acids is significantly increased instead . Uremia impaired glucose tolerance , suggesting that the inhibition of carbohydrate utilization organization , fasting blood insulin higher than normal , given regular doses of exogenous insulin many do not make blood sugar drop. Blood insulin , glucagon , growth hormone , parathyroid hormone , adrenocorticotropic hormone, gastrin and so has increased. In addition, uremic patients often accompanied by hyperlipidemia, elevated triglycerides aggravate atherosclerosis , hyperlipidemia is the result of fat metabolism disorders.

Late symptoms of uremia

In the early clinical uremia only primary disease symptoms can be seen only in the examination creatinine clearance rate. These uremic patients with decompensated often under stress , the sudden deterioration of renal function , and the emergence of symptoms of uremia , clinically known as reversible uremia ; But once the removal of stress factors , renal function often return to the generations repayment period . If the progression of the disease to the " healthy survival" renal unit can not meet the minimum requirements of the body , even in the absence of stress factors , uremic symptoms will gradually manifested . Late symptoms may exhibit the following points:

1 . Gastrointestinal manifestations of uremia earliest and most common symptom . Early to anorexia, abdominal discomfort chief complaint , nausea after vomiting, diarrhea, mouth ulcers and oral mucosa urine odor , and even gastrointestinal bleeding and so on. Cause gastrointestinal symptoms , reserving toxic substances (e.g., guanidine ) effects on the nervous system , and increased excretion of urea from the digestive tract , or by the action of the intestinal bacteria produce hydrolytic enzymes and ammonia , ammonium carbonate , gastrointestinal irritation mucosa, causing gastrointestinal disorders , and varying degrees of mucosal inflammation and ulcers. In addition , water, electrolyte and acid-base balance disorders also cause gastrointestinal symptoms for a reason.

2 . Spirit, spirit wilt Mi nervous system , fatigue , dizziness , headache , memory loss , insomnia , may have numb limbs , hands and feet burning and itching of skin , itching unbearable even lower limbs , with frequent moves , you can not stop and so on. Can occur late lethargy , irritability , delirium , muscle tremors or twitching , convulsions, coma. Causes of mental, neurological symptoms , probably metabolite retention common result of leaving the water , electrolyte imbalance , metabolic acidosis, and high blood pressure, nervous system effects , and peripheral neuropathy may be associated with " the molecules ' retention relationship over the large .

3 . Cardiovascular system performance uremia often have high blood pressure , which is mainly due to water and sodium retention , and also part of renin activity increased, decreased secretion of prostaglandins and so on . Longer-term expansion of hypertensive left ventricular hypertrophy causes , myocardial damage , heart failure, and cause systemic arteriosclerosis . Renal arteriosclerosis time and accelerate deterioration of renal function . Retention of toxic substances remain , including elevated parathyroid hormone can cause myocardial damage, occurred uremic pericarditis , then, precordial pericardial friction sound can be heard , a few patients may have symptoms of pericardial effusion , severe cases can occur pericardium tamponade. Uremic pericarditis is one of the critical condition of the performance of the metastatic cardiac calcium would severely damage the heart function.