The dangerous consequences of kidney failure: Let's learn about Uremia in simple terms

Imagine what would happen if you couldn't take out the trash in your house for a few days? The whole house would get dirty and start smelling, wouldn't it? Our bodies are the same way. If our body's 'trash filter', that is, the kidneys, don't work properly, toxins start to accumulate inside the body. That dangerous condition, where the level of toxins increases and symptoms appear, is called Uremia. This is not a condition to be trifled with. Let's talk about this in detail.

Simply put, what is Uremia?

Uremia is a dangerous condition that occurs when your kidneys are not working properly and are unable to filter and remove waste products from your blood. This is the end result of untreated kidney failure . Symptoms of uremia occur when waste levels in your blood become very high.

Normally, when our kidneys are healthy, they filter waste products and extra fluids from the blood. These waste products and fluids are excreted from the body in the form of urine (pee). They also help maintain the proper levels of acids, electrolytes, and hormones like vitamin D and erythropoietin (EPO). When the kidneys are damaged, this filtering process does not work properly. As a result, toxins build up in the body.

Uremia is most often caused by kidney failure due to chronic kidney disease (CKD) . This is also known as end-stage renal disease (ESKD). It can also occur if kidney failure occurs due to a sudden, severe kidney injury (acute kidney injury).

What are the symptoms of uremia?

The symptoms of uremia do not become severe all at once. They are very subtle at first. It is very important to recognize these symptoms correctly and seek medical advice quickly.

The first symptoms are nausea, vomiting, and loss of appetite . You may feel nauseous when you first wake up in the morning. You may also have an aversion to the smell of food. Some people may not eat until they start eating. If a kidney transplant is not an option, a doctor may recommend starting dialysis as soon as these mild symptoms begin.

What are the main causes of uremia?

The main cause of uremia is chronic kidney disease (CKD), which causes complete kidney failure. Any disease that causes CKD can eventually lead to kidney failure and uremia.

The most common causes of CKD among us in Sri Lanka are:

• Diabetes
• High blood pressure (Hypertension)

There can be many other reasons besides these two. Therefore, if you have diabetes or high blood pressure, it is essential to always take care of your kidney health.

Who is more at risk?

People who have kidney failure and are unable to start dialysis before symptoms of uremia appear are at the highest risk. Sometimes, people don't even know they have chronic kidney disease. This can result in them not getting the treatment they need to prevent kidney failure.

If you have CKD, especially if your estimated kidney function (eGFR) is less than 45, it is very important to see a nephrologist and begin treatment.

How to recognize this condition?

Your doctor will follow several steps to diagnose uremia.

1. Listen carefully to your symptoms.

2. Ask about your and your family's health history, especially kidney disease.

3. A complete physical examination is performed.

4. Several blood tests are done to check kidney function.

These blood tests mainly look at these things.

In addition to these tests, things like a kidney ultrasound scan may be done to find the cause of kidney failure.

What are the treatments for uremia?

The only way to completely cure uremia is to restore kidney function. That is, to restart the kidneys' function, either artificially or naturally.

There are two main treatment methods:

1. Dialysis

This involves cleaning your blood using a machine or other method.

• Hemodialysis: This involves sending blood to a machine outside your body, cleaning it, and then returning it to your body.
• Peritoneal Dialysis: This uses the lining of your abdomen (peritoneum) and a special fluid to purify your blood.

2. Kidney Transplant

This is the best treatment option. In this case, the damaged kidney is replaced with a kidney from a healthy donor (living or deceased). Since kidney transplantation is preferable to dialysis, it is very important to consider it.

Can't it be cured with medicine?

Medications cannot completely cure the symptoms of uremia. However, your doctor may prescribe medications such as these to help prevent other effects of uremia on the body:

• EPO hormone to prevent anemia.
• Iron tablets if you have iron deficiency.
• Calcium, vitamin D, and phosphate binders to prevent bone disease.

When should you see a doctor?

See your doctor regularly to monitor the health of your kidneys, especially if you have risk factors for kidney disease.

• If anyone in the family has kidney disease.
• If you have high blood pressure.
• If there are changes in urination patterns.
• If you have swelling in your ankles, hands, or face (edema).
• If you regularly take NSAIDs.

Can uremia be prevented?

Preventing uremia actually means preventing or controlling the development of chronic kidney disease (CKD). If you have CKD, you can do these things to help prevent the disease from getting worse:

• Work closely with a nephrologist.
• Keep your blood pressure, diabetes , and other medical conditions under control.
• Take the medications prescribed by the doctor exactly and on time.
• Avoid medications (especially NSAIDs), alcohol, and other drugs that can damage the kidneys.
• Follow a heart-healthy, low-salt diet.
• Exercise well.
• Maintain a healthy body weight.
• If you smoke, stop it immediately.

Uremia, Kidney Disease, Kidney Failure, Dialysis, Chronic Kidney Disease, CKD, Kidney Failure Sinhala