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6 eGFR Equations (beta)


Definitions of Azotemia and Uremia

© 1997 Andrew Lundin, M.D. All rights reserved. Reproduced with permission.

If I am going to use medical terms, I should define them for you. I would ask you to say when something is not clear, but medical students often do not remember what uremia means and are afraid to ask for fear of public embarrassment.

1. Azotemia (nitrogen in blood):

One major role of a healthy kidney is to get rid of the byproducts of nitrogen metabolism (from protein). Azotemia occurs when the kidneys are damaged and can no longer efficiently get rid of these metabolites. BUN (blood urea nitrogen) and creatinine are just two easily measured markers of nitrogen accumulation. When their levels are increased one can be said to have renal dysfunction. Eight five to 90% of kidney function can be lost (if gradual) before one notices any obvious symptoms. For those who visit a doctor regularly and have blood drawn, kidney dysfunction can be detected by accident. For others, diagnosis comes when they develop symptoms at a late stage, and may require dialysis in the short term. The possible advantage of knowing early is applying the possible interventions that might slow progression and the ability to prepare psychologically (if that is possible).

2. Uremia (urine in blood):

The end stage of "kidney failure" when one begins to get symptoms of increasing severity as the kidney fails further. Such symptoms include:

  • 1. Progressive loss of energy - decreased exercise tolerance
  • 2. Progressive loss of interest in life and normal activities*
  • 3. Decrease of appetite, some weight loss (may be masked by fluid retention
  • 4. Loss of appetite with nausea and vomiting marks a serious turn for the worse
  • 5. Uremic pericarditis (inflammation of the outside lining of the heart), lethargy, confusion, coma indicate a progression of the final stages of uremia to death.

Intervention with dialysis or transplant early in the course can prevent later complications. However, some patients have to become ill before appreciating what dialysis can do.

Peter Lundin, M.D

*This symptom is a description of reactive depression, a normal reaction to an adverse life event. In detail it is best discussed by a psychologist or psychiatrist. However, when one's body is failing as with uremia or other disease, whether overtly sensed or not, depression can follow. Depression can recur with under dialysis or can persist in those who have not accepted the loss of a previous life style and the intrusion of dialysis. Getting good dialysis, support from family friends, professionals and fellow patients with shared experiences all help. Having the desire and ability to get on with living is also essential. If the feelings persist despite the above, medication can be helpful. I have seen some patients take up to several years to accept their new life, and when it happens it is often like the light bulb going on as depicted in a cartoon. The sudden realization that life can go on. For this to happen, however, life cannot be full of " other shoes dropping".

Remember, this information is for education purposes only. Please consult your own physician for specific treatment recommendations. All medical and therapeutic decisions must come from your health care provider.The information obtained through this service, and the information which you receive through the Internet is only for general guideline purposes, and is not an ultimate source of information, nor something which you should rely on as a sole source for your medical care. The authors, editors, producers, sponsors, and contributors shall have no liability, obligation or responsibility to any person or entity for any loss, damage, adverse consequence alleged to have happened directly or indirectly as a consequence of this material.

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