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What are the main manifestations of uremia?

2017-01-24 13:51

What are the main manifestations of uremia?

The clinical manifestations of renal failure early is not obvious, easily missed. But in the late stage, the lesions can be involved in the various organs of the body, there are a variety of manifestations.

1, toxic and accumulation of metabolites caused symptoms:

(1) the digestive system manifestations: digestive system performance is one of the earliest and most common, mainly of anorexia, indigestion. Who can have severe glossitis, oral erosion. If the digestive tract ulcer involving blood vessels can have haematemesis, hematochezia.

(2) the performance of hematopoietic system: chronic renal failure patients with varying degrees of anemia, mostly due to long-term malnutrition, erythropoietin and hemolytic. Renal failure patients have bleeding tendency manifested as subcutaneous hemorrhage and ecchymosis, gingival bleeding, epistaxis, serious person can produce digestive tract bleeding and death. In addition, there are abnormal white blood cells, due to the "urotoxin" role, the generation and function of disorder of white blood cells, white blood cell counts decreased (mainly lymphopoiesis decrease), neutrophil chemotaxis ability, phagocytosis and killing of bacteria is also reduced.

(3) manifestation of cardiovascular system: common hypertension, uremic pericarditis, myocarditis and arrhythmia and heart failure.

(4) the respiratory symptoms of respiratory system in general can have difficulty breathing in acid poisoning, can also produce bronchitis, pneumonia and pleurisy etc. by uremia.

(5) skin manifestations: pale, dry, itchy, and "urea cream"".

(6): the skeletal system due to calcium and phosphorus metabolism, can appear osteoporosis, osteomalacia or osteitis fibrosa and pain and pseudo fracture.

(7) neuropsychiatric symptoms: Central manifestations of unresponsive, depression, irritability, excitement, convulsions, lethargy and coma. Around the performance of peripheral nerve degeneration performance, skin allergies, pain, limb weakness and disability etc..

(8) endocrine dysfunction:

1) the performance of parathyroid dysfunction: mainly for hyperparathyroidism, can appear disorders of calcium and phosphorus metabolism, the changes of uremic osteopathy.

2) thyroid dysfunction due to T3 and free T3 index decreased, manifestations of hypothyroidism symptoms, such as fatigue, fatigue, drowsiness, dry skin, hearing loss, hyporeflexia, low temperature.

3): female sexual dysfunction manifested as irregular menstruation or amenorrhea, by reducing the amount of. The main manifestations of impotence and decreased sperm motility. Delayed onset of sexual maturation in children.

2, water, electrolyte and acid-base imbalance: the kidney is an important organ to regulate water, electrolyte and acid-base balance, its damage, can directly affect the normal conduct of these links, causing a series of clinical manifestations.

(L) dehydration and edema: edema can occur in patients with renal failure. This is due to renal tubular dysfunction, concentrated loss of function, even without drinking water, also can discharge a large number of results caused by the dilution of the urine, thirst, urine and dehydration performance, if not pay attention to add would lead to the decreased renal blood flow and renal ischemia, accelerated kidney damage, so in this case the replenishment of important than medication. On the other hand, renal excretion ability is poor, if water intake is overloaded, and out of water retention in the body, performance, weight gain, oliguria, edema, swelling and renal vascular effects of renal blood flow, also can aggravate renal damage. Therefore, it is important to measure the body weight, record 24 hours urine volume and other additional excretion.

(2) the change of sodium and potassium: hyponatremia is caused by the dysfunction of renal tubular reabsorption of sodium, and also with the long-term low salt diet, the use of diuretics and diarrhea, etc.. High sodium is due to uremia when the amount of urine and no edema, which does not limit the intake of salt, sodium retention and beyond the renal sodium excretion. Weight gain, edema, and even reduced urine output. It should be observed that there is a lack of fatigue, lethargy, tendon reflexes and other low sodium performance and the performance of the high sodium, but also frequently review the contents of various electrolytes in the blood, in order to adjust in time. Oliguria and long-term use of potassium sparing diuretics are the most common causes of hyperkalemia. In addition the excretory function of uremic patients decreased, and because of poor appetite, calorie intake is insufficient, cause tissue and accelerate the decomposition of the release of large amounts of potassium, and acidosis, the kidney sodium hydrogen exchange, sodium potassium exchange decreases, can make the blood potassium increased quickly, clinical myocardial inhibition, such as heart sound low heart rate, slow arrhythmia and even arrest; also common musculoskeletal symptoms such as numbness, fatigue, weakness and paralysis, paralysis, lower limbs symptoms often by upward development; there may be fainting and mental disorders; sometimes can appear respiratory muscle inhibition, lead to respiratory arrest. The occurrence of hypokalemia includes two aspects, on the one hand because of body water retention dilutional low potassium, while low potassium, potassium content and many, mainly potassium re distribution caused by; on the other hand due to the loss of intake too little, vomiting and diarrhea, and diuretic loss caused the lack of potassium, low blood potassium appears real. Low blood potassium besides gastrointestinal paralytic symptoms (such as abdominal distension, decreased bowel sounds, and the rest of the performance) are similar to the symptoms of hyperkalemia.

(3) acidosis: mild acidosis can have no clinical manifestations. When carbon dioxide combining power less than 15 mmol / L, can be expressed as dyspnea, loss of appetite, nausea, vomiting, weakness, irritability, severe disturbance of consciousness, faint


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