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What are the symptoms of uremia2017-05-09 17:38
Metabolic acidosis and electrolyte imbalance were the most common.
(1) metabolic acidosis in chronic renal failure uremia stage of human metabolism of acid products such as phosphoric acid, sulfuric acid and other substances due to renal excretion disorder and retention, can occur". Mild chronic acidosis, but most patients have few symptoms, such as arterial blood HCO3<15 mmol/L, can appear obvious loss of appetite, vomiting, weakness, deep breathing etc..
(2) the disturbance of water and sodium metabolism, mainly manifested as water sodium retention, or low blood volume and hyponatremia. When the renal function is not complete, the kidney's ability to adapt to the excessive sodium overload or over capacity is gradually decreased. Uremia patients such as unduly limiting water, can lead to excessive volume load, different degrees of common subcutaneous edema (eyelids, lower limbs) and / or effusion (pleural and abdominal), then prone to high blood pressure, left ventricular dysfunction (chest tightness performance, activity intolerance and even could not lie down at night) and brain edema. On the other hand, when patients with a lot of urine, and excessive water restriction, or concurrent vomiting, diarrhea and other gastrointestinal symptoms, and easily lead to dehydration. In clinical capacity overload is common, so patients in uremic intake should pay attention to proper control of water (except drinking water also includes soup, fruit, Rice porridge more food water), avoid excessive fluid replacement should be the treatment process, to prevent the occurrence of heart failure and pulmonary edema.
(3) potassium disorders: when GFR was reduced to 20-25ml/min or less, the renal excretion of potassium capacity decreased gradually, then prone to hyperkalemia; especially when excessive intake of potassium, acidosis, infection, trauma, such as gastrointestinal bleeding occurs, more prone to hyperkalemia. Severe hyperkalemia (serum potassium >6.5mmol/L) has a certain risk, the need for timely treatment and rescue (see hyperkalemia treatment). At the same time, due to lack of potassium intake, too much loss of gastrointestinal tract, the use of potassium excretion and other factors, there may be hypokalemia. The most common clinical manifestations are hyperkalemia, so patients with uremia should strictly limit the intake of food containing high potassium, and should regularly review the blood potassium.
(4) disturbance of calcium and phosphorus metabolism, mainly phosphorus and calcium deficiency. Chronic renal failure renal generation 1, 25- (OH) 2D3 decreased, intestinal calcium absorption is reduced; the target organ of 1, 25- (OH) 2D3 resistant, the renal tubular reabsorption of calcium decreased, in addition, hyperphosphatemia can make higher calcium phosphate product, promote the deposition of calcium phosphate, calcium induced ectopic and hypocalcemia. The food is rich in phosphorus, and the concentration of serum phosphorus is regulated by the absorption of phosphorus by the intestinal tract and the excretion of the kidney. When the decline in glomerular filtration rate, urinary P excretion decreased when phosphorus concentration increased gradually, hyperphosphatemia further inhibited 1, 25- (OH) 2D3 synthesis, exacerbation of hypocalcemia. Parathyroid glands secrete more PTH to maintain calcium. Secondary hyperparathyroidism (referred to as hyperparathyroidism).