Overview
Uraemia describes the clinical manifestations of high levels of urea and other waste products present in the blood that are normally excreted. Azotaemia describes increased levels of these products detected on testing without the clinical manifestations.
Normally, amino acids are deaminated to produce ammonia (NH3), which is toxic as it can raise the pH in cells. It is therefore converted into urea, as it does not exert these toxic effects.
Uraemia is usually seen in end-stage chronic kidney disease (CKD).
Presentation
Patients may present with:
- Nausea and/or vomiting
- Fatigue
- Anorexia
- Weight loss
- Muscle cramps
- Pruritus
- Peripheral neuropathy
- Metabolic acidosis
- Pericarditis
- Encephalopathy – which may manifest as restlessness, drowsiness, cognitive impairment, confusion, coma
