Uremia Questions & Answers

Updated: Jan 17, 2019
  • Author: A Brent Alper, Jr, MD, MPH; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Questions & Answers

Overview

What is uremia?

How does uremia develop?

What are complications of untreated uremia?

What are cardiac complications of uremia?

What are the glycemic complications of uremia?

What are the renal complications of uremia?

Which specialist consultation is necessary in the management of uremia?

What is included in the patient education about uremia?

What is the role of the kidney in the pathogenesis of uremia?

What are the symptoms of uremia?

What is the role of anemia in the pathogenesis of uremia?

How is anemia characterized in uremia?

What causes anemia in patients with chronic kidney disease (CKD) and uremia?

What is the role of elevated parathyroid hormone (PTH) levels in the pathogenesis of uremia?

What is the role of hepcidin in the pathogenesis of uremia?

What is the pathogenesis of uremic bleeding?

What is the role of platelet adhesion and aggregation in the pathogenesis of uremia?

How is uremic bleeding managed?

What risks are increased with use of anticoagulants or antiplatelet therapy in patients with uremia?

What is the role of acidosis in the pathogenesis of uremia?

What is the role of metabolic acidemia in the pathogenesis of uremia?

What is the effect of oral bicarbonate supplementation on the disease course of uremia?

What is the role of hyperkalemia in the pathogenesis of uremia?

When is hyperkalemia most likely to occur in patients with uremia?

What is the role of calcium-vitamin D metabolic pathway in the pathogenesis of uremia?

What role does vitamin D play in the pathophysiology of uremia?

What is the role of hyperphosphatemia in the pathogenesis of uremia?

What is the role of hyperparathyroidism in the pathogenesis of uremia?

How is vitamin D deficiency treated in patients with uremia?

What is the role of cinacalcet in the treatment of uremia?

Which endocrine abnormalities are associated with uremia?

What risks are increased in patients with comorbid diabetes and uremia?

How are thyroid hormones affected by uremia?

How does reproductive hormone dysfunction affect men with uremia?

How does reproductive hormone dysfunction affect women with uremia?

Which cardiovascular abnormalities are associated with uremia?

What are the signs and symptoms of malnutrition in uremia?

What effect does uremia have on protein catabolism?

What causes anorexia in uremia?

What is the significance of a decreased serum albumin concentration in uremia?

Which primary glomerular and tubular disorders may result in chronic kidney disease (CKD) and uremia?

Which systemic disorders are associated with chronic kidney disease (CKD) and uremia?

What is the role of acute kidney injury (AKI) in the etiology of uremia?

What is the role of diabetes in the etiology of uremia?

What is the role of genetics in the etiology of uremia?

What is the prevalence of uremia in the US?

What is the incidence of end-stage renal disease (ESRD) in patients with uremia in the US?

What are the trends in prevalence rates for end-stage renal disease (ESRD) due to uremia in the US?

Which countries have the highest prevalence of end-stage renal disease (ESRD)?

What are the racial predilections of uremia?

How does the incidence of uremia vary by sex?

How does the prevalence of uremia vary by age?

What is the prognosis of uremia of end-stage renal disease (ESRD)?

What is the prognosis of uremia in acute kidney injury (AKI)?

What is the morbidity associated with chronic kidney disease (CKD) and uremia?

What is the mortality rate for end-stage renal disease (ESRD)?

What are the cardiovascular disease risks in patients with uremia?

What are the risks of delayed dialysis for uremia in end-stage renal disease (ESRD)?

Presentation

What are the signs and symptoms of uremia?

How do the nonspecific symptoms of uremia affect diagnosis?

What are the metabolic abnormalities characteristic of uremia?

What are symptoms of uremia in patients with diabetes?

Which cardiovascular conditions are associated with uremia?

What are GI symptoms of uremia?

What are the signs and symptoms of uremic encephalopathy?

What are cutaneous signs and symptoms of uremia?

Which physical findings are characteristic of uremia?

Which dermatologic findings are characteristic of uremia?

Which eye and mouth exam findings are characteristic of uremia?

Which cardiovascular findings characteristic of uremia?

Which pulmonary findings are characteristic of uremia?

DDX

What are the diagnostic considerations for uremia?

Which conditions should be included in the differential diagnoses of uremia?

What are the differential diagnoses for Uremia?

Workup

How is uremia diagnosed?

Which blood studies should be considered in the workup of uremia?

What is the role of urinalysis in the evaluation of uremia?

What is the role of isotope clearance assessment in the evaluation of uremia?

What is the role of an anemia workup in the evaluation of uremia?

What is the role of glomerular filtration rate (GFR) in the diagnosis of uremia?

What is chronic kidney disease (CKD) staged?

What is the role of renal ultrasonography in the diagnosis of uremia?

What is the significance of an ultrasonographic finding of large kidneys in the evaluation of uremia?

What is the role of CT scanning in the diagnosis of uremia?

What is the role of MRI in the diagnosis of uremia?

What is the role of renal biopsy in the diagnosis of uremia?

What are the histologic findings characteristic of uremia?

Treatment

What is the role of dialysis in the treatment of uremia?

What is included in the treatment of uremic pruritus?

What are the treatment options for refractory pruritus in uremia?

What are the renal replacement therapy options for uremia?

What is the role of renal transplantation in the treatment of uremia?

What are possible risks of surgery for the treatment of uremia?

Which specialist consultations should be considered in the treatment of uremia?

When is transfer indicated during treatment for uremia?

What are the activity restrictions for patients with uremia?

How is uremia managed during pregnancy?

Which specialists should be consulted in the treatment of children with uremia?

When is dialysis initiated for the treatment of uremia?

What are the different types of dialysis used to treat uremia?

When is surgical referral necessary for the treatment of uremia?

How should dialysis be accessed for hemodialysis for uremia?

When is a peritoneal dialysis catheter used to treat uremia?

What are the benefits of a Tenckhoff peritoneal dialysis catheter for the treatment of uremia?

When is emergent dialysis indicated in uremia?

What are emergent treatment options for hyperkalemia in uremia?

How is nonemergent hyperkalemia treated in uremia?

Which medications can contribute to the hyperkalemia in uremia?

What are the treatment options for anemia in uremia?

What is the role of erythropoietic-stimulating agents (ESAs) in the treatment of uremia?

How is anemia treated in patients with uremia on dialysis?

What is the second-line treatment for anemia in uremia?

How is hyperparathyroidism treated in uremia?

How is hypocalcemia treated in uremia?

How is hyperphosphatemia treated in uremia?

How is acidemia treated in uremia?

Which specialist should be consulted regarding dietary modification for treatment of uremia?

What is the role of a low-protein diet in patients with uremia?

What is the efficacy of a low protein diet in the treatment of uremia?

How does a low-protein diet affect mortality in patients with uremia?

What are the recommendations for low-protein diet in the treatment of uremia?

When is inpatient care indicated for uremia?

What is included in inpatient care of uremia?

What is included in outpatient management of uremia?

What are the medications used in the inpatient treatment of uremia?

What are the medications used in the outpatient treatment of uremia?

How is uremia prevented?

Medications

Which medications are used in the treatment of uremia?

Which medications in the drug class Phosphate binders are used in the treatment of Uremia?

Which medications in the drug class Antidiabetic agents are used in the treatment of Uremia?

Which medications in the drug class Antidotes are used in the treatment of Uremia?

Which medications in the drug class Trace Elements/Metals are used in the treatment of Uremia?

Which medications in the drug class Vitamins, Fat-Soluble are used in the treatment of Uremia?

Which medications in the drug class Calcium Salts are used in the treatment of Uremia?

Which medications in the drug class Colony-stimulating factors are used in the treatment of Uremia?