Azotemia is a biochemical alteration characterized by the presence of high concentrations of nitrogenous products, such as urea, creatinine, uric acid and proteins, in the blood, serum or plasma, which can interfere with the glomerular filtration rate and, consequently, lead to progressive and possibly permanent to the kidneys.
This change can be the result of any condition that interferes with blood circulation to the kidneys, such as heart failure, dehydration, hemorrhage or tumors of the urinary tract, for example. It is important that the level of these substances is identified quickly so that the doctor can start the appropriate treatment for the case.
Main causes
Azotemia can be classified according to its cause into:
- Pre-renal azotemia: The accumulation of nitrogenous substances occurs due to situations that decrease blood volume, interfering with the arrival of blood in the kidneys, such as heart failure, acute dehydration, hemorrhage, a protein-rich diet and increased cortisol concentration due to to some underlying disease.
- Renal azotemia: In this type of azotemia, the accumulation of nitrogenous substances occurs due to the failure in the process of excretion of these substances by the kidneys, leading to an increase in the concentration of urea and creatinine in the plasma. Renal azotemia usually occurs due to kidney failure, tubular necrosis and glomerulonephritis.
- Post-renal azotemia: This type of azotemia is characterized by a disproportionate increase in urea in relation to creatinine due to changes in the urinary flow or obstruction of the excretory pathways, which can be caused by nephrolithiasis or a tumor in the urinary system, for example.
The presence of urea and creatinine in the blood are normal, however when there is any change in the kidneys or that interferes with the blood circulation, the concentration of these substances can increase in order to be toxic to the organism, which can result in permanent damage to the kidneys.
Azotemia symptoms
Azotemia can show some symptoms, being, in these cases, called uremia. The main symptoms are:
- Decrease in the total volume of urine;
- Pale skin;
- Thirst and dry mouth;
- Excessive tiredness;
- Tremor;
- Lack of appetite;
- Abdominal pain.
In addition to these symptoms, there may also be difficulty in concentration and attention, mental confusion and change in the color of urine. Understand what is uremia.
How the diagnosis is made
The diagnosis of azotemia is made through laboratory tests, mainly the measurement of urea and creatinine in the blood. In addition, it is important to check the levels of total proteins and uric acid in the blood, in addition to having a 24-hour urine test, which allows kidney function to be assessed. Find out how the 24-hour urine test is done.
How to treat
The treatment of azotemia aims to decrease the concentration of nitrogen compounds in the blood and alleviate any other associated symptom, avoiding permanent damage to the kidneys. Thus, according to the cause and type of azotemia, the nephrologist can indicate the best type of treatment.
The doctor may recommend administration directly into the vein of fluids in order to increase blood volume and thus decrease the concentration of nitrogen compounds in the blood. In addition, it may be recommended by the doctor, the use of diuretic drugs, which reduce the concentration of potassium in the blood or antibiotics, in case there is an infection that can cause azotemia.
It is important to maintain healthy habits, with regular exercise and healthy eating, reducing the consumption of foods rich in potassium and proteins, in addition to increasing the consumption of vegetables. Know what to eat to improve kidney function.
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