Uremia and the cause of the pathogenesis of

Uremia, nitrogen metabolites and other toxic substances can not be discharged is stored in the body, with the exception of water, electrolytes and acid-base balance disorder, and can cause multiple organ systems and disease.


1. Digestive system in the accumulation of urea into the digestive tract, the intestinal bacteria in the role of a urea-ammonia, can stimulate gastrointestinal inflammation of the mucous membrane from cellulose, and even a bleeding ulcer. A wide range of diseases, from the mouth, esophagus can be involved until the rectum. To uremic esophagitis, gastritis and colitis more common. Patients often have nausea, vomiting, abdominal pain, diarrhea, blood in the stool, and other symptoms.


2. Heart, lung disease Shuinazhuliu, renal ischemia, an increase of renin secretion caused by long-term effect of hypertension to heart can cause heart failure. High blood urea and pleural infiltration pericardium can cause pericarditis cellulose and cellulose pleurisy, cardiac auscultation can be heard and pleural friction sound. Heart failure can cause pulmonary edema. Urea from the blood from the respiratory tract can cause respiratory inflammation, and sometimes along the alveolar wall can have a transparent membrane; pulmonary vascular permeability increase in alveolar cavity fiber protein and a large number of single-cell nuclear leakage, very few neutrophils, known as the urine Duzheng pneumonia.


3. Hematopoietic system for major changes in anemia and bleeding. Anemia causes: ① serious kidney damage erythropoietin have inadequate. ② stored in the metabolites, some as phenol and its derivatives can inhibit the bone marrow hematopoietic function. Some other poisons such as guanidine and its derivatives can be shortened survival of red blood cells, red blood cell damage and speed up the cause hemolytic. ③ transferrin from the excessive loss of urine, causing the transport of iron barriers.


Uremia patients often have bleeding tendencies, manifested as bleeding gums, epistaxis, gastrointestinal bleeding, and so on. Bleeding reasons: ① toxic substances inhibit bone marrow, reducing platelet formation. ② some patients do not reduce the number of platelets, there are bleeding tendencies. This may be due to blood Guanidines toxic substances platelet dysfunction, reduced platelet cohesion and the release of platelet factor of three due to reduced role.


4. Skeletal system of urea often have low blood calcium. This may be due to: ① excretion of phosphate kidney function decline, the increased concentration of phosphate in the blood, the calcium concentration dropped. ② in the phosphate reserves in the intestines and into the water-insoluble calcium-binding of calcium phosphate, calcium absorption reduced, from more. ③ 1,25 - dihydroxy bile alcohol is the calcification of vitamin D in the intestinal absorption of calcium to promote the activities of the form of the kidney. Chronic renal disease, 1,25 - dihydroxy gall calcification of alcohol in obstacles, small intestine caused by poor absorption of calcium, caused hypocalcemia.


Long-term reduction of uremia when blood calcium can cause hyperparathyroidism, which caused widespread demineralized bone tissue, known as renal osteodystrophy, its shape and bone softening and cystic fiber similar to bone inflammation. Clinical use of 1,25 - dihydroxy gall calcification alcohol and drug treatment similar to those with kidney disease and the obstacles to good effect of calcium metabolism.


5. Uremia patients skin and skin Chang Cheng Hui Huangse itching, skin color and pigment anemia and urine to accumulate in the skin on. In the accumulation of urea can be discharged through the sweat glands in the skin surface Jie Jingzhuang powder known as urea cream, common in the face, nose, cheek, etc.. Itching reasons unclear, and may stimulate the nerve endings of urea on.


6. Nervous system in a large number Cerebral deposition of urea, increased osmotic pressure, can cause brain swelling, bleeding and sometimes with a small stove to soften. Toxic substances and can cause cell damage nerve cells God degeneration and vascular permeability higher increase cerebral edema. Uremic patients can be advanced in drowsiness, convulsions, Mujiang, coma and other symptoms.


Some patients have symptoms of peripheral nerve and feel abnormal limb numbness, burning sensation, and so on. Its causes unclear, and may increase the content of guanidine-related.


Uremia caused the toxic substances have not yet fully understand. Although the number of blood urea content can reflect the severity of uremia, but the addition of urea, metabolites and other toxic substances such as guanidine also have an important role. Uremia the occurrence of a certain toxin is not alone cause, but a number of factors combined results.