What can be done to diagnose uremia

Uremia is not an independent disease, but a syndrome. Many kidney diseases will turn into uremia when they develop to the late stage. Therefore, when diagnosing uremia, it is necessary to test some indicators and combine them with the condition of the disease itself to draw accurate conclusions. It is very important to diagnose uremia in a timely manner. So, what can be done to diagnose uremia?

Generally, the main examination methods for uremia are:

1. Urinalysis: The changes in urine of patients with uremia vary greatly depending on the primary disease, and it is the main method for examining uremia. The common points are: ① The urine osmotic pressure is reduced, most morning urine is below 450mOsm/kg, the specific gravity is low, mostly below 1.018, and in severe cases it is fixed between 1.010 and 1.012. During the concentration and dilution test, the nocturnal urine volume is greater than the daily urine volume, the specific gravity of each urine does not exceed 1.020, and the difference between the highest and lowest urine specific gravity is less than 0.008. ② The urine volume decreases, mostly below 1000ml/day. In the late stage, when the creatinine clearance rate drops to below 1.0-2.0ml/second, anuria may occur. ③ Urine protein is +～+++. In the late stage, most of the glomeruli have been destroyed, so the urine protein decreases instead. ④ Examination of urine sediment may reveal varying numbers of red blood cells, white blood cells, epithelial cells and granular casts. If thick, short, homogeneous, waxy casts with cracked edges are found, it will be helpful for diagnosis.

2. Routine blood examination: In uremia, hemoglobin is generally below 80g/L, and most of the time it is only 40-60g/L, which is normocytic normochromic anemia. When the patient has combined chronic blood loss and malnutrition, it may also present as microcytic hypochromic anemia. There are fewer changes in white blood cells, but acidosis and infection may increase the white blood cell count. The platelet count is low or normal, but the function is reduced. The erythrocyte sedimentation rate is often accelerated due to anemia and hypoproteinemia. This is also the main method for examining uremia.

3. Renal function test: In the compensatory stage of renal insufficiency, although the renal creatinine clearance rate decreases, the blood creatinine does not increase; in the azotemia stage, although the blood creatinine has increased, the patient has no clinical symptoms of uremia and no metabolic acidosis; in the uremia stage, when the renal creatinine clearance rate is <25ml/min, the blood creatinine will increase significantly and be accompanied by metabolic acidosis, which is also of great significance for the examination of uremia.