Azotemia: Difference between revisions

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'''Associate Editor in Chief:''' {{MUT}}
#Redirect [[Acute kidney injury]]


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==overview==
'''Azotemia''' is a medical condition characterized by abnormal levels of [[nitrogen]]-containing compounds, such as [[urea]], [[creatinine]], various body waste compounds, and other [[nitrogen]]-rich compounds in the [[blood]]. The cause is usually insufficient filtering of the blood by the [[kidney]]s. 


Azotemia can be classified according to its cause. In '''prerenal azotemia''' the blood supply to the [[kidney]]s is inadequate. In '''postrenal azotemia''' the urinary outflow tract is obstructed. Other forms of azotemia are caused by diseases of the [[kidney]]s themselves.


Other causes of azotemia include [[congestive heart failure]], [[shock]], severe [[burn]]s, prolonged [[vomiting]] or [[diarrhea]], some antiviral medications, [[liver]] [[failure]], or [[trauma]] to the [[kidney]]s.
[[Category:Kidney diseases]]
[[Category:Organ failure]]
[[Category:Ddx]]


[[Uremia]] is a broader term referring to the pathological manifestations of severe azotemia.  Azotemia is one of many clinical characteristics of uremia, which is a syndome characteristic of [[renal disease]].  [[Uremia]] includes azotemia, as well as [[acidosis]], [[hyperkalemia]], [[hypertension]], [[anemia]] and [[hypocalcemia]] along with other findings.
==Signs and symptoms (prerenal azotemia)==
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
* Decreased or absent urine output
* [[Confusion]]
* Decreased alertness
* [[Dry mouth]]
* [[Fatigue]]
* [[Orthostatic blood pressure]] (rises or falls, significantly depending on position)
* [[Pale skin color]]
* [[Rapid pulse]]
* [[Thirst]], [[swelling]] ([[edema]], [[anasarca]])
A [[urinalysis]] will typically show a decreased urine sodium level, a high urine creatinine-to- serum creatinine ratio, a high urine urea-to-serum urea ratio, and concentrated urine (determined by osmolality and specific gravity). None of these is particularly useful in diagnosis.
Prompt treatment of some causes of azotemia can result in restoration of kidney function; delayed treatment may result in permanent loss of renal function. Treatment may include [[hemodialysis]] or peritoneal [[dialysis]], medications to increase cardiac output and increase blood pressure, and the treatment of the condition that caused the azotemia to begin with.
==Complete Differential Diagnosis of the Causes of Azotemia==
(In alphabetical order)
*[[Chronic kidney disease]]
*[[Chronic renal failure]]
*[[Congestive heart failure]]
*[[Crescentic glomerulonephritis]]
*[[Liver failure]]
*[[Multiple organ dysfunction syndrome]]
*[[Nephritic syndrome]]
*[[Nephrotic syndrome]]
*[[Pentamidine]]
*[[Post-streptococcal glomerulonephritis]]
*Prolonged vomiting or diarrhea
*[[Rapidly progressing glomerulonephritis]]
*[[Renovascular Disease]]
*[[Scleroderma]]
*Severe burns
*[[Shock]]
*[[Trauma]] to the [[kidneys]]
== Related Chapters ==
*[[Kidney failure]]
*[[Uremia]]
*[[Nephrology]]
==References==
{{Reflist|2}}
{{SIB}}


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[[Category:Kidney diseases]]
[[Category:Organ failure]]
[[Category:Symptoms]]
[[Category:Ddx]]
[[de:Azotämie]]
[[it:Azotemia]]
[[nl:Azotemie]]
[[pt:Azotemia]]

Latest revision as of 17:57, 27 June 2018