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complications of uremia
Etiology:
1) fluid & electrolyte imbalances
a) volume expansion & contraction
b) hypernatremia & hyponatremia
c) hyperkalemia & hypokalemia
d) metabolic acidosis
e) hyperphosphatemia
f) hypocalcemia
2) endocrine & metabolic disorders
a) renal osteodystrophy*
b) vitamin-D deficient osteomalacia
c) secondary hyperparathyroidism*
d) carbohydrate intolerance
e) hyperuricemia*
f) hypothermia
g) hypertriglyceridemia*
h) protein-calorie malnutrition*
i) impaired growth & development*
j) infertility & sexual dysfunction*
k) amenorrhea*
3) gastrointestinal disorders
a) anorexia
b) nausea & vomiting
c) uremic fetor
d) gastroenteritis
e) peptic ulcer*
f) gastrointestinal bleeding*
4) cardiovascular & pulmonary disorders
a) arterial hypertension
b) congestive heart failure & pulmonary edema
c) pericarditis
d) cardiomyopathy*
e) uremic lung
f) accelerated atherosclerosis*
5) skin disorders
a) pallor
b) hyperpigmentation*
c) pruritus*
d) ecchymoses*
e) uremic frost
f) calciphylaxis [2]
6) neuromuscular disorders
a) fatigue
b) sleep disorders*
c) headache*
d) impaired concentration & intellect
e) lethargy
f) asterixis
g) muscular irritability
h) peripheral neuropathy*
i) restless legs syndrome*
j) paralysis*
k) myoclonus*
l) seizures*
m) coma
n) myopathy*
7) hematologic & immunologic disorders
a) normocytic, normochromic anemia
b) lymphopenia*
c) bleeding diathesis
d) increased susceptibility to infection*
e) hypersplenism & splenomegaly*
* May presist or progress despite optimal therapy.
Management:
- all resolve in time with successful renal transplantation
Related
uremia
General
complication
References
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1277
- Medical Knowledge Self Assessment Program (MKSAP) 16
American College of Physicians, Philadelphia 2012