Azotemia

Clinic

• It is a medical condition characterized by abnormally high levels of nitrogen-containing compounds in the blood.
• It is largely related to insufficient or dysfunctional filtering of blood by the kidneys.
• It can lead to uremia and acute kidney failure if not controlled.

Types

Three classifications, depending on its causative origin: prerenal azotemia, renal azotemia, and postrenal azotemia.

Measurements of urea and creatinine (Cr) in the blood are used to assess renal function. For historical reasons, the lab test measuring urea is known as "blood urea nitrogen" (BUN). The BUN:Cr ratio is a useful measure in determining the type of azotemia and will be discussed in each section below. A normal BUN:Cr is equal to 15.

• Prerenal azotemia: Caused by a decrease in blood flow to the kidneys. It can occur following hemorrhage, shock, volume depletion, congestive heart failure, adrenal insufficiency, and narrowing of the renal artery among other things.

• Primary renal azotemia: Acute kidney failure typically leads to uremia. Causes include kidney failure, glomerulonephritis, acute tubular necrosis, or other kidney disease.

• Postrenal azotemia: It can be caused by congenital abnormalities such as vesicoureteral reflux, blockage of the ureters by kidney stones, pregnancy, compression of the ureters by cancer, prostatic hyperplasia, or blockage of the urethra by kidney or bladder stones.

Signs and symptoms

• Oliguria or anuria
• Fatigue / Decreased alertness / Confusion
• Asterixis (flapping tremor)
• Pale skin
• Tachycardia
• Xerostomia/ Thirst
• Edema, anasarca
• Orthostatic blood pressure (fluctuates depending on body position)
• Uremic frost
• Para clinic
  • Decreased urine sodium level in urinalysis
  • High urine creatinine ratio
  • High urea ratio, and specific gravity