Azotemia is a condition where the kidneys cannot remove nitrogenous waste from the blood, leading to high levels of compounds such as BUN. It can cause fatigue, confusion, high blood pressure, and kidney failure. There are three types of azotemia, and treatment depends on the underlying cause. Symptoms include rapid heartbeat, decreased urine output, and joint inflammation. Diagnosis involves blood and urine tests, and treatment may include hospitalization, medication, or surgery.
BUN refers to an unusually large amount of nitrogenous waste products in the bloodstream. Normally, the kidneys filter the blood and excrete waste products in the form of urine. In the case of azotemia, the kidneys are unable to sufficiently remove urea, creatinine, and other nitrogen-containing compounds from the blood. An individual with the condition could experience fatigue, confusion, high blood pressure, and eventual kidney failure without treatment. Emergency care is often needed to identify and remedy the underlying cause to prevent serious health complications.
Doctors classify azotemia into three general categories, depending on where the problems first occur. Prerenal azotemia refers to a complication that reduces blood flow to the kidneys, such as atherosclerosis. Intrarenal azotemia is essentially renal failure; the problem lies in the kidneys themselves. Postrenal azotemia is the result of an obstruction in urine flow after waste leaves the kidneys. All three types can lead to dangerous increases in blood urea nitrogen (BUN) and other compounds that are usually excreted in the urine.
A person with any of the three types of azotemia can experience a rapid heartbeat and increased blood pressure. He or she may become confused, fatigued, and lightheaded, and experience a decrease in urine output. Also, the skin may turn pale and the joints may become inflamed and swollen. Some people experience significant pain and tenderness in the abdomen and lower back. The onset of the condition is often acute, meaning that symptoms come on suddenly, although some cases get progressively worse over the course of several weeks or months.
An individual who believes they have symptoms of azotemia should visit a doctor or go to the emergency room as soon as possible. A doctor can conduct a thorough physical exam, ask the patient about symptoms, and collect blood and urine samples for laboratory analysis. Laboratory specialists can confirm a diagnosis by identifying high levels of BUN in the blood and low levels of nitrogen in the urine. Additional imaging tests, such as sonograms, can help your doctor pinpoint the underlying cause of your kidney problems.
Patients are often hospitalized and given intravenous fluids to reduce the risk of dehydration. If the problem is found to be intrarenal, a dialysis machine can be used to temporarily take over the blood filtration process while the kidney problems are evaluated. Many patients with prerenal and postrenal problems are able to recover by taking medications to control blood pressure, open up narrowed blood vessels, and reduce inflammation. Surgery may be needed if the kidneys shut down completely or if a blockage isn’t resolved with medication.
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