Uremia.
Dr. Sayeed Ahmad D. I. Hom. (London)

 

Uremia, presence in the bloodstream of too many chemical wastes such as urea, a nitrogen-rich waste product attributable to extra protein in the diet. As chemical wastes build up in the body they produce a toxic effect, possibly resulting in drowsiness, irritability, nausea, vomiting, breathlessness, headaches, and muscle cramps. In extreme cases, uremia may cause convulsions, coma, or death.

The kidneys normally filter chemical wastes from the blood and send them to the urinary system for elimination from the body.

Uremia most commonly develops when the kidneys fail to function properly. In some cases, however, uremia occurs when blood flow to the kidneys is reduced due to severe bleeding, serious burns, or heart attack, or when more wastes are formed in the bloodstream as a result of traumatic injuries or large surgical incisions than can be removed by the kidneys. A kidney stone, a tumor in the urinary tract, or a severely enlarged prostate in males may also cause uremia.

Victims of uremia due to kidney failure undergo kidney dialysis, a medical procedure that removes wastes from the blood. Transplantation of kidneys from healthy donors to uremic patients has also proven effective in some cases.

 

Urea

Urea, colorless, crystalline compound, CO(NH₂)₂, with melting point 132.7� C (270.9� F), also known as carbamide. It is found abundantly in the urine of humans and other mammals. In lesser quantities, it is present in the blood, liver, lymph, and serous fluids and is found in the excrement of fish and many other lower animals. Urea is produced mostly in the liver as the end product of protein metabolism. The nitrogen in urea, which constitutes most of the nitrogen in the urine, is produced mainly from food protein, but part comes from the breakdown of body cells.

 

Urine

Urine, pale yellow fluid produced by the kidneys, composed of dissolved wastes and excess water or chemical substances from the body. It is produced when blood filters through the kidneys, which remove about 110 liters (230 pints) of watery fluid from the blood every day. Most of this fluid is reabsorbed into the blood, but the remainder is passed from the body as urine. Urine leaves the kidneys, passes to the bladder through two slender tubes, the ureters, and exits the body through the urethra. A healthy adult can produce between 0.5 to 2 liters (1 to 4 pints) of urine a day, but the quantity varies considerably, depending on fluid intake and loss of fluid from sweating, vomiting, or diarrhea.

Water accounts for about 96 percent, by volume, of the urine excreted by a healthy person. Urine also contains small amounts of urea, chloride, sodium, potassium, ammonia, and calcium. Other substances, such as sugar, are sometimes excreted in the urine if their concentration in the body becomes too great. The volume, acidity, and salt concentration of urine are controlled by hormones. Measurements of the composition of urine are useful in the diagnosis of a wide variety of conditions, including kidney disease, diabetes, and pregnancy.

 

Kidney Dialysis

Kidney Dialysis, also known as hemodialysis, medical treatment used to remove waste materials from the blood of patients lacking renal function. Blood from an artery is pumped through a dialyzer, or artificial kidney, where it flows past a semipermeable membrane. Dialysis fluid passing on the other side of the membrane removes unwanted elements in the blood by diffusion. The blood is then returned to the body through a vein.

In Allopathic treatment, the following drugs are used:

 

Captopril

Captopril, drug typically used to control high blood pressure. It is also used to treat congestive heart failure, heart attacks, and kidney disease in diabetic patients. Captopril is classified as an ACE inhibitor. It works by interfering with angiotensin-converting enzymes (ACE) in the body, which influence salt and water retention. The result is relaxed artery walls and lowered blood pressure.

Captopril should be taken one hour before a meal. Tablets are taken orally two or three times a day in doses ranging from 25 to 150 mg. Patients are often started on a small dosage, which is increased as needed. Captopril must be taken regularly to be effective, even after symptoms are relieved, which usually takes several weeks. Long-term use of this drug for months or years is not uncommon.

Patients with kidney disease or impaired kidney function should use captopril with caution. Exercise or other physical activity should be approved by a doctor. This drug should not be taken by pregnant women, as it can harm the fetus, especially in the second and third trimesters. Breast-feeding women should be aware that captopril is known to appear in breast milk. Captopril has not been proven safe for children.

Possible side effects include itching, skin rash, loss of taste, and extremely low blood pressure. Less common side effects include blurred vision, confusion, light-headedness, constipation, depression, fatigue, muscle pain or weakness, light sensitivity, nausea, peptic ulcer, sleepiness, fainting, wheezing stroke, or heart failure. A reaction that includes chest pain, sweating, vomiting, diarrhea, or swelling of the arms, legs, mouth, or throat (including difficulty swallowing) requires immediate medical attention. Yellowing of the skin or eyes may indicate a liver problem, which also requires immediate medical care.

Although captopril may be prescribed in combination with a diuretic or digitalis (found in the drug digoxin), it can react adversely with these drugs. It also may react adversely with aspirin, certain blood pressure medications such as beta blockers, lithium, nitroglycerin, anti-inflammatory medications, and potassium supplements (including salt substitutes that contain potassium).

Brand Names: Capoten, Capozide

 

Furosemide

Furosemide, drug used to help the body remove excess fluid by increasing urine flow, also known as a diuretic. This is useful in the treatment of high blood pressure, congestive heart failure, kidney disease, and liver disease. It reduces water and salt in the body, relieving pressure on the circulatory system and various organs.

Furosemide must be prescribed by a doctor. Available in tablet and liquid form, it is usually taken twice a day in dosages starting at 20 to 80 mg. This is increased as needed to a maximum daily dosage of 600 mg. The drug may be taken with food to minimize stomach irritation. Effectiveness is usually apparent after two to three weeks, although long-term treatment (months to years) is not uncommon with this drug. Potassium supplements or a potassium-rich diet is needed in some patients to prevent excess potassium loss.

Patients with liver or kidney disease, diabetes, gout, lupus erythematosus, or an allergy to sulfa drugs should use furosemide with caution. Its safety for use during pregnancy is not known, but it does appear in breast milk. Children may take this drug, with dosage based on body weight.

Possible side effects may include constipation, diarrhea, nausea, headache, fever, dizziness, excessive thirst, skin rash, hives, impotence, ringing in the ears, light-sensitivity, or blurred vision. Furosemide may interact adversely with aspirin, barbiturates, narcotics, and other muscle-relaxing drugs.

Brand Name: Lasix

 

ACE Inhibitor

ACE Inhibitor, any of a group of drugs used to treat high blood pressure (hypertension). ACE inhibitors are also used to treat congestive heart failure, heart attacks, and kidney disease in diabetic patients. Properly known as angiotensin-converting enzyme (ACE) inhibitors, these drugs work by interfering with the enzymes that convert an inactive chemical known as angiotensin I to an active form, angiotensin II. Angiotensin II increases the retention of salt and water in the body, raising blood pressure. Inhibiting the formation of angiotensin II results in relaxed arterial walls and lowered blood pressure.

ACE inhibitors are prescription drugs available in tablets and capsules that are taken orally. Dosages range from 2.5 to 450 mg per day, depending on the particular type of ACE inhibitor and the condition being treated. An injectable liquid form is typically prescribed in 1.25-mg doses administered every six hours. Effectiveness may not be apparent for two to four weeks. Because ACE inhibitors control but do not cure high blood pressure, they are often used in long-term therapy (months to years) even after symptoms are relieved. Specific ACE inhibitors include captopril, enalapril, and lisinopril.

ACE inhibitors should not be taken by pregnant women as the drugs can harm the fetus, especially in the second and third trimesters. These drugs increase the level of potassium in the blood, so other medications and diet supplements that contain potassium (or that affect potassium levels) such as diuretics should be used with caution.

Potential side effects associated with ACE inhibitors include abdominal pain, constipation, diarrhea, fatigue, insomnia, headache, and vomiting. Less common side effects include anemia, chest pain, changes in heart rhythm, or heart attack.

 

Diuretic

Diuretic, chemical compound that increases the flow of urine and thus eliminates accumulations of water in cells, tissues, blood, and organs. The retention of excess water may occur following injury, as when water accumulates in the knee; in congestive heart failure, when the heart pumps insufficient blood to eliminate a normal volume of fluid; and in a variety of other disabilities, including hypertension, cirrhosis of the liver, and kidney diseases. Heart stimulants, such as digitalis, produce a diuretic effect by increasing blood pressure and thus increasing the flow of blood through the kidneys. Certain alkaloids found in coffee and tea (caffeine, theobromine, and theophylline, in increasing order of strength) increase urine output by counteracting the tendency of blood proteins to prevent the removal of water from the blood by the kidneys. A class of drug known as loop diuretics, such as furosemide, are extremely effective when taken orally. All diuretics may have severe side effects, may cause abnormal excretion of sodium, potassium, and chloride, and may become ineffective after repeated use.

 

HOM�OPATHIC TREATMENT FOR UREMIA

* With an�mia and paralytic symptoms ----- Ars., Camph., Chin-a., Cinch., Phos., Ph-ac., Ter.

* Asphytic form. ----- Hydr-ac.

* With acute atrophy of brain and medulla Oblongata. ----- Phos.

* Convulsions. ----- Apoc., Cic., Crot-h., Cupr., Cupr-ar., Dig., Hydr-ac., Kali-s., Merc-c., Mosch., Plb., Ter.

* Tendency to convulsions. ----- Plb.

* With dropsy. ----- Apis

* With cerebral hyper�mia. ----- Am-c., Bell., Con., Cupr., Gels., Glon., Merc-c., Stram., Tab., Ter., Ver-v.

* With drowsiness, insensibility and frightful Convulsions (contracted kidney). ----- Dig.

* Especially in drunkards. ----- Ars.

* In emphysema, with heart disease. ----- Ars.

* Hydropericardium. ----- Ars.

* Narcosis. ----- Aur.

* In senile hypertrophy, and induration of prostate, stricture of urethra, and ammoni�mia. ----- Iod.

* Puerperal. ----- Benz-ac.

* At beginning of scarlatina. ----- Ars.

* Impending, in scarlatina. ----- Ail., Arum-t.

* Senile. ----- Iod., Lyc.

* With sopor. ----- Agar., Anac., Bell., Hydr-ac., Kali-br., Op.

* Threatened. ----- Canth.

* Uremic Coma. ----- Am-c., Apis, Apoc., Ars., Asc-c., Bell., Cann-i., Canth., Carb-ac., Cic., Cupr., Cupr-ar., Glon., Hell., Hydr-ac., Hyos., Kali-br., Morph., Op., Phos., Pic-ac., Piloc., Stram., Tab., Ter., Urea, Urt-u., Verat-v.

 

NOTE :

Any information given above is not intended to be taken as a replacement for medical advice. Therefore, it is very important that the patients should avoid self-treatment and rather consult the most abled and qualified classical hom�opath and take the treatment under his proper guidance and advice.

 

Reference:

MS Encarta Encyclop�dia.

Repertory of Hering�s Guiding Symptoms of Our Materia Medica by Calvin B. Knerr, M. D.

 

 

Copyright with Dr. Sayeed Ahmad 2004

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