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MEANING OF
UREMIA
Uremia or uraemia
is the illness
accompanying
kidney failure (also
called renal failure),
in particular the
nitrogenous waste
products
associated with the
failure of this
organ.
In kidney failure,
urea and other
waste products,
which are normally
excreted into the
urine, are retained
in the blood. Early
symptoms include
anorexia and
lethargy, and late
symptoms can
include decreased
mental acuity and
coma. Other
symptoms include
fatigue, nausea,
vomiting, cold,
bone pain, itch,
shortness of
breath, and
seizures. It is
usually diagnosed
in kidney dialysis
patients when the
glomerular filtration
rate, a measure of
kidney function, is
below 50% of
normal.[2] Uremia
can also result in
uremic pericarditis.
There are many
dysfunctions
caused by uremia
affecting many
systems of the
body, such as
blood (lower levels
of erythropoietin),
sex (lower levels of
testosterone/estrog
en), and bones
(osteoporosis and
metastatic
calcifications).
Uremia can also
cause decreased
peripheral
conversion of T4 to
T3, producing a
functionally
hypothyroid state.
Azotemia is
another word that
refers to high levels
of urea, but is used
primarily when the
abnormality can be
measured
chemically but is
not yet so severe
as to produce
symptoms.
SIGNS AND
SYMPTOMS OF
UREMIA
FATIGUE (also
called exhaustion,
tiredness,
languidness,
languor, lassitude,
and listlessness) is
a subjective feeling
of tiredness which
is distinct from
weakness, and has
a gradual onset.
Unlike weakness,
fatigue can be
alleviated by
periods of rest.
Fatigue can have
physical or mental
causes. Physical
fatigue is the
transient inability of
a muscle to
maintain optimal
physical
performance, and
is made more
severe by intense
physical exercise.
[1][2][3] Mental
fatigue is a
transient decrease
in maximal
cognitive
performance
resulting from
prolonged periods
of cognitive activity.
It can manifest as
somnolence,
lethargy, or
directed attention
1 fatigue.[4]
Medically, fatigue is
a non-specific
symptom, which
means that it has
many possible
causes. Fatigue is
considered a
symptom, rather
than a sign
because it is a
subjective feeling
reported by the
patient, rather than
an objective one
that can be
observed by
others. Fatigue and
‘feelings of fatigue’
are often
confused.)
PERIPHERAL
NEUROPATHY
(Peripheral
neuropathy (PN) is
damage or disease
affecting nerves,
which may affect
sensation,
movement, gland
or organ function,
and other aspects
of health,
depending on the
type of nerve
affected. Common
causes include
systemic diseases
(such as diabetes
or leprosy), vitamin
deficiency,
medication (e.g.,
chemotherapy),
traumatic injury,
excessive alcohol
consumption,
immune system
disease, or
infection, or it may
be inherited
(present from
birth).[1][2][3] In
conventional
medical usage, the
word neuropathy
(neuro- + -pathy)
without modifier
usually means
peripheral
2 neuropathy.
Neuropathy
affecting just one
nerve is called
"mononeuropathy"
and neuropathy
involving multiple
nerves in roughly
the same areas on
both sides of the
body is called
"symmetrical
polyneuropathy" or
simply
"polyneuropathy."
When two or more
(typically just a few,
but sometimes
many) separate
nerves in disparate
areas of the body
are affected it is
called
"mononeuritis
multiplex,"
"multifocal
mononeuropathy"
or "multiple
mononeuropathy."
Peripheral
neuropathy may be
chronic (a long
term condition
where symptoms
begin subtly and
progress slowly) or
acute (sudden
onset, rapid
progress and slow
resolution). Acute
neuropathies
demand urgent
diagnosis. Motor
nerves (that control
muscles), sensory
nerves, or
autonomic nerves
(that control
automatic functions
such as heart rate,
body temperature
and breathing),
may be affected.
More than one type
of nerve may be
affected at the
same time.
Peripheral
neuropathies may
be classified
according to the
type of nerve
predominantly
involved, or by the
underlying cause.
Where the cause is
unknown it is
described as
idiopathic
neuropathy.[1][2][3]
Neuropathy may
cause painful
cramps,
fasciculations (fine
muscle twitching),
muscle loss, bone
degeneration, and
changes in the
skin, hair, and
nails. Additionally,
motor neuropathy
may cause
impaired balance
and coordination
or, most commonly,
muscle weakness;
sensory
neuropathy may
cause numbness to
touch and vibration,
reduced position
sense causing
poorer coordination
and balance,
reduced sensitivity
to temperature
change and pain,
spontaneous
tingling or burning
pain, or skin
allodynia (severe
pain from normally
nonpainful stimuli,
such as light
touch); and
autonomic
neuropathy may
produce diverse
symptoms,
depending on the
affected glands and
organs, but
common symptoms
are poor bladder
control, abnormal
blood pressure or
heart rate, and
reduced ability to
sweat normally)
SEIZURES
(Epileptic seizures
(colloquially a fit)
are brief episodes
of "abnormal
excessive or
synchronous
neuronal activity in
the brain". The
outward effect can
vary from wild
thrashing
movement (tonic-
clonic seizure) to
as mild as a brief
loss of awareness
(absence seizure).
The syndrome of
recurrent,
unprovoked
seizures is termed
epilepsy, but
seizures can occur
in people who do
not have epilepsy.
Additionally there
are a number of
conditions that look
like seizures but
3 are not.
After a first seizure,
treatment is
generally not
needed unless
specific problems
are found on either
electroencephalogr
am or imaging of
the brain.
About 5-10% of all
people will have an
unprovoked seizure
by the age of 80
and the chance of
experiencing a
second seizure is
between 40% and
50%.[4] Epilepsy
affects about 1% of
the population
currently and
affects about 4% of
the population at
some point in time.
Most of affected,
nearly 80%, live in
developing
countries.)
ANOREXIA
(Anorexia (deriving
from the Greek "α
(ν)-" (a(n)-, a prefix
that denotes
absence) + "όρεξη"
(orexe) = appetite)
is the decreased
sensation of
appetite. While the
term in non-
scientific
publications is
often used
interchangeably
with anorexia
nervosa, many
possible causes
exist for a
decreased
appetite, some of
which may be
harmless, while
others indicate a
serious clinical
condition or pose a
4 significant risk.
For example,
anorexia of
infection is part of
the acute phase
response (APR) to
infection. The APR
can be triggered by
lipopolysaccharides
and peptidoglycans
from bacterial cell
walls, bacterial
DNA, double-
stranded viral RNA,
and viral
glycoproteins,
which can trigger
production of a
variety of
proinflammatory
cytokines. These
can have an
indirect effect on
appetite by a
number of means,
including peripheral
afferents from their
sites of production
in the body, by
enhancing
production of leptin
from fat stores.
Inflammatory
cytokines can also
signal to the central
nervous system
more directly by
specialized
transport
mechanisms
through the blood–
brain barrier, via
circumventricular
organs (which are
outside the barrier),
or by triggering
production of
eicosanoids in the
endothelial cells of
the brain
vasculature.
Ultimately the
control of appetite
by this mechanism
is thought to be
mediated by the
same factors
normally controlling
appetite, such as
neurotransmitters
(serotonin,
dopamine,
histamine,
norepinephrine,
corticotropin
NAUSEA (Nausea
(Latin nausea, from
Greek ναυσία -
nausia,[1] "ναυτία" -
nautia, motion
sickness", "feeling
sick," "queasy" or
"wamble"[2][3]) is a
sensation of
unease and
discomfort in the
upper stomach with
an involuntary urge
to vomit.[4] It often,
but not always,
precedes vomiting.
A person can suffer
nausea without
vomiting. (Greek
ναῦς - naus, "ship";
ναυσία started as
meaning
5 "seasickness".)
Nausea is a non-
specific symptom,
which means that it
has many possible
causes. Some
common causes of
nausea are motion
sickness,
dizziness,
migraine, fainting,
gastroenteritis
(stomach infection)
or food poisoning.
Side effects of
many medications
including cancer
chemotherapy,
nauseants or
morning sickness
in early pregnancy.
Nausea may also
be caused by
anxiety, disgust
and depression.[5]
[6][7]
Medications taken
to prevent and treat
nausea are called
antiemetics. The
most commonly
prescribed
antiemetics in the
US are
promethazine,
metoclopramide
and ondansetron.)
CRAMPS (A cramp
is an involuntary
temporary strong
muscle contraction
or overshortening,
which may cause a
severe pain.
Usually the onset is
sudden while the
cramp resolves
spontaneously in a
few seconds to
minutes. Common
causes of skeletal
muscle cramps
may include
muscle fatigue, low
sodium, low
potassium, and/or
low magnesium.
[citation needed]
Smooth muscle
cramps may be
due to
menstruation or
6 gastroenteritis.)
ENDOCRINE AND
METABOLIC
AMENORRHEA
(Amenorrhoea
(BE), amenorrhea
(AmE), or
amenorrhœa, is the
absence of a
menstrual period in
a woman of
reproductive age.
Physiological
states of
amenorrhoea are
seen during
pregnancy and
lactation
(breastfeeding), the
latter also forming
the basis of a form
of contraception
known as the
lactational
amenorrhoea
method. Outside of
the reproductive
years there is
absence of menses
during childhood
and after
menopause.
Amenorrhoea is a
symptom with
many potential
causes. Primary
amenorrhoea
(menstruation
cycles never
starting) may be
caused by
developmental
problems such as
the congenital
absence of the
uterus, failure of
the ovary to receive
or maintain egg
cells, and genetic
diseases such as
5-alpha-reductase
deficiency which
causes one to be
intersex. Also,
delay in pubertal
development will
lead to primary
amenorrhoea. It is
defined as an
absence of
secondary sexual
characteristics by
age 14 with no
menarche or
normal secondary
sexual
characteristics but
no menarche by 16
years of age.
Secondary
amenorrhoea
(menstruation
cycles ceasing) is
often caused by
hormonal
disturbances from
the hypothalamus
and the pituitary
gland, from
premature
menopause or
intrauterine scar
formation. It is
defined as the
absence of menses
for three months in
a woman with
previously normal
menstruation or
nine months for
women with a
history of
oligomenorrhoea)
CAUSES
Besides renal
failure, the level of
urea in the blood
can also be
increased by:
increased
production of urea
• in the liver, due to:
o high protein diet
increased protein
breakdown
(surgery, infection,
o trauma, cancer)
gastrointestinal
o bleeding
drugs (e.g.
tetracyclines and
o corticosteroids)
decreased
elimination of urea,
• due to:
decreased blood
flow through kidney
(e.g. hypotension,
o cardiac failure)
urinary outflow
o obstruction
o bladder rupture
• dehydration
chronic infection of
the kidney such as
chronic
• pyelonephritis
EFFECTS OF
UREMIA
Abstract
End-stage renal
disease (ESRD) is
simultaneously
associated with
immune activation,
marked by
systemic
inflammation, and
immune deficiency.
Systemic
inflammation
contributes to
atherosclerosis,
cardiovascular
disease, cachexia,
and anemia,
whereas immune
deficiency leads to
impaired response
to vaccination, and
increased
incidence and
severity of
microbial
infections. ESRD-
associated
inflammation and
immune deficiency
are associated with
the following: (a)
general expansion
of monocytes and
elevations of their
basal integrin, Toll-
like receptor (TLR)
-2, TLR-4
expression,
cytokine
production, and
reactive oxygen
species (ROS)
generation and
reduced phagocytic
capacity, (b)
depletion and
impaired inhibitory
activity of
regulatory T cells,
(c) spontaneous
activation,
degranulation,
increased basal
ROS production,
decreased
phagocytic
capacity, and
increased
apoptosis of the
circulating
polymorphonuclear
leukocytes, (d)
upregulation of
ROS production
machinery and

MEANING OF
NEPHROSIS
Nephrosis refers to
a non-inflammatory
nephropathy.[1]
Also known as
nephrotic
syndrome,
nephrosis is any
degenerative
disease of the renal
tubules. Nephrosis
can be caused by
kidney disease, or
it may be
secondary to
another disorder.[2]
It should not be
confused with
nephritis, where
inflammation is
implied. However,
some sources
equate nephrosis
with nephropathy.
[3]
It can also be used
to indicate an
emphasis on the
renal tubule.[4]
Examples include
amyloid nephrosis
and osmotic
nephrosis
IN OTHER WAY IT
CAN BE SEEN AS:
Nephrosis is a
medical term for
kidney disease.
Sometimes called
nephrotic
syndrome or
nephropathy,
nephrosis has
numerous possible
causes. Nephrosis
is typically
diagnosed by the
results of a urine
test, and though
treatment varies
with the cause, it
often requires life
long treatment with
the hope of
preventing
permanent kidney
failure.
Nephrosis can
affect all age
groups. The
symptoms of
nephrosis are often
not outward, but
include high protein
levels in the urine,
low blood protein
levels, high
cholesterol and
edema, or swelling.
Some outward
symptoms can
include difficulty
with or a decrease
of urination, and in
children, frequent
accidents and
difficulty with toilet
training can
indicate kidney
disease or
disorder. Swelling
of the ankles,
fingers or face from
fluid retention are
also outward
symptoms of
kidney disease.
Nehprosis can be
determined by the
results of routine
urine testing. Other
tests are usually
performed
subsequent to the
urinalysis to help
determine the
cause. In many
cases, nephrosis is
secondary to a
disease that affects
major body organs.
Diabetes, lupus,
and some cancers
can cause kidney
disease, or it may
be a hereditary
condition. In some
cases, nephrosis is
the result of
infection or drug
use.
SIGNS AND
SYMPTOMS OF
NEPHROSIS
Breathing
Troubles?
Shortness of breath
is a common
symptom of chronic
obstructive
pulmonary disease
(COPD).
Take a Breathing
Test
Joint Pain?
Is your joint pain
caused by
rheumatoid
arthritis,
osteoarthritis or a
musculoskeletal
condition?
Inflammation and
Swelling
Swelling is usually
a sign of excess
fluid buildup or
inflammation in the
body. Swelling may
be widespread or
localized to a
particular area of
the body.
Lip Swelling (What
is lip swelling?
Lip swelling is the
enlargement or
distention of one or
both lips due to
fluid buildup or
inflammation within
the lip tissue. Lip
swelling may also
be referred to as lip
edema.
A variety of mild to
serious disorders,
diseases and
conditions can lead
to lip swelling.
Swelling can result
from infections,
inflammation,
trauma or
malignancy
(cancer).
Depending on the
cause, lip swelling
can be brief and
disappear quickly,
such as when you
have sunburned
and chapped lips.
Lip swelling that
develops over time
and occurs along
with additional
symptoms may be
a sign of an
infection or
extensive
inflammation.
Because lip
swelling and
swelling in general
may be a sign of a
life-threatening
condition, such as
an anaphylactic
reaction, you
should seek
emergency medical
care (call 911) if
you experience lip
swelling
accompanied by
difficulty breathing,
hives or rash,
intense distress,
fever, and redness
or warmth.)
SYMPTOMS
What other
symptoms might
occur with lip
swelling?
Lip swelling may
occur with other
symptoms
depending on the
underlying disease,
disorder or
condition. For
example, lip
swelling due to
infection may be
associated with
fever, redness, and
warmth around the
lips.
Groin Swelling
(What is groin
swelling?
Groin swelling is a
sign of fluid buildup
or inflammation in
the groin area. The
groin area is
basically where
your abdomen
ends and your legs
begin. The groin is
also called the
inguinal area and
includes your upper
inner thigh, as well
as the front area
where your legs
attach to your
torso.
The swollen area of
the groin may
appear as a lump
that is solid and
firm or soft to the
touch, and it may
be tender and
painful. In men,
groin swelling may
also refer to
swelling of the
scrotum or the
testicles within the
scrotum.
Groin swelling can
be due to serious
infections,
inflammation,
trauma, malignancy
(cancer), and other
abnormal
processes, such as
a hernia, pulled
muscle, or
testicular torsion.
Depending on the
cause, groin
swelling can begin
suddenly and
disappear quickly,
such as after a mild
allergic reaction.
Groin swelling that
develops over time
and occurs along
with additional
symptoms may be
a sign of a more
serious condition,
such as a sexually
transmitted disease
(STD).
Because groin
swelling or a lump
in your groin can
be a symptom of a
life-threatening
condition, such as
testicular cancer in
men, you should
seek prompt
medical care and
talk with your
medical
professional about
your symptoms.
Any type of
swelling in the
groin should be
examined by a
licensed health
care professional.
SYMPTOMS
What other
symptoms might
occur with groin
swelling?
Groin swelling may
be accompanied by
other symptoms
depending on the
underlying disease,
disorder or
condition. For
example, groin
swelling due to an
infection may be
accompanied by
fever, redness, and
warmth around the
affected area.
Symptoms that
may occur along
with groin swelling
include:
Read more about
groin
swellingsymptoms
CAUSES
What causes groin
swelling?
Groin swelling can
be caused by
relatively minor
conditions, such as
a lipoma (a fatty
growth) or small
hernia that is not
causing any other
symptoms. Groin
swelling can also
be caused by a
wide variety of
infectious diseases
that lead to
swelling of the
lymph nodes in the
groin area. In some
cases, groin
swelling is a
symptom of a
serious or life-
threatening
condition, such as
testicular torsion or
malignancy
(cancer).
Infection-related
causes of groin
swelling
Groin swelling can
be due to various
infections including:
• Abscess
Cellulitis (skin
• infection)
Epididymitis
(testicle
inflammation or
• infection)
• Leg infection
Sexually
transmitted
diseases (STDs)
such as chlamydia,
genital herpes or
• gonorrhea
Other causes of
groin swelling
Swelling in the
groin area can
accompany other
conditions
including:
• Allergic reaction
Cancer such as
testicular cancer or
• lymphoma
Cyst (benign, fluid-
filled pocket of
• tissue)
• Drug reaction
Hydrocele (swelling
• of the scrotum)
• Inguinal hernia
Injury to the groin
• area
• Kidney stones
Lipoma (benign
• fatty growth)
Lymphatic
• obstruction
Pulled muscle or
• other strain
Testicular torsion
(twisting of the
• spermatic cord)
CAUSES OF
NEPROSIS
What causes
nephrotic
syndrome?
Nephrotic
syndrome is
caused by damage
to the kidneys,
generally as the
result of another
disorder. The part
of the kidney that
becomes damaged
is called the
glomerulus, or the
filtering unit of the
kidney. When
glomeruli are
damaged, they
cannot handle
waste in the
bloodstream
properly, so they
fail to block the
passage of protein
into the urine. The
body then retains
excess water,
leading to swelling.
Common causes of
nephrotic
syndrome
Nephrotic
syndrome generally
results from
another disorder
that damages the
kidneys, such as:
Amyloidosis (rare
immune-related
disorder
characterized by
protein buildup in
organs and tissues
that can cause
serious
• complications)
Certain infectious
diseases such as
• hepatitis
Certain
• medications
Diabetes (chronic
disease that affects
your body’s ability
to use sugar for
• energy)
Glomerulonephritis
(kidney
• inflammation)
Glomerulosclerosis
• (kidney scarring)
Minimal change
disease (kidney
disease in which
the kidneys appear
microscopically
• normal)
Multiple myeloma
(cancer of plasma
cells in the bone
• marrow)
Other autoimmune
• disorders
Systemic lupus
erythematosus
(disorder in which
the body attacks its
own healthy cells
• and tissues)
What are the risk
factors for
nephrotic
syndrome?
A number of factors
increase the risk of
developing
nephrotic
syndrome. Not all
people with risk
factors will get
nephrotic
syndrome. Risk
factors include:
Certain cancer
• medications
Family history of
autoimmune
• disorders
Personal history of
autoimmune
• disorders
• Recent infection
EFFECTS OF
NEPHROSIS
Heart failure (HF),
often called
congestive heart
failure (CHF) or
congestive cardiac
failure (CCF),
occurs when the
heart is unable to
provide sufficient
pump action to
maintain blood flow
to meet the needs
of the body.[1][2][3]
Heart failure can
cause a number of
symptoms
including shortness
of breath, leg
swelling, and
exercise
intolerance. The
condition is
diagnosed by
patient physical
examination and
confirmed with
echocardiography.
Blood tests help to
determine the
cause. Treatment
depends on
severity and cause
of heart failure. In a
chronic patient
already in a stable
situation, treatment
commonly consists
of lifestyle
measures such as
smoking cessation,
light exercise,
dietary changes,
and medications.
Sometimes,
depending on
etiology, it is
treated with
implanted devices
(pacemakers or
ventricular assist
devices) and
occasionally a
heart transplant is
required.
Common causes of
heart failure include
myocardial
infarction and other
forms of ischemic
heart disease,
hypertension,
valvular heart
disease, and
cardiomyopathy.[4]
The term heart
failure is
sometimes
incorrectly used for
other cardiac-
related illnesses,
such as myocardial
infarction (heart
attack) or cardiac
arrest, which can
cause heart failure
but are not
equivalent to heart
failure.
Heart failure is a
common, costly,
disabling, and
potentially deadly
condition.[4] In
developed
countries, around
2% of adults suffer
from heart failure,
but in those over
the age of 65, this
increases to 6–
10%.[4][5]

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