Azotemia

Azotemia is a toxic condition characterized by abnormal and dangerously high levels of urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood as a result of insufficient filtering of the blood by the kidneys. Also known as prerenal azotemia and uremia, it is not uncommon, especially in hospitalized patients, and can be caused by medical conditions that impair blood flow to the kidney(s). Some examples would be congestive heart failure, shock, severe burns, prolonged vomiting or diarrhea, or some sort of trauma to the kidney(s).

Signs and symptoms

• Decreased or no urine produced
• Fatigue
• Decreased alertness
• Confusion
• Pale skin color
• Rapid pulse
• Dry mouth
• Thirst swelling (edema, anasarca)
• Orthostatic blood pressure (rises or falls, significantly depending on position)

A urinalysis will typically show a decreased urine sodium level, a high urine creatinine to serum creatinine level, a high urine urea to serum urea ratio, and concentrated urine (determined by osmolality and specific gravity).

In order to reverse damage to the kidneys, treatment must begin within 24 hours. Treatment may include hemodialysis or peritoneal dialysis, medications to increase cardiac output and increase blood pressure, and the treatment of the condition that caused the azotemia to begin with.