UREMIA SYNDROME ,UREMIC SYMPTOMS, CAUSES AND TREATMENT
WHAT IS HEMOLYTIC UREMIC SYNDROME(HUS)?
Uremia Syndrome is a condition that affects the blood and the blood vessels . The resulting effect is:
- the destruction of the blood platelets(Thrombocytes) which are cells responsible for blood clotting
- reduction(low) in red blood cell count(Erythrocyte); that is Anaemia
- kidney failure resulting from damage of the small vessels of the kidneys.
Other delicate organs of the body such as the brain or heart may be likely affected too-due to damage to the very small blood vessels of the organs.
UREMIA SYNDROME: results from accumulation in the blood of constituents normally eliminated in the Urine that produces a severe toxic condition and usually occurs in severe kidney disease
Renal insufficiency or failure can be a sudden and acute problem or it may occurs gradually over an extended period of time. End stage failure is sometimes called uremic syndrome or uremia. Any degenerative condition of renal parenchyma can result in this complication
This renal insufficiency or failure occurs when a small number of functioning nephrons are overwhelmed by body demand.
Renal blood flow is reduced, output is reduced also and urea, potassium and phosphate level rise in the blood as a result of inadequate removal of waste product.
Water excretion will be gradually reduced or water overload and salt deficiency are the major reversible causes of diminishing renal function leading to total renal failure and eventual death.
The kidney because of its rich blood supply an involvement with metabolic activities is prone to nnephrotic substances kidney consecrates and excretes and excretes many types of substances that enter the body for inhhalation, ingestation and absorbtion. Exposure to nephrotoxin can be induced : iotrogenic, accidental or a sucidal attempt. Damage could be induced by direct toxicity in the cells, hypersensitivity, Isachamia and mechanical obstruction.
Toxic substances like solvent, insecticides and heavy metals may cause renal failure. Certain agents such as anti-free are converted in the body form ethylene glycol to oxalic acid with which is nephrotoxic .
Carbon tetrachloride is damaging to renal function and damage occur 7 to 10 days after exposure. Renal failure follows any condition that causes Ischaemia e.g. Anaphylasis or shock which produces acute tubular necrosis, Antibiotics, Antimicrobial, radiological contra media or certain analgesics can also create renal failure by mechanisms, including acute tubular necrosis, nephrotic syndrome, glomerular nephritis.
The solubility of this drug seem to be an important factor in how complete they are excreted. Crystals or sediment they leave behind can obstruct minute glomerular structure
The nurse can help the patient understand the potential hazard motioned e.g. persons with diabetes, renal disease or chronic alcoholism should not take the above drug without medical guidance. Adequate ventilation must be assured where ever they are taken.
TYPES OF UREMIA SYNDROME(HUS)
Hemolytic Uremic syndrome has types and it is considered a syndrome disease(a disease or disorder that involves a particular group of signs and symptoms. Most times HUS appears after a severe bowel infection with certain strains of bacteria called Escherichia coli(E.coli). It can also occur as a result of impact of certain medicines, but this case is very rare though. HUS occurs in humans for no specific reason particularly which is considered even more rare. This article encapsules the type of Hemolytic Uremic Syndrome that is endemic in infants and children as a result of bacterial infection (E.coli).
Uremic Symptoms vary according to the patient's age and the acute or chronic nature of the disease. Acute renal failure occurs when the output drops suddenly to less than 400mls per day.
It shows three distinct things
- Olygouric phase
- Anuric phase
- Polyuric or Recovery phase
Uremia Syndrome is generally predominant in children that have suffered any form of illness involving diarrhea (usually bloody). Most times children recover from their bowel illness( intestine/gut illness). Notwithstanding, a smaller percentage of children will become pale and experience reduction in energy due to the furtherance/progression of the illness to Uremia Sydrome a chronic infective state; this may likely result in reduction in their urine output, but cases of loss of color in the skin indicates a striking symptom
HOW HEMOLYTIC UREMIC SYNDROME STARTS
Uremia Syndrome resulting from bacterial infections of E.coli occurs when the bacterial toxins progress(cross) from the intestines into the bloodstream and damage the very small blood vessels. The toxic bacterial infection of E.coli may transmitted from poor hygienic conditions which includes eating spoiled, undercooked or poorly processed food products , or even from infected /contaminated water. Uremic syndrome is majorly endemic in certain region like pacific northwest and Argentina.
HOW UREMIC SYNDROME AFFECTS THE KIDNEYS
In a case of Uremia Syndrome, the tiny filter units in the kidneys known as the glomeruli become clogged/clouded with thrombocytes(blood platelets) and damaged erythrocyte (red blood cells). Thus this results to problems with the ability of the kidney to filter and eliminate waste products.
TREATMENT OF HEMOLYTIC UREMIC SYNDROME
Generally Uremia syndrome is treated with proper medical care in the hosspital. A close attention to accumulation of fluid (fluid volume) of the patient is very important. This involves intravenous (IV) fluids and nutritional supplementation either by IV or through tube feeding. Transfusion of blood may be likely needed depending on the severity of the case but in about 50% cases, short-term kidney replacement treatment in the form of dialysis is pertinent. In most cases, Patients in need of kidney dialysis will recover the kidney function perfectly and ultimately be able to discontinue their dialysis treatment. At times specialized treatment called plasmapheris may also be important/applicable(Plasmapherisis is a process for removing blood plasma without depleting the donor or patient of other blood constituents ( as red blood cells) by separating out the plasma from the whole blood and returning the rest to the donor's patient's circulatory system)
CASES OF KIDNEY FAILURE
When Uremia syndrome causes mild kidney failure, the patient is given close attention, especially as it pertains fluid volume. Fluid volume may be all that is necessary for sufficient treatment. In cases of severe kidney failure (i.e. when the kidney function has reduced to less than 10% of normal function) then dialysis may be pertinent to do the work of the kidneys. Various forms of dialysis is applicable depending on the individual's needs. Most HUS patients that require application of dialysis ultimately recover their kidney function
CHANCES OF RECOVERING FROM HUS
Over 85% of patients with the most common form of Uremia syndrome recover their complete kidney function. However even with full recovery of their kidney function, there is possibility for high blood pressure or other kidney associated problems in the future. generally, the outlook in Hemolytic Uremic Syndrome in line with uremic symptoms is related the severity of other delicate organs of the body such as the brain, pancreas, liver or the heart.
POSSIBILITY OF OTHER CHILDREN IN THE FAMILY HAVING UREMIA SYNDROME IF ONE HAS BEEN AFFECTED
It is possible for other members of the family or close personal contacts to get infected and develop HUS because the most common form of the infection is bowel infection(gut/intestine)
GENERAL OUTLOOK OF HEMOLYTIC UREMIC SYNDROME
Inasmuch of the fact that there is still much to do, there has been an appreciable increase in understanding the underlying cause of Uremia Syndrome and the processes that contributes to kidney damage. Medications that are channeled towards preventing the absorption of the bacterial toxins (E.coli) in children with HUS are currently being studied in clinical treatment trials.