Clinical symptoms

Nitrogen blood less often without clinical symptoms, can only be diagnosed through blood tests nitrogen. If nitrogen increase, will have some disorders can be diagnosed by clinical trenlam. But the signs   clinical   necessarily go hand in hand   the percentage of nitrogen in the blood. In some cases, blood urea above 1g / liter) but still no clinical symptoms, in contrast with the new blood urea 1 g / liter had clinical symptoms. The common symptoms are:

 

Nerve Syndrome

Lightweight:

Patients with fatigue, dizziness, headache, dizziness, sight see "floaters", insomnia.

Weighing just:

Patients drowsiness, delirium said, struggling.

Very severe:

Go into a coma, convulsions due to cerebral edema, pupillary contraction, respond to low light. Examination found no focal neurological signs, no meningeal syndrome.

Metabolic syndrome

Lightweight, loss of appetite, abdominal distension, bloating.

Heavier nausea, diarrhea, black tongue, oral mucosa and throat ulcers, and there are gray pseudomembranous colitis.

Respiratory Syndrome

Breath with ammonia odor. Disorder   Cheyne-Stokes respiration or coma KUSSMAUL when breathing slow and weak. Check lung pleural rub can see by nitrogen escaping pleura caused.

Heart Syndrome

Small tachycardia, hypertension. If in the final stages of kidney inflammation that can cause heart attacks. There can be left ventricle thickening, due to high blood pressure. Listen to the sound of palm heart can pericardial   Nitrogen released by the pericardium.

Bleeding syndrome

Characteristics of nitrogen is very easy to saturate the tissues and cause bleeding, because the nitrogen escaping blood vessels and organizations, leading to the red blood cells, plasma and out.

In the retina: retinal inflammation and retinal bleeding.

Bleeding under the skin and mucosa, blood into the array.

Gastrointestinal bleeding: a cheek vomiting, bloody diarrhea.

Bleeding meninges, the brain.

Bleeding pleura, pericardium.

Temperature

If e reduction in temperature. Not every case she high blood nitrogen   co Dey enough of these symptoms, which may be only a 1.2 or 3 symptoms alone, the early symptoms are the symptoms of digestive and nervous. Often high blood nitrogen levels, not so easy to make with the clinical symptoms, and chronic high blood nitrogen, if low, less clinical symptoms, as has been shown clinically, in the final stages of renal failure.

Symptoms biochemical

Urea, creatinine and non-protein N increased blood

In peritoneal water, urea increased cerebrospinal water.

Reserve alkaline reduction

Due to the phenomenon of acid blood. Blood acid is due to: a non-volatile acids (phosphoric acid, sulfuric acid) metabolism from protit born with retention. On the other hand the body normally create NH3 to neutralize acid   discharged, the fixed alkalis   (Na) is kept   Back in the body, there is little substance or base (NH3) will neutralize pollutants. In renal failure. NH3 generated not enough, the fixed alkalis   (Na) must be the place for NH3. Thus causing the blood acid.

Electrolyte disorders

PO4 increased, decreased Ca, K increases (especially nitrogen supplied blood and the last stage of chronic blood nitrogen). Cl, Na often reduced, possibly due to fluid retention or intercellular space for a long time to eat light, and by vomiting, diarrhea. Reduced Cl, Na sometimes cause high blood nitrogen.

When high blood nitrogen   to some extent, will go to coma.

Coma due to high blood nitrogen

Symptom

Phase begins:

Low blood nitrogen, only experience symptoms such as headache, cold limbs, tingling, dizziness, chest pain, loss of appetite, Prance.

Pre-coma:

The symptoms are more severe. Patients at the province, while drowsy, struggle, twitching muscles, fear, anxiety. Nausea, vomiting, diarrhea. Can vomiting blood, bloody diarrhea, very tired, difficulty breathing, blue-gray, the temperature dropped.

Check it at that: no localized paralysis, heart pericardial rub moan stagnant lung, pleural rub, pupillary contraction, high blood pressure.

Phase coma completely:

The patient unconscious ignorant, reflexes are lost or reduced, shortness of breath, wheezing type Cheynes - Stokes or Kusmaul weak or slow breathing, breath odor of ammonia. Check that there glossitis, mouth parotid gland. Try to see high blood urea, alkaline reserve reduction, Cl, Na reduction, K increases.

The patient will die within a few hours or a few days, rarely live more than 5 days. But there are cases out if treated promptly (serum, intestinal or peritoneal dialysis) and usually increased blood nitrogen newly healed.

The definitive diagnosis of coma due to high blood nitrogen

Clinical:

Coma occurs slowly.

No focal neurological symptoms, with miosis.

Dyspnea type Cheyne - Stokes, breath odor of ammonia.

There is a history of inflammatory   Chronic kidney, renal tuberculosis, kidney stones or kidney disease treatment level   (Glomerulonephritis level).

Tests:

High blood urea, urine protein, red blood cells, leukocytes many, cylindrical shaped particles.

Reserve alkaline reduced, Cl, Na reduction, K increases.

Cause

There are two main causes: physical damage in the kidney and renal lesions in stages.

Cause Renal

Acute:

Glomerulonephritis caused by bacterial infection.

Inflammation acute tubular:

Due to the toxicity,   organized by the destruction of the body. The mellitus little or no urine, thus increasing the blood nitrogen. Need to combat the phenomenon of nitrogen to prevent blood serum by honme, bowel or peritoneal dialysis. Patients go pee, blood urea reduction is a good prognosis of the disease.

Yellow fever bleeding Lepxospira:

Cause acute hepatorenal syndrome.

Sepsis caused the drive small abscess of the kidney:

Chronic renal disease.

Chronic nephritis.

Renal pelvis water retention (due to gravel, work ..)

Multiple cystic kidney.

Chronic pyelonephritis.

Sclerotic renal arterioles in the elderly.

All of these reasons can cause chronic high blood nitrogen, at lamsang show symptoms, but for some reason certain advantages to doing serious illness can cause acute blood nitrogen. eg renal cysts cause many chronic increase blood nitrogen, but the cause of multiple infections, can cause blood nitrogen soared and coma. Lao kidney, kidney stones ... too.