Urea in the blood is elevated causes, diagnosis, how to treat

After we have eaten the next portion, the process of their processing and assimilation begins in the body. Food is broken down into elements: proteins, fats, carbohydrates. In turn, proteins are broken down into amino acids. As a result of protein metabolism in the body, a simple and final product is produced containing nitrogen – the toxic substance ammonia (NH3). To make it safe, the liver converts it into urea ((NH2) 2CO) through an enzymatic action. The resulting compound is filtered from the blood into the renal glomeruli, and then, together with urine, is excreted from the body.

Thus, by the level of carbamide (the second name of urea), one can judge the performance of the kidneys and liver, as well as control the state of muscle tissue. If it was found that the urea in the blood is increased, you need to waste no time to establish the cause and proceed to treatment. Otherwise, the body will be poisoned with ammonia, which has a detrimental effect on internal organs and brain activity.

urea5 - 9Normal performance

Elevated blood urea is a direct reflection of changes in glomerular filtration rate (kidney activity). In a healthy person, this rate is 125 ml/min. At the same time, an increased content of urea in the blood occurs when the glomerular filtration is reduced by about half. This suggests that an increase in blood urea is a delayed sign of renal failure. It cannot detect the disease at an early stage of development.

Nevertheless, in medical practice, biochemical studies are used quite often and the level of urea in the blood serum plays an important role in diagnosis. Therefore, the reference values ​​given in the table are often used in clinical practice.

Category of the surveyedUrea level (mmol/l)
In newborns+1,2
In children from one to 14 years old+1,8
In women under 60+2,3
In men under 60+3,7
Pregnant women+1,5
In people over 60+2,8

As you can see, the data varies both by age and gender. In the blood of women, the content of this component is always lower than that of men. This is explained by the fact that men prefer protein foods, and their physical activity is higher. It should be noted that high levels of urea in athletes is considered quite normal. The main thing is that the concentration does not exceed the threshold of 15 mmol/l.

With age, the functional activity of the kidneys decreases, as evidenced by an increase in the level of urea. The glomerular filtration rate decreases and there is a gradual increase in the content of urea in the blood – physiological growth.

Factors causing changes in normal concentration

Why is blood urea elevated? Its level depends on 3 factors:

  • The number of amino acids formed after protein metabolism, since ammonia is then produced from them,
  • Liver efficiency (the ornithine cycle is used to synthesize urea),
  • Kidney condition (for its elimination).

The reasons for the increase in blood urea are conventionally divided into 3 groups:

  • Physiological,
  • Medication,
  • Pathological.

The physiological factors include our diet, physical activity. If a person prefers protein food, and it takes up most of his daily menu, then this can cause an excess of urea. The content of this element begins to grow when you consume 2,5 grams of protein per 1 kg of body weight. Fasting can also trigger an increase in (NH2) 2CO in the blood as a large amount of protein is released from muscle tissue. Exercise and nervous stress are also factors that lead to the elimination of protein from the muscles and, as a result, the results of studies on urea will be overestimated.

Upward deviations can also be caused by drugs. The group of medicines that give a similar effect include:

  • Cephalosporins,
  • Anabolics,
  • Steroids,
  • Corticosteroids,
  • Salicylates,
  • Androgens,
  • tetracycline
  • “Eutirox”,
  • “Lasix”,
  • neomycin,
  • sulfonylamides.

The level of urea can increase when there is an increased breakdown of proteins and changes in the blood, the reasons for these phenomena:

  • Temperature for 2 weeks,
  • Infectious diseases,
  • Burns,
  • Sepsis,
  • Bleeding in the gastrointestinal tract,
  • Tumors (leukemia, lymphoma),
  • Postoperative period,
  • Constipation,
  • Intoxication with phenol, mercury salts, chloroform,
  • Dehydration due to vomiting, diarrhea, or excessive sweating.

urea6 - 11But still the main cause is considered to be kidney dysfunction. Elevated blood urea levels are observed in the following disorders:

  • CRF – chronic renal failure. After the concentration of urea has increased, so does creatinine. Analyzes show values ​​of more than 10 mmol/l,
  • Blockage of the urinary tract with stones or neoplasms
  • Pyelonephritis
  • Poor blood supply to the kidneys due to heart attack, dehydration, shock.

clinical picture

The first heralds of higher blood urea concentrations are:

  • Headache,
  • Constant fatigue
  • Insomnia.

Over time, the situation escalates, toxic substances accumulate and the patient develops new symptoms:

  • Low temperature,
  • Vomiting, or nausea
  • Diarrhea,
  • Dyspnea,
  • Itching
  • Iron deficiency
  • Pain in the lumbar region
  • Urinary problems (either too much or too little urine)
  • Thirst,
  • Disruption of taste buds and smell
  • Joints begin to hurt – arthralgias appear.

If the patient continues to pull a visit to the doctor, then he will have other more dangerous signs:

  • Dystrophy of the heart muscle,
  • Pulmonary edema,
  • Ulcerative gastritis
  • High blood pressure.

External symptoms of severe uremia (excess of urea in the blood):

  • Dry and pale skin
  • Brittle nails and hair
  • Bleeding gums
  • Frequent urge to use the toilet
  • Deterioration of vision
  • Puffiness
  • Increased sweating
  • Uremic powder is a crystalline coating on the skin, the result of excessive accumulation of urea in the body.
  • The skin starts to smell like urine. It is impossible to get rid of this aroma. The only effective way to reduce blood urea is hemodialysis.

uremiya01 - 13

Note: The last two symptoms are signs of extreme and end-stage renal failure. So, urea is able to be deposited in the form of crystals, for example, on the pericardium, and each heartbeat is accompanied by a loud, sometimes audible shuffling even at a distance. Old doctors called the rubbing noise of the pericardium “the death knell of the uremic.” Of course, nowadays such neglected situations are rare.

Diagnostics

urea4 - 15Checking for an increase in the level of urea in the blood in adults is carried out by means of a biochemical test. Blood is drawn from a vein.

A biochemical blood test is performed in the morning, since during the day the content of the substance fluctuates and an error of 20% is possible. In order for the results obtained to be accurate and to help determine the causes and treatment, biochemistry is given on an empty stomach. This eliminates third-party factors that can distort the result. For example, a hearty breakfast with protein foods.

All patients admitted to hospital undergo this examination. In addition, the mandatory delivery of the analysis in the following conditions:

  • Coronary heart disease,
  • Diabetes,
  • Hypertension,
  • Diseases of the gastrointestinal tract, in which the absorption of food is impaired (gluten enteropathy),
  • Pregnancy,
  • Cirrhosis and hepatitis
  • Infection or inflammation in the kidneys
  • Poor CBC results
  • Monitoring the condition of patients on hemodialysis,
  • Sepsis and shock
  • Control over protein metabolism in athletes.

The following describes the decoding of the increased indicator in terms of severity:

  • Extrarenal pathological changes – up to 10 mmol/l, creatinine is normal,
  • Mild kidney damage – 10-15,9 mmol/l,
  • Renal failure of moderate severity – 16-27 mmol/l,
  • Severe renal dysfunction – 28-35 mmol/L,
  • end stage renal failure with poor prognosis – more than 50 mmol/l.

As additional studies, to confirm the diagnosis, check is performed:

  1. Erythrocyte level,
  2. Lymphocyte count,
  3. Blood sugar.

What can high urea levels cause?

Small amounts of urea are safe and non-toxic. But a high level is a sign of kidney dysfunction, which means that the kidneys do not remove toxic metabolic elements from the body. This leads to water-salt and acid-base imbalance. Hormonal disorders occur, leading gradually to multiple organ failure.

It is also important that dangerous ammonia accumulates in the body and tissue poisoning occurs. If the level of urea is not reduced in time, then the whole body is saturated with it, and irreversible processes (necrosis) begin in the cells of the brain. Against this background, the patient may develop psychological and neurological diseases.

Measures to stabilize urea levels

If blood urea is elevated, it is important to identify the causes of the increase in order to determine how to treat them. The following measures will reduce urea levels:

  • Diet revision (reducing the amount of protein),
  • Reduction of stressful situations and hypothermia,
  • Elimination of physical overvoltage,
  • Stabilization of the water-salt balance,
  • Prevention of chronic and acute kidney disease.

If the deviation in the big direction was caused by improper nutrition, the patient is prescribed a diet and a decrease in physical activity. This should help muscle tissue to return to normal, and the kidneys to remove excess residual nitrogen components from the body.

Nutritionists have selected a list of foods that reduce the level of urea in the blood. A list of forbidden “menu ingredients” was also created. There are also several recommendations on how to remove excess and prevent the problem from recurring in the future:

  • There should be 6 meals a day,
  • Drink at least 2 liters of water per day,
  • Fasting days no more than 1 time per week.

The list of permitted products is quite extensive and varied, so there is no particular discomfort when following a diet:

  • Rabbit meat,
  • A hen,
  • Turkey,
  • Dairy products,
  • Eggs
  • Fish with a fat content below 8%
  • Pasta and porridge 1-2 times a week,
  • Vegetables,
  • Fruits,
  • Vegetable and olive oil,
  • Juices and decoctions,
  • Weak tea and coffee
  • From sweets: jelly, jam, jam, marmalade.

You should reduce consumption, and it is better to exclude completely from the diet:

  • Sausages,
  • Canned food – meat and fish,
  • Mayonnaise, ketchup, sauces,
  • Smoked meats,
  • Salty dishes,
  • Fatty meat and fish, as well as broths based on them,
  • Sorrel,
  • Mushrooms,
  • Cauliflower,
  • Soda,
  • Alcohol,
  • Strong coffee and tea.

If the urea level rises, then the doctor will prescribe crystalloid infusions to reduce the concentration. In the event that such therapy does not help, hemodialysis is prescribed to the patient, since there are no drugs to reduce uremia. Kidney transplant is also a means of getting rid of uremia.

Phytotherapy

The following remedies are used in traditional medicine, but they are unable to lower the level of urea in the blood. After all, urea is the simplest possible compound of inorganic nitrogen, which is soluble. And in order to reduce the level of uremia, it is necessary to turn urea into an even more soluble substance, and such a substance does not exist.

But in the early stages of the disease, herbal medicine allows, for example, to increase the volume of urine excreted, or the blood supply to the kidney, and then a temporary improvement may occur.

  • Chamomile,
  • Madder dye,
  • St. John’s wort,
  • Quinoa,
  • Currant,
  • Rosehip,
  • Dandelion,
  • Wheatgrass,
  • Liquorice root.

Below are a few recipes:

  • Any of the ingredients are used: chamomile, St. John’s wort, quinoa. 1 tbsp. a spoonful of medicinal herbs is poured 1 tbsp. boiling water. You wait 15 minutes. You can use it as a tea 2-3 times a day,
  • Rosehip decoction can be made both from berries and from the root. 2-4 roots 5-10 cm each (minimum diameter 0,5 mm) are placed in a kettle with 1 liter of water and boiled for 0,5-1 hour. You can drink the broth both cold and hot,
  • A decoction of any ingredient: licorice root, dandelion or wheatgrass. 1 tbsp. a spoonful of phyto-bases are diluted in 2 cups of boiling water. Drink 3 times daily.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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