Uremia – Patient Education

1. What It Is

Uremia is a serious condition that happens when your kidneys are not working well and waste products build up in your blood. Normally, healthy kidneys filter out waste and extra water. When kidneys are damaged or failing, these wastes stay in your body, causing sickness. Uremia often happens in people with chronic kidney disease or kidney failure and may require dialysis.

2. Causes and Risk Factors

You are more likely to get uremia if you have:

• Chronic kidney disease (CKD)
  
  

• Uncontrolled high blood pressure
  
  

• Diabetes
  
  

• Severe dehydration
  
  

• Certain autoimmune diseases (like lupus)
  
  

• Urinary blockages (kidney stones, enlarged prostate)
  
  

• Polycystic kidney disease
  
  

• Heavy use of certain pain or anti-inflammatory medicines (NSAIDs) over time
  
  

3. Signs and Symptoms (Including Early Warning Signs)

Early warning signs:

• Swelling in ankles, feet, or face
  
  

• Feeling very tired or weak
  
  

• Loss of appetite
  
  

• Nausea or vomiting
  
  

Other common symptoms:

• Itchy skin
  
  

• Muscle cramps
  
  

• Trouble concentrating or confusion
  
  

• Shortness of breath
  
  

• Metallic taste in mouth or bad breath (from waste buildup)
  
  

• Decreased urination or changes in urine color
  
  

4. Complications If Untreated or Not Following Care Plan

If not treated, uremia can cause:

• Heart problems (irregular heartbeat, heart failure)
  
  

• Seizures
  
  

• Severe fluid overload in lungs (pulmonary edema)
  
  

• Permanent kidney damage
  
  

• Death
  
  

5. Treatment and Self-Care Measures

Medical Treatments:

• Dialysis: A machine removes waste and fluid from your blood. May be hemodialysis (blood filtered outside body) or peritoneal dialysis (fluid in belly filters blood).
  
  

• Medicines:
  
  

  • Phosphate binders – lower phosphorus in blood.
    
    

    • Side effects: Constipation, nausea.
      
      

  • Erythropoietin-stimulating agents – help make red blood cells to treat anemia.
    
    

    • Side effects: Headache, high blood pressure.
      
      

  • Diuretics – help remove extra fluid (only if some kidney function remains).
    
    

    • Side effects: Low blood pressure, dehydration, electrolyte changes.
      
      

• Treating underlying cause – controlling diabetes, high blood pressure, or infections.
  
  

Self-Care:

• Go to all dialysis sessions — skipping even one can be dangerous.
  
  

• Take medicines exactly as prescribed.
  
  

• Keep all lab and doctor appointments.
  
  

6. Dietary Needs

• Limit sodium (salt) – reduces swelling and fluid buildup.
  
  

• Limit potassium (in foods like bananas, oranges, potatoes) to prevent heart problems.
  
  

• Limit phosphorus (in dairy, nuts, beans, cola) to protect bones and blood vessels.
  
  

• Eat high-quality protein but in the amount your doctor or dietitian recommends.
  
  

• Follow fluid restriction if ordered — too much fluid can cause swelling and breathing problems.
  
  

7. Lifestyle Changes

• Quit smoking.
  
  

• Limit or avoid alcohol.
  
  

• Monitor blood pressure daily.
  
  

• Check weight daily to catch fluid buildup early.
  
  

• Manage blood sugar if diabetic.
  
  

• Stay active with gentle exercise as allowed.
  
  

8. Safety Considerations

• Skipping dialysis or taking in too much fluid can cause life-threatening problems.
  
  

• Some medicines and over-the-counter drugs can harm the kidneys — check with your doctor before taking anything new.
  
  

• Uremia can make you confused or weak — use caution when driving or operating machinery.
  
  

9. Prevention and Maintenance Tips

• Keep blood pressure and blood sugar under control.
  
  

• Follow kidney-friendly diet and fluid limits.
  
  

• Take all medicines as prescribed.
  
  

• Attend every dialysis session.
  
  

• Have regular lab checks to monitor kidney function.
  
  

When to Call for Help

Call Your Home Health Agency or Doctor If:

• You have swelling in feet, ankles, or face that is new or getting worse.
  
  

• You feel unusually tired or weak.
  
  

• You have nausea or vomiting that lasts more than 1 day.
  
  

• You have itching that doesn’t improve.
  
  

• You notice a metallic taste in your mouth or change in appetite.
  
  

• You gain more than 2–3 pounds in a day or 5 pounds in a week.
  
  

Go to the Emergency Room or Call 911 If:

• You have chest pain or trouble breathing.
  
  

• You are very confused, cannot think clearly, or have trouble waking up.
  
  

• You have a seizure.
  
  

• You stop urinating completely.
  
  

• You have sudden severe shortness of breath or swelling in the face and throat.
  
  

© 2025 Judith Regan / K.N.O.W. – Knowledge for Nurturing Optimal Well-Being. All rights reserved. | Educational use only | Not a substitute for medical advice | In emergencies call 911

Patient Homework / Assessment

Instructions: Write “True” if the statement is correct, “False” if it is not. If false, correct the statement so it is true.

1. True or False: Uremia means waste products are building up in the blood because the kidneys are not working well.
   
   

2. True or False: Skipping dialysis sessions is safe if you feel okay.
   
   

3. True or False: People with diabetes or high blood pressure have a higher risk for uremia.
   
   

4. True or False: Swelling in the feet can be an early sign of uremia.
   
   

5. True or False: Uremia can be cured quickly with antibiotics.
   
   

6. True or False: Dialysis helps remove waste and extra fluid from the blood.
   
   

7. True or False: Limiting salt can help control swelling and fluid buildup.
   
   

8. True or False: A metallic taste in the mouth can be a sign of uremia.
   
   

9. True or False: High potassium levels can cause dangerous heart problems.
   
   

10. True or False: Phosphate binders are used to lower phosphorus in the blood.
    
    

11. True or False: Fluid limits are not important for people with kidney failure.
    
    

12. True or False: Itching can happen when waste builds up in the body.
    
    

13. True or False: Confusion can be a sign of severe uremia.
    
    

14. True or False: People with uremia should check with their doctor before taking over-the-counter medicines.
    
    

15. True or False: Quitting smoking can help protect kidney and heart health.
    
    

16. True or False: Controlling blood sugar has no effect on kidney health.
    
    

17. True or False: Missing dialysis can cause swelling and breathing problems.
    
    

18. True or False: Daily weight checks can help detect fluid buildup early.
    
    

19. True or False: Low phosphorus levels are a problem in uremia.
    
    

20. True or False: Uremia is a sign of serious kidney disease.
    
    

Individualized Patient Questions

(To tailor the education to each patient’s needs)

1. How many dialysis treatments do you have each week?
   
   

2. Have you missed any treatments recently? If so, why?
   
   

3. What is your target weight after dialysis?
   
   

4. Do you follow fluid restrictions? How much fluid are you allowed each day?
   
   

5. What foods do you avoid because they are high in potassium or phosphorus?
   
   

6. Do you take phosphate binders or other kidney medicines?
   
   

7. Have you noticed changes in your appetite or taste?
   
   

8. How do you manage your blood pressure at home?
   
   

9. Do you check your weight daily?
   
   

10. Have you had any recent lab tests for potassium, phosphorus, or creatinine?
    
    

11. How do you keep track of your medicines and doses?
    
    

12. What is your usual blood sugar range (if diabetic)?
    
    

13. Have you had shortness of breath or chest pain recently?
    
    

14. Do you know your most recent GFR (kidney function) result?
    
    

15. Do you have a plan for what to do if you feel very sick between dialysis treatments?