high blood nitrogen

Introduction

Introduction High blood nitrogen refers to an increase in the proportion of nitrogen in the blood, which is prone to occur when kidney function is impaired. Normal human blood NPN is 25 ~ 35mg%, of which urea nitrogen is 10-15mg%. Blood urinary toxic, creatinine, uric acid and other non-protein nitrogen (NPN) levels are significantly elevated, called azotemia.

Cause

Cause

(1) Causes of the disease

Renal dysfunction is the main cause of high blood nitrogen. Plasmacytoma, amino acid or excessive intake of protein can also cause high blood nitrogen.

Insufficient renal perfusion secondary to the following conditions can lead to the symptoms: 1 decreased cardiac output; 2 blood loss; 3 hypotension; 4 dehydration syndrome; 5 postoperative period; 6 late stage tumor; 7ADH secretion syndrome; 8 with vasoconstrictor. Common causes of prerenal renal failure include vomiting, diarrhea, dehydration, major bleeding, burns, etc., and can also be seen in severe edema and ascites (relative blood volume deficiency).

(two) pathogenesis

Although secondary hypertensive blood has no organic disease of the kidney, the production of non-protein nitrogen is not reduced, and non-protein nitrogen excreted by the kidney is affected, resulting in azotemia and hypochloremia.

Examine

an examination

Related inspection

Urine creatinine urinary creatinine (Ucr) serum-nitrogen uric acid creatinine (Cr, Crea)

Check: A blood test reveals an increase in the proportion of nitrogen in the blood.

First, the whole body edema: almost all have different degrees of edema, edema is most obvious in the face, lower limbs, scrotum. The edema can last for weeks or months, or it can be swollen during the entire course of the disease. After infection (especially streptococcal infection), edema often recurs or aggravates, and even azotemia can occur.

Second, the symptoms of digestive tract: due to edema of the gastrointestinal tract, often do not think about diet, nausea, vomiting, abdominal distension and other symptoms of digestive tract dysfunction. When there is azotemia, the above symptoms are aggravated.

Third, high blood pressure: an important clinical manifestation of non-nephrotic syndrome, but there are water, sodium sputum slip, blood volume increased, temporary high blood pressure may occur. Type II primary renal pelvic syndrome can be associated with hypertension.

Fourth, proteinuria: a large number of proteinuria is the most important condition for the diagnosis of physiology.

V. Hypoproteinemia: Mainly due to the decrease of plasma protein, the degree is closely related to the degree of proteinuria.

Sixth, hyperlipidemia: the blood triglyceride is significantly increased.

Seven, urinary foam, long-term does not disappear, which indicates that more protein is excreted in the urine. Urine discoloration, urine is dark brown, washed meat, soy sauce or turbid, such as Taomi water, immediately see a doctor. Too much or too little urine, the average urine volume of normal people is 1500 ml per day, 4-8 times a day. If there is no fever, a lot of sweating, a lot of drinking water, etc., when the amount of urination suddenly decreases or suddenly increases, it is necessary to go to the hospital for examination to see if it is a kidney disease. Nocturia, normal people within 60 years of age, generally should not have nocturia, if young people with nocturia increased, it is likely to be an early manifestation of kidney dysfunction. Edema, edema of the eyelids or face after getting up in the morning, more subsided in the afternoon, increased after exertion, relieved after rest. Severe edema can occur on the inside of the ankles, in the lower extremities, in the lumbosacral region, and so on. Low back pain, low back pain without clear cause, kidney, spine and lower back muscles should be checked.

Diagnosis

Differential diagnosis

Differential diagnosis of high blood nitrogen:

1, plasma cell tumor: there may be superficial bone swelling (ribs, sternum, clavicle), progressive weight loss. Anemia, fever, high blood nitrogen, bleeding tendency, hypercalcemia and hyperuricemia, giant tongue caused by extra-osseous tumor and amyloidosis, a few cases of renal insufficiency, severe cases can cause uremia.

2, renal insufficiency: renal function is only about 25% to 50% of normal, the renal function at this stage is not enough to maintain normal operation, characterized by mild nitrogenemia, that is, blood BUN and Cr microliters, urine concentration capacity change Poor nighttime, mild anemia; if the patient has vomiting, diarrhea or restricting the patient to drink water or taking protein anabolic drugs, the patient is likely to have severe nitrogenemia and acidosis.

3, renal failure: at this stage, renal function has declined to a serious degree of severe anemia, hypocalcemia; hyperphosphatemia, metabolic acidosis, concentrated urine and nocturia, in addition to frequent urinary, high blood nitrogen Symptoms, low blood calcium is also common, occasionally complicated by hyperkalemia.

4, uremia (end stage renal failure): renal function is only below normal 10%, this stage of renal function has declined to a very serious degree and affect the systemic system, such as no dialysis treatment, will be due to systemic invasion The combination of mental coma, incoherence, lung water, and hyperkalemia caused the heartbeat to stop suddenly.

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