VA AM Report Pearls: My-remia? Ur-emia!

Hey team,

Great case today by Drs Motzkin and Rodriguez and Stetson, encephalopathy in an older man with a likely component of uremia.


Above from NEJM review article 2007 on Uremia. Do you see BUN on that list? Me neither! The point is, BUN and creatinine (and cystatin-C) are all proxies for renal function, but we don’t measure all of the “uremic toxins” the normal kidney handles. As our renal colleagues pointed out this morning, uremia is a clinical diagnosis: encephalopathy, myoclonus, sustained clonus, in this case even hypothermia! Rare to see later findings (uremic frost, uremic fetor) but always look. Treatment is dialysis, though our patient improved with diuresis and time.



Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s