Yusuf Kagzi, Umer Rizwan, Aliya Kagzi

BUNEMIA: A SEVERE CASE OF UREMIA COMPLICATED BY CHRONIC KIDNEY DISEASE

  • General Medicine
  • General Earth and Planetary Sciences
  • General Environmental Science
  • General Medicine
  • Ocean Engineering
  • General Medicine
  • General Medicine
  • General Medicine
  • General Medicine
  • General Earth and Planetary Sciences
  • General Environmental Science
  • General Medicine
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Uremia is characterized by elevated nitrogen compounds in the blood and often arises from renal impairment. It can lead to severe complications like metabolic encephalopathy and platelet dysfunction. Supportive care with intravenous uids can improve renal clearance. Severe sequela may necessitate dialysis. We describe a 56-year-old male with stage ve chronic kidney disease who presented with reduced uid intake, pan-colitis, and diarrhea. CT of the abdomen and pelvis without contrast reported non-specic pan-colitis with wall thickening. Blood urea nitrogen on presentation was 260 mg/dL and serum creatinine 17.09 mg/dL. Despite initial improvement in renal function with intravenous uids and bicarbonate therapy. The patient subsequently developed stroke and hypertensive urgency. Dialysis was started for possible uremic encephalitis complicating right occipito-parietal ischemic stroke. After a challenging clinical course, discussions with the family led to the withdrawal of care, and the patient ultimately passed away. This case underscores the efcacy of hemodialysis in managing severe uremia, even when complicating factors such as chronic kidney disease are present. It also highlights the importance of considering intravenous uids as an initial approach when dialysis is not immediately available. There is conicting evidence of reduced mortality at 30 days with early initiation of hemodialysis. The impact of chronic uremia on mental status remains an area of uncertainty, warranting further investigation for prognostic and management considerations in similar cases.

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