Overview of Uremia

Uremia is a urinary tract infection (UTI) that causes a systemic infection that spreads throughout the body through the bloodstream. The severe effects of this systemic infection are called sepsis.

As many as 25% of sepsis patients are found to have a urinary tract infection as the source of the disease.

Uremia is very serious and can quickly become life-threatening. Even with rapid diagnosis and treatment, urosepsis can develop into an infection that is difficult to control with medication and supportive care. In the most severe cases, sepsis can lead to multisystem organ failure.

development of uremia

A urinary tract infection is an infection that affects the secretory urinary tract. The urinary tract includes the kidneys, ureters, bladder, and urethra. Any of these infections can cause discomfort, pain, frequent urination, and fever.

Most UTIs are considered lower urinary tract infections and affect the bladder (cystitis) and urethra (urethritis). Kidney (pyelonephritis) and ureteral infections are less common, they are usually more serious, and can be more harmful than low-grade UTIs.

Early identification of UTIs and appropriate treatment is the best way to prevent uremia. It is possible to develop urosepsis without first showing symptoms of a urinary tract infection or seeking treatment.

Urinary Tract Infection Symptoms

There are some common signs and symptoms of UTIs that you can experience in any combination. For example, some people may have a fever, while others may feel normal but may notice a change in the appearance of urine.

The most common signs and symptoms of UTIs include:

  • burning pain when urinating
  • pelvic pain or pressure
  • strong-smelling urine
  • Frequent urge to urinate
  • Urine discoloration

How to tell if you have a urinary tract infection

Symptoms of uremia are similar to those of sepsis and may include fever, increased heart rate, low blood pressure (low blood pressure), shortness of breath, and difficulty breathing.

risk factors for uremia

Anyone with a UTI can develop uremia, but certain factors make it more likely.

These factors increase the risk of uremia:

  • have surgery
  • weakened immune system
  • kidney transplant
  • long illness
  • Recent UTI Diagnosis
  • History of recurrent urinary tract infections
  • history of uremia
  • Urinary system disease
  • old age
  • diabetes
  • frequent catheterization
  • most recent catheterization
  • Inability to completely empty the bladder
  • Indwelling (long-term) catheters
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Why urosepsis is more common after surgery

There are several common causes of postoperative urosepsis. You may have a urinary catheter placed during surgery, and it may be in place for hours or days after surgery.

Catheter placement is done using aseptic technique. However, the catheter is a foreign body, which means it is susceptible to bacterial contamination.

Certain types of surgery can further increase the risk of infection. Surgery in or near the urinary tract can increase the risk of subsequent urinary tract infections or uremia. Procedures such as kidney transplants, prostate surgery, and bladder surgery are known to increase the risk of developing uremia.

urinary tract infection after surgery


If you develop a urinary tract infection or uremia while the catheter is being placed, your catheter may be removed and replaced with a new one (if you still need one). The removed catheter may be sent to a laboratory to determine the type of infection.

In all cases, antibiotic therapy is required to treat uremia. Blood cultures and susceptibility are sometimes done to determine which antibiotic is most effective. Most people experience improvement in signs and symptoms within 72 hours of antibiotic treatment.

Ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) may be needed to determine the source of infection.

Treatment of uremia largely depends on the severity of the disease. If you have mild symptoms, you can treat it effectively with antibiotics at home.

However, urosepsis may progress to septic shock. If you have signs of this complication, including confusion and organ failure, you may need to be admitted to an intensive care unit, and treatment may include intravenous antibiotics, blood pressure management, and assisted ventilation.