What is the Difference Between Uremia and Azotemia

The key difference between uremia and azotemia is that uremia is a kidney condition that occurs when there is a high urea content in the blood, while azotemia is a kidney condition that occurs when there is a high nitrogen content in the blood.

When a patient suffers from kidney disease, this means his or her kidneys are damaged and can’t filter blood the way they normally should. People are at a higher risk of kidney diseases if they have diabetes and high blood pressure. If someone experiences kidney failure, the treatment options may either include dialysis or a kidney transplant. Uremia and azotemia are two different types of kidney conditions. They are both related to kidney disease or injury.

CONTENTS

1. Overview and Key Difference
2. What is Uremia 
3. What is Azotemia
4. Similarities – Uremia and Azotemia
5. Uremia vs Azotemia in Tabular Form
6. Summary – Uremia vs Azotemia

What is Uremia?

Uremia is a medical condition that involves high levels of urea in the blood. Urea is one of the major components of urine. Uremia occurs when kidneys become damaged. In this condition, the toxins or bodily waste people’s kidneys normally send out in the urine end up in the bloodstream instead. These toxins are normally known as creatinine and urea. Uremia can also be defined as an excess of amino acid and protein metabolism end products in the blood that should be usually excreted in the urine. Moreover, uremic syndrome is the terminal clinical manifestation of kidney failure. Uremia is also a sign of the last stages of chronic kidney disease. It is caused by extreme and irreversible damage to the kidneys by chronic kidney disease, which is due to high blood pressure, diabetes, inflammation, enlarged prostate, certain types of cancer, kidney stones, and kidney infection.

Figure 01: Uremia

The symptoms of uremia include extreme tiredness and fatigue, cramping in the legs, little or no appetite, headache, nausea, vomiting, and trouble concentrating. Uremia can be diagnosed through creatinine and BUN urine and blood tests and measuring glomerular filtration rate (eGFR). Furthermore, the treatments for uremia include dialysis (hemodialysis and peritoneal dialysis), kidney transplant, and regenerative medicine.

What is Azotemia?

Azotemia is a kidney condition that occurs when there is a high nitrogen content in the blood. Azotemia is usually experienced by older adults and patients in hospitals. This condition occurs when kidneys have been damaged due to decrease blood flow to kidneys (due to blood loss, heart attack, liver failure, infection), damage to the structure of the kidneys (due to blood clots, infections, toxins, chemotherapy drugs, antibiotics) and blockage in the ureters (due to urinary tract infection, kidney stones, some forms of cancers). Based on the causes, there are three types of azotemia: pre-renal azotemia, intrinsic azotemia, and post–renal azotemia.

Figure 02: Azotemia

The symptoms of azotemia include not often urinating, feeling tired, nausea, confusion, weakness, shortness of breath, chest pain or pressure in the chest, swelling in the legs, feet, or ankles, irregular heartbeat, and coma or seizure. The possible complications may include itching, nausea, vomiting, damage to the brain, and weakness or numbness in the hands or feet. Azotemia is usually diagnosed through urine and blood tests such as tests for creatinine levels and blood urea nitrogen (BUN). Furthermore, the treatment options for azotemia include intravenous fluids (IV) to increase fluid and blood volume, medications to control potassium in the blood or to restore blood calcium levels, and dialysis to remove any toxins in the blood.

What are the Similarities Between Uremia and Azotemia?

• Uremia and azotemia are two different types of kidney conditions.
• They are related to kidney disease or injury.
• Both kidney conditions can be diagnosed through urine and blood tests such as creatinine and BUN (blood urea nitrogen) tests.
• Both kidney conditions can be treated through dialysis.

What is the Difference Between Uremia and Azotemia?

Uremia is a kidney condition that occurs when there is a high urea content in the blood, while azotemia is a kidney condition that occurs when there is a high nitrogen content in the blood. Thus, this is the key difference between uremia and azotemia. Furthermore, uremia is caused by extreme and irreversible damage to kidneys by chronic kidney disease due to high blood pressure, diabetes, inflammation, enlarged prostate, certain types of cancer, kidney stones, and kidney infection. On the other hand, azotemia is caused when kidneys have been damaged due to decrease blood flow to kidneys (due to blood loss, heart attack, liver failure, infection), damage to the structure of the kidneys (due to blood clots, infections, toxins, chemotherapy drugs, antibiotics), and blockage in the ureters (due to urinary tract infection, kidney stones, some forms of cancers).

The below infographic presents the differences between uremia and azotemia in tabular form for side-by-side comparison.

Summary – Uremia vs Azotemia

Uremia and azotemia are two different types of kidney conditions related to kidney disease or injury. Uremia occurs when there is a high urea content in the blood, while azotemia occurs when there is a high nitrogen content in the blood. So, this summarizes the difference between uremia and azotemia.

Reference:

1. “Uremia: Complications, Causes, Symptoms & Treatment.” Cleveland Clinic.
2. “Azotemia: Causes, Symptoms, Treatments, and More.” WebMD.

Image Courtesy:

1. “Blausen 0310 Diabetic Nephropathy” By Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work (CC BY 3.0) via Commons Wikimedia
2. “Physical symptoms implicated with Kidney Ischemia” By Jaclorenzo – Own work (CC BY-SA 4.0) via Commons Wikimedia

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