Uremia

Uremia is a disease of catabolism (breaking down of tissues) with evidence of (tissue) weight loss and malnutrition. Dialysis and transplant reverse this when they work well. For HD the URR should be above 65% (Kt/v >1.4) and with further study may turn out to be higher. Those who are well dialyzed should have the appetite to eat well enough to return toward their pre-illness real weight. Poor appetite and real weight loss must always be signs of great concern to the nephrologist since, if not due to underdialysis, they indicate another severe illness is lurking and should be searched for.

Peter Lundin

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