Diabetes can lead to complications in the blood vessels, eyes, nerves and kidneys. If the kidneys start to fail, they cannot perform all of their functions, including the elimination of waste products. These waste products, including urea, accumulate in the bloodstream and can affect many other organs in the body. Thus, diabetic renal poisoning is otherwise known as uremia, a condition of too much urea and nitrogen waste in the blood.
Nervous System Symptoms
When the body breaks down proteins, it produces ammonia. Because ammonia is so toxic, the liver changes it to urea and sends it through the bloodstream to the kidneys. As explained by Elizabeth Corwin, Ph.D., in "Handbook of Pathophysiology," when the kidneys are failing, urea and other waste products accumulate in the bloodstream and can damage the brain and nerves. As a result, patients usually feel very sleepy. They sleep longer and are hard to wake up. They also have difficulty thinking clearly, feel very tired and have headaches. Patients may make jerky movements with their hands or go into a seizure or coma as well.
Heart Symptoms
Renal poisoning can cause pericarditis, which is an inflammation of the pericardium, the membrane that surrounds the heart. Patients may have pain in their chests that can spread to their neck or shoulders. The pain is worse when they swallow, breathe deeply or cough. It is also worse when they lie down and improves when they sit up and lean forward, writes Brian Hoit, M.D., in the Merck Manual for Healthcare Professionals. Some people may also have a fever with their heart symptoms.
Digestive System Symptoms
Uremic poisoning can cause gastroenteritis, or the inflammation of the membrane that lines the stomach and the intestines, explains Joanne Bargman, M.D., in "Harrison's Principles of Internal Medicine." Patients may have decreased appetite, which can result in weight loss and reduced muscle mass owing to a lack of protein. Some patients may become nauseated and vomit. Ulcers can develop, which can bleed and result in blood in bowel movements or vomit. Some patients have inflammation in their gums and sores on their mouth.
Blood Cell Symptoms
The kidneys secrete the hormone erythropoietin, which stimulates the bone marrow to produce red blood cells. Red blood cells carry oxygen, so having more red blood cells increases the amount of oxygen available for cells and tissues. Patients with uremic poisoning become anemic because their kidneys are failing. They feel tired and short of breath and have difficulty completing their usual activities. The poisoning may also decrease the number of white blood cells, which fight infection; therefore, patients become susceptible to infection. Uremic poisoning also causes abnormalities in platelets, which results in easy brusing and bleeding, explains Leslie Andritsos, M.D. in "The Washington Manual of Medical Therapeutics."
References
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D., et al.; 2008
- Merck Manual for Healthcare Professionals: Pericarditis
- "Washington Manual of Medical Therapeutics"; Gopa Green, M.D., Ian Harris, M.D., Grace Lin, M.D., Kyle Moylan, M.D.; 2004
