Talk:Uremia

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[edit] Merge with azotemia?

According to Stedman's azotemia is a synonym for uremia.[1]

Since uremia is used much more commonly-- as suggested by Google (uremia=951,000 hits vs. azotemia=337,000 hits) and PubMed (uremia=22,139 hits vs. azotemia=1,764 hits) -- I think azotemia should be merged into uremia. Nephron  T|C 21:06, 1 January 2007 (UTC)

• SUPPORT - as per above. Nephron  T|C 21:06, 1 January 2007 (UTC)
• SUPPORT-absolutely-in fact both could redirect to renal failure, which is what they are both almost always used as synonyms for.Felix-felix 14:54, 2 January 2007 (UTC)
• I wouldnt merge them. All I know is that a nephrologist will jump down your throat if you use them interchangably. Uremia is the symptomatic manifestation of azotemia. —The preceding unsigned comment was added by 75.180.4.194 (talk • contribs) 11:40, 16 January 2007 (UTC).

Speaking as a nephrologist, all the ones that I know quite happily interchange the terms, along with the more accurate term, renal failure.FelixFelix ^talk 23:14, 14 March 2007 (UTC)

• DO NOT SUPPORT-Agree with above. Azotemia is measured biochemically and uremia is a clinical diagnosis.65.95.117.45 16:19, 28 January 2007 (UTC)Ben
• DO NOT SUPPORT The two users above are correct, it is possible to be azotemic without any symptoms and therefore not uremic. —The preceding unsigned comment was added by TheDoqtor (talk • contribs) 12:20, 30 January 2007 (UTC).
• DO NOT SUPPORT As said above.

[edit] Plan to close discussion & move

I did a longer search of the web for definitions of uremia and azotemia. I found four additional definitions that support the assertion that uremia and azotemia are the same: [2] [3] [4] [5]

Two sites suggest something a bit different-- something along the lines of:

"Azotemia: A higher than normal blood level of urea or other nitrogen containing compounds in the blood." [6] [7].

If one examines the etymology of azotemia it is: 'azote' = nitrogen + 'emia' = more [8]. Uremia likely has a similar etymology, i.e. urea + emia = uremia

It is my experience that the terms are used interchangably, in a clinical context (an assertion supported by Felix-Felix). Since, urea contains nitrogen it is fair to say that a uremia also constitutes an azotemia. Therefore, I think it would make sense to merge uremia into azotemia. (Technically speaking, I don't think merging in the opposite direction would be wrong (i.e. azotemia into uremia)-- as urea, AFAIK, is the body's way of packaging nitrogenous waste.)

I did NOT find anything to back-up the assertion made by Ben (65.95.117.45). Ben could you provide a reference for the above?

If no factual objection is presented to the above and Ben doesn't come forward with a reference I move to close the discussion in 10 days and merge (uremia into azotemia) on the basis of the above facts. Nephron  T|C 04:08, 15 March 2007 (UTC)

According to Kumar, Robbins and Cotrans Pathologic Basis of Disease 7th edition, "When azotemia becomes associated with a constellation of clinical signs and symptoms and biochemical abnormalities, it is termed uremia." With the exception of the #5 reference above, I don't feel that web dictionaries trump a medical textbook, and #5 is a website for patient information designed to make explanations of disease easier. Azotemia is distinct from uremia and it should be maintained as such on an encyclopedia site like this.TheDoqtor 14:06, 20 March 2007 (UTC)

I looked through Robbins & Cotrans; it suggests that azotemia is a biochemical abnormality whilst uremia is a biochemical abnormality + characteristic (clinical) symptoms. Interesting it that this contradicts some of the primary literature -- "THE KIDNEY IN CIRRHOSIS. I. CLINICAL AND BIOCHEMICAL FEATURES OF AZOTEMIA IN HEPATIC FAILURE." PMID 14128217. Robbins & Cotrans is a great book for pathology... but I'm not sure I'd crown it the authority on the terminology used by nephrologists and I, personally, have some reservations about how the section on renal pathology in the book is written. Nephron  T|C 23:10, 30 March 2007 (UTC)

The idea that imprecise terminology is prevalent does not render it correct. A great many physicians use the terms interchangably in many situations. Primary literature is indeed important, but while medical textbooks have the benefit of being edited many times over by a large body of contributors (7 editions for Robbins & Cotran), primary research articles are edited by a much more limited group, namely the scientists and physicians who did the study and their immediate associates. Furthermore, the purpose of the aformentioned study and many of the others previously cited is not to precisely define azotemia and uremia as is the case in an encyclopedia such as this site. I don't doubt that even many nephrologists use the terms interchangably as evidenced by FelixFelix above. However, the problem still remains that these terms are not exact synonyms. Ask any medical student who has recently taken a nephrology exam (or more preferably, the attending teaching that portion of the course) or resident who has used the term uremia and azotemia interchangably on the wards. Not every physician objects, but those that do, do so vehemently and have the accepted body of medical literature on their side. If doubt still remains in your mind, I will continue to cite more examples of why azotemia is not exactly the same as uremia, but the impeachement of Robbins and Cotran in favor of any primary research article whos purpose is not directly related to defining those two terms seems incorrect to me.TheDoqtor 23:35, 30 March 2007 (UTC)