A health condition in which a person has increased creatinine, nitrogen, and other waste products in the blood is called azotemia. While some people with this disease do not experience any symptoms, others may notice chest pain, swelling in the lower extremities, urinary problems, and tiredness. The treatment usually is different among people because it depends on the azotemia type.

What is Azotemia?

When the waste products in the blood are too high, it leads to a condition called azotemia. In normal circumstances, the waste products appear due to the breakdown of protein in foods and drinks you consume. Additionally, they appear in the liver and through the bloodstream go to the kidneys that filter these products and leave the body through urine.

Azotemia Types

  • Prerenal azotemia – This is the most common type of this condition and it happens when there is not enough blood flow to the kidneys. Usually, the following factors provoke this azotemia type. Examples include liver failure, blood loss, dehydration, heart failure, certain medications (such as Ibuprofen and Aspirin), and others.
  • Intrinsic azotemia – In such cases, this disease occurs due to damage to the kidneys. The most common causes are infections, sepsis, blood clots, some medicines (such as chemotherapy drugs), and toxins (including alcohol and recreational drugs).
  • Postrenal azotemia – A blockage in the urinary tract usually provokes this type of azotemia. Urinary tract infections (UTIs), ureteral stones, and cancer are the most common postrenal azotemia.

What is The Difference between Renal Failure and Azotemia?

Azotemia happens when there are too many waste products in the blood. However, kidney failure is a condition in which the kidneys are not working at all. Therefore, one of the main causes of azotemia is kidney failure.

In addition, azotemia is considered a common health condition because it accounts for approximately 16% of hospital admissions.


In most cases, azotemia is asymptomatic but if it reaches the advanced stages, it can cause some unpleasant symptoms. Examples include:

  • Fatigue (extreme tiredness)
  • Dyspnea (shortness of breath)
  • Confusion
  • Nausea
  • Vomiting
  • Decreased amount of urine
  • Chest pain
  • Edema (swelling in the legs, ankles, and feet)
  • Arrhythmia (irregular heartbeat)
  • Lack of appetite

In severe cases of azotemia, people may experience coma or seizures.


The causes usually depend on the type of azotemia you experience. Check below some examples:

  • Prerenal azotemia – An injury that impacts blood flow in any part of your body and negatively affects the kidneys. The causes include blood loss, dehydration, damaged blood vessels (hemorrhage), burns, heart failure, and liver failure.
  • Intrinsic azotemia – Inflammatory health conditions commonly cause this azotemia type (such as vasculitis and infections).
  • Postrenal azotemia – The primary cause of postrenal azotemia is a blockage in the ureters or bladder. Ureteral stones, UTIs, swollen kidneys (hydronephrosis), and benign prostatic hyperplasia (increased prostate size) are the risk factors of this azotemia type.

What is The Difference between Dehydration and Azotemia?

These are different conditions and dehydration is usually the cause of azotemia. Check below the dehydration causes:

  • Diarrhea
  • Vomiting
  • Sweating
  • Not drinking water
  • Certain medications (such as diuretics)

Additionally, this health condition is not contagious which means it cannot pass from one person to another. People older than 65 years old often are more likely to develop azotemia.


If you leave this disease untreated it may lead to a dangerous build-up in the blood (uremia). Mostly, uremia is provoked by chronic kidney disease (CKD). Moreover, if you are not treating uremia it can be fatal.


Physicians usually diagnose this condition by asking you some questions about medical history and symptoms. They also can perform a physical examination. If your doctor suspects you have azotemia, it can order you to do a test (blood urea nitrogen or BUN) to verify your creatinine levels. This chemical substance is a waste product of muscle tissue metabolism.

Additionally, you should inform your doctor if you have a bleeding disorder or using any medicines before this BUN test.

Levels of BUN that Indicates Azotemia

Check below normal BUN levels according to age and sex:

  • For children (1-17 years old) the normal BUN level is 7-20 mg/dL
  • People assigned to male at birth (AMAB) 8-24 mg/dL
  • People assigned to female at birth (AFAB) 6-21 mg/dL

If the BUN level is higher than those listed above, it means you have azotemia.

In addition, your doctor may also test your creatinine levels in the azotemia diagnosis. In case you have a level higher than those listed below, it means you have a kidney problem. Examples include:

  • Children from 1 to 16 years old (0.2-0.9 mg/dL)
  • Adult people AMAB (0.6-1.2 mg/dL)
  • Adult people AFAB (0.5-1.1 mg/dL)

Other Tests

In case the doctors are not sure you have azotemia, they can order other tests that will help to confirm this disease. Examples include:

  • Urinalysis
  • Urine output (this test helps to measure the amount of urine you have during 24 hours)
  • Imaging tests (including CT scans and ultrasound)
  • Kidney biopsy


Doctors often prescribe the treatment depending on the azotemia type you experience. Check below some treatment methods:

  • IV fluids (usually used to treat dehydration)
  • Medicines (such as diuretics)
  • Ureteral stents
  • Dialysis (a procedure that helps to remove waste products from the blood)


  • Do not use medications more than is prescribed by your doctor, especially nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics (such as Penicillin and Sulfonamides), and herbal supplements. However, it is recommended to consult with your doctor before using any medicines.
  • Treat blood loss by applying pressure to and bandaging any wounds.
  • Treat kidney disease
  • Manage dehydration
  • Limit or avoid alcoholic beverages because they can affect how your kidneys filter the blood.
  • Adopt a healthy diet (including vegetables, whole grains, and fresh fruits)
  • Regular exercise
  • Quit smoking

For more details, talk with your healthcare provider.

Frequently Asked Questions

When should I go to the emergency room (ER)?

The following symptoms may be a sign of acute kidney failure. If any of them occur, immediately contact your physician. Examples include:

  • Seizures
  • Coma
  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting
  • Fatigue
  • Metallic taste
  • Swelling
  • Reduced amount of urine

Is it possible to cure azotemia?

Early diagnosis and treatment can cure this condition. However, if it is diagnosed in later stages, regular dialysis usually is necessary.

What is the medicine used in the azotemia treatment?

Usually, physicians prescribe the following medicines to treat azotemia. Examples include diuretics, adrenergic agents, plasma volume expanders, and corticosteroids. Ask your healthcare professional if you have any other questions.

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