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It could be due to the uremic state from chronic kidney failure. The uremic state includes anorexia, nausea, vomiting, pericarditis, peripheral neuropathy, and central nervous system abnormalities (ranging from loss of concentration and lethargy to seizures, coma, and death). No direct correlation exists between the absolute serum levels of blood urea nitrogen (BUN) or creatinine and the development of these symptoms. Some patients have relatively low levels (eg, a BUN of 60 mg/dL [21.4 mmol/L] in an older patient) but are markedly symptomatic, while others have marked elevations (eg, a BUN of 140 mg/dL [50mmol/L]) but remain asymptomatic. To continue life, uremic patients require the institution of renal replacement therapy with hemodialysis, peritoneal dialysis, or renal transplantation. He should see his doctor.