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{{Chronic renal failure}}
{{Chronic renal failure}}
{{CMG}} {{AE}} {{AN}}
{{CMG}} {{AE}} {{AN}}
==History and symptoms==


Initially it is without specific symptoms and can only be detected as an increase in serum [[creatinine]]. As the [[kidney]] function decreases:
==Overview==
* [[Blood pressure]] is increased due to fluid overload and production of vasoactive hormones leading to [[hypertension]] and[[congestive heart failure]]
There are no pathognomonic symptoms associated with chronic renal failure. [[Malaise]], [[nausea]], unintentional [[weight loss]], [[pruritus]], [[lower extremity edema]], and [[sleep disorders]] are common non-specific symptoms of chronic renal failure.  
* [[Urea]] accumulates, leading to [[azotemia]] and ultimately [[uremia]] (symptoms ranging from lethargy to [[pericarditis]] and[[encephalopathy]])
* [[Potassium]] accumulates in the blood (known as [[hyperkalemia]] with symptoms ranging from [[malaise]] to fatal [[cardiac arrhythmia]]s)
* [[Erythropoietin]] synthesis is decreased (leading to [[anemia]] causing [[fatigue (physical)|fatigue]])
* [[Fluid balance|Fluid volume overload]] - symptoms may range from mild [[edema]] to life-threatening [[pulmonary edema]]
* [[Hyperphosphatemia]] - due to reduced phosphate excretion, associated with [[hypocalcemia]] (due to [[vitamin D3]] deficiency).
** Later this progresses to [[tertiary hyperparathyroidism]], with [[hypercalcaemia]], [[renal osteodystrophy]] and vascular calcification
* [[Metabolic acidosis]], due to decreased generation of [[bicarbonate]] by the kidney, leads to uncomfortable breathing and further worsening of bone health.


==[[References]]==
==Personal History and Symptoms==
{{reflist|2}}
===Dermatologic===
*Pruritus
 
===Neuromuscular===
*Anorexia
*Fatigue
*Nausea (especially in the morning)
*Sleep disturbances and sleep apnea
*Hiccups
*Dry mouth
*Headache
*Reduced sense of smell and taste
*Lower extremity cramps and edema
*Restless legs
*Extremity numbness, paresthesias, and weakness (sensorimotor peripheral neuropathy) 
*Seizures
*Decreased mental acquity
*Coma
 
===Cardiothoracic===
*Chest pain (uremic pericarditis)
 
===Abdominal===
*Abdominal distention (serositis)
*Abdominal discomfort
 
===Hematologic===
*Skin pallor
*Bleeding tendency
 
===Metabolic===
*Unintentional weight loss
*Amenorrhea
*Sexual dysfunction
**Loss of libido
**Impotence
*Failure to thrive (in children)
 
==Family History==
*Renal diseases
*History of dialysis or renal transplantation
*History of hearing loss ([[Alport's syndrome]])
*History of inborn errors of metabolism ([[Fabry disease]] or [[cystinuria]])


==Medications History==
*History of excessive NSAID use
*Chronic exposure to nephrotoxic agents (e.g. heavy metals)


==References==
{{reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Nitrogen metabolism]]
[[Category:Kidney diseases]]
[[Category:Organ failure]]
[[Category:Causes of death]]
[[Category:Nephrology]]

Latest revision as of 01:06, 3 June 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]

Overview

There are no pathognomonic symptoms associated with chronic renal failure. Malaise, nausea, unintentional weight loss, pruritus, lower extremity edema, and sleep disorders are common non-specific symptoms of chronic renal failure.

Personal History and Symptoms

Dermatologic

  • Pruritus

Neuromuscular

  • Anorexia
  • Fatigue
  • Nausea (especially in the morning)
  • Sleep disturbances and sleep apnea
  • Hiccups
  • Dry mouth
  • Headache
  • Reduced sense of smell and taste
  • Lower extremity cramps and edema
  • Restless legs
  • Extremity numbness, paresthesias, and weakness (sensorimotor peripheral neuropathy)
  • Seizures
  • Decreased mental acquity
  • Coma

Cardiothoracic

  • Chest pain (uremic pericarditis)

Abdominal

  • Abdominal distention (serositis)
  • Abdominal discomfort

Hematologic

  • Skin pallor
  • Bleeding tendency

Metabolic

  • Unintentional weight loss
  • Amenorrhea
  • Sexual dysfunction
    • Loss of libido
    • Impotence
  • Failure to thrive (in children)

Family History

Medications History

  • History of excessive NSAID use
  • Chronic exposure to nephrotoxic agents (e.g. heavy metals)

References

Template:WH Template:WS

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