Chronic renal failure physical examination: Difference between revisions

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[[Chronic renal failure]] causes disturbances in not only the filtration function of the kidney, but also on normal functioning of virtually every organ in the body.
[[Chronic renal failure]] causes disturbances in not only the filtration function of the kidney, but also on normal functioning of virtually every organ in the body.


==Signs and symptoms==
{{Chronic renal faliure}}
===Symptoms===
{{CMG}} {{AE}}{{AN}}
 
*General ill feeling and [[fatigue]]
*Generalized itching ([[pruritus]]) and [[dry skin]]
*[[Headaches]]
*Weight loss without trying
*[[Anorexia]]
*[[Nausea]]
Other symptoms may develop, including:
*Abnormally dark or light skin and changes in nails
*Bone pain
Nervous system symptoms:
*Drowsiness and [[confusion]]
*Inability to concentrate
*Numbness in the hands, feet, or other areas
*Muscle twitching or cramps
*Breath odor
*Easy bruising, nosebleeds, or blood in the stool
*Excessive thirst
*Frequent hiccups
*Loss of [[libido]] and [[impotence]]
*[[Amenorrhea]]
*Sleep problems, such as [[insomnia]], [[restless leg syndrome]], or [[obstructive sleep apnea]]
*[[Edema]] of hands and feet
*[[Vomiting]], especially in the morning
 


===Signs===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |                 
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | Improves with optimal program of dialysis and related therapy
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | Persists or worsens after optimal program of dialysis and related therapy
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | Develops only after initiation of dialysis therapy
|-
|-bgcolor="LightSteelBlue"
| '''Fluid and Electrolytes'''
|bgcolor="Beige"| Volume expansion, [[Hyponatremia]], [[Hyperkalemia]], [[Hyperphosphatemia]] 
|bgcolor="Beige"|                                                                             
|bgcolor="Beige"|                                                                             
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine-Metabolic disturbances'''
|bgcolor="Beige"| [[Secondary hyperparathyroidism]], Vitamin-D deficient osteomalacia, Carbohydrate resistance, [[Hyperuricemia]], [[Hypertriglyceridemia]], Protein energy malnutrition, [[Amenorrhea]]
|bgcolor="Beige"| [[Secondary hyperparathyroidism]], [[Hyperuricemia]], [[Hypertriglyceridemia]], Increased lipoprotein A levels, Decreased [[HDL]] levels, Protein energy malnutrition, Impaired growth and development, [[Infertility]] and sexual dysfunction, [[Amenorrhea]], Beta 2 microglobulin associated amyloidosis
|bgcolor="Beige"| Adynamic bone, Beta 2 microglobulin associated amyloidosis
|-
|-bgcolor="LightSteelBlue"
| '''Neuromuscular disturbances'''
|bgcolor="Beige"| [[Fatigue]], Impaired mentation, [[Lethargy]], [[Asterixis]], [[Peripheral neuropathy]], [[Restless leg syndrome]], [[Myoclonus]], [[Seizures]], [[Coma]]
|bgcolor="Beige"| [[Sleep disorders]], [[Headache]], [[Peripheral neuropathy]], [[Restless leg syndrome]], [[Seizures]], Muscle cramps, [[Myopathy]]
|bgcolor="Beige"| Muscle cramps, [[Myopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Cardiovacsular and Pulmonary'''
|bgcolor="Beige"| [[Systemic hypertension]], [[Congestive heart failure]], [[Pulmonary edema]], [[Pericarditis]], [[Hypertrophic cardiomyopathy]], [[Dilated cardiopathy]], Uremic lung
|bgcolor="Beige"| [[Systemic hypertension]], [[Hypertrophic cardiomyopathy]], [[Dilated cardiomyopathy]], Accelerated [[atherosclerosis]]
|bgcolor="Beige"| [[Hypertrophic cardiomyopathy]], [[Dilated cardiomyopathy]], Accelerated [[atherosclerosis]], [[Hypotension]] and [[arrhythmia]]s
|-
|-bgcolor="LightSteelBlue"
| '''Dermatology'''
|bgcolor="Beige"| [[Pallor]], [[Hyperpigmentation]], [[Ecchymoses]], [[Uremic frost]]
|bgcolor="Beige"| [[Pruritis]], [[Hyperpigmentation]]
|bgcolor="Beige"| [[Hyperpigmentation]], Nephrogenic fibrosing dermopathy
|-
|-bgcolor="LightSteelBlue"
| '''Gastro-intestinal disturbances'''
|bgcolor="Beige"| [[Anorexia]], [[Nausea]] and [[vomiting]], [[Gastroenteritis]], [[Peptic ulcer]], [[Gastrointestinal bleeding]]
|bgcolor="Beige"| [[Peptic ulcer]], [[Gastrointestinal bleeding]]
|bgcolor="Beige"| [[Gastrointestinal bleeding]], Idiopathic [[ascites]], [[Peritonitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|}


==References==
==References==

Revision as of 20:53, 22 July 2012

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

Overview

Chronic renal failure causes disturbances in not only the filtration function of the kidney, but also on normal functioning of virtually every organ in the body.

Template:Chronic renal faliure Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [4]

Signs

Improves with optimal program of dialysis and related therapy Persists or worsens after optimal program of dialysis and related therapy Develops only after initiation of dialysis therapy
Fluid and Electrolytes Volume expansion, Hyponatremia, Hyperkalemia, Hyperphosphatemia
Endocrine-Metabolic disturbances Secondary hyperparathyroidism, Vitamin-D deficient osteomalacia, Carbohydrate resistance, Hyperuricemia, Hypertriglyceridemia, Protein energy malnutrition, Amenorrhea Secondary hyperparathyroidism, Hyperuricemia, Hypertriglyceridemia, Increased lipoprotein A levels, Decreased HDL levels, Protein energy malnutrition, Impaired growth and development, Infertility and sexual dysfunction, Amenorrhea, Beta 2 microglobulin associated amyloidosis Adynamic bone, Beta 2 microglobulin associated amyloidosis
Neuromuscular disturbances Fatigue, Impaired mentation, Lethargy, Asterixis, Peripheral neuropathy, Restless leg syndrome, Myoclonus, Seizures, Coma Sleep disorders, Headache, Peripheral neuropathy, Restless leg syndrome, Seizures, Muscle cramps, Myopathy Muscle cramps, Myopathy
Cardiovacsular and Pulmonary Systemic hypertension, Congestive heart failure, Pulmonary edema, Pericarditis, Hypertrophic cardiomyopathy, Dilated cardiopathy, Uremic lung Systemic hypertension, Hypertrophic cardiomyopathy, Dilated cardiomyopathy, Accelerated atherosclerosis Hypertrophic cardiomyopathy, Dilated cardiomyopathy, Accelerated atherosclerosis, Hypotension and arrhythmias
Dermatology Pallor, Hyperpigmentation, Ecchymoses, Uremic frost Pruritis, Hyperpigmentation Hyperpigmentation, Nephrogenic fibrosing dermopathy
Gastro-intestinal disturbances Anorexia, Nausea and vomiting, Gastroenteritis, Peptic ulcer, Gastrointestinal bleeding Peptic ulcer, Gastrointestinal bleeding Gastrointestinal bleeding, Idiopathic ascites, Peritonitis
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes

References

Template:WH Template:WS

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