Chronic renal failure physical examination

Chronic renal failure Microchapters
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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

Chronic renal failure causes disturbances in not only the filtration function of the kidney, but also in the normal functioning of virtually every organ in the body. Symptoms and overt signs of kidney disease are often subtle or absent until renal failure ensues. Thus, the diagnosis of chronic renal failure often take the patient by surprise.

Appearance of the Patient

The patient may have difficulty breathing from complications of chronic renal failure such as pulmonary edema and pericarditis. Peripheral edema is most often present.

Vitals

Blood Pressure

• Hypertension may be present and is a potential cause for renal damage

Respiratory Rate

• Tachypnea may be present

Skin

• Deposits of tiny, white, friable, crystalline material (called uremic frost) may be present on the face.

HEENT

Fundoscopy

• Fundoscopy is important in evaluating diabetic and hypertensive patients to look for retinal damage as evidence of diabetic retinopathy or hypertensive retinopathy

Heart

Pre-cordial examination

• Left ventricular heave may be present

Auscultation

• S4 may be heard
• Pericardial friction rub from pericarditis may be present

Lungs

Auscultation

• Rales/Crackles from pulmonary edema

Extremities

• Peripheral edema may be present.

Neurologic

• Asterixis
• Sensory neuropathy