Acute renal failure history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

When a patient presents with uremic symptoms, first step is to differentiate an acute from a chronic process. A recent rise in serum creatinine levels indicate an acute pathology of renal failure, whereas chronically elevated creatinine levels are seen in chronic renal failure. However, chronic renal insufficiency is also associated with osteopathy, neuropathy and small, scarred kidneys.

History

Patients should be asked about use of nephrotoxic agents, which are a common cause of acute kidney injury. History of a diagnosed renal disorder like amyloidosis or polycystic kidney disease can also help to establish the diagnosis. Long standing history of anemia unresponsive to therapy is associated with chronic renal insufficiency.

Symptoms

• Bloody stools
• Breath odor
• Bruising easily
• Changes in mental status or mood
• Decreased appetite
• Decreased sensation, especially in the hands or feet
• Fatigue
• Flank pain (between the ribs and hips)
• Hand tremor
• High blood pressure
• Metallic taste in mouth
• Nausea or vomiting, may last for days
• Nosebleeds
• Persistent hiccups
• Prolonged bleeding
• Seizures
• Slow, sluggish movements
• Swelling - generalized (fluid retention)
• Swelling of the ankle, foot, and leg
• Urination changes:
• Decrease in amount of urine
• Excessive urination at night
• Urination stops completely