Chronic renal failure physical examination

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.

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