Chronic renal failure physical examination
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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.[1] [2]
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 uremic pericarditis may be present
Lungs
Auscultation
Extremities
- Peripheral edema may be present.
Neurologic
References
- ↑ Kuo CC, Hung JB, Tsai CW, Chen YM (2010). "Uremic frost". CMAJ. 182 (17): E800. doi:10.1503/cmaj.091779. PMC 2988568. PMID 20696798. Unknown parameter
|month=ignored (help) - ↑ Udayakumar P, Balasubramanian S, Ramalingam KS, Lakshmi C, Srinivas CR, Mathew AC (2006). "Cutaneous manifestations in patients with chronic renal failure on hemodialysis". Indian J Dermatol Venereol Leprol. 72 (2): 119–25. PMID 16707817.