Acute tubular necrosis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
On physical examination, patients with acute tubular necrosis may show the findings of volume depletion. They usually appear ill, dehydrated, and lethargic. Common physical examination findings of acute tubular necrosis include orthostatic hypotension and other signs of hypovolemia (dry mucous membranes, sunken eyes, poor skin turgor and delayed capillary refill, and decreased jugular venous pressure).
Physical Examination
Appearance of the Patient
- Patients with acute tubular necrosis may appear ill, dehydrated, or lethargic depending on the severity of renal hypoperfusion and damage.
Vital Signs
Skin
Skin examination of patients with acute tubular necrosis may show following findings:
- Diminished skin turgor
- Dry mucous membranes
- Delayed capillary refill
HEENT
Lungs
- Pulmonary examination of patients with acute tubular necrosis is usually normal. Bilateral crackles may be found on auscultation due to pulmonary edema.
- Tachypnea may be caused by metabolic acidosis as a result of severe volume depletion.
Heart
Abdomen
Abdominal examination of patients with acute tubular necrosis may show following findings:
Neuromuscular
- Muscle weakness and convulsions because of moderate to severe electrolyte imbalance.
- Changes in sensorium
- Muscle tenderness