Chronic renal failure history and symptoms
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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]
History and symptoms
Initially it is without specific symptoms and can only be detected as an increase in serum creatinine. As the kidney function decreases:
- Blood pressure is increased due to fluid overload and production of vasoactive hormones leading to hypertension andcongestive heart failure
- Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis andencephalopathy)
- Potassium accumulates in the blood (known as hyperkalemia with symptoms ranging from malaise to fatal cardiac arrhythmias)
- Erythropoietin synthesis is decreased (leading to anemia causing fatigue)
- Fluid volume overload - symptoms may range from mild edema to life-threatening pulmonary edema
- Hyperphosphatemia - due to reduced phosphate excretion, associated with hypocalcemia (due to vitamin D3 deficiency).
- Later this progresses to tertiary hyperparathyroidism, with hypercalcaemia, renal osteodystrophy and vascular calcification
- Metabolic acidosis, due to decreased generation of bicarbonate by the kidney, leads to uncomfortable breathing and further worsening of bone health.