Chronic renal failure

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Kidney anatomy

Kidney - blood and urine flow

White nail syndrome

Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; CRF; Chronic kidney failure

Initial symptoms may include the following:

• Unintentional weight loss
• Nausea , vomiting
• General ill feeling
• Fatigue
• Headache
• Frequent hiccups
• Generalized itching (pruritus)

Later symptoms may include the following:

• Increased or decreased urine output
• Need to urinate at night
• Easy bruising or bleeding
• May have blood in the vomit or in stools
• Decreased alertness
  • drowsiness , somnolence   lethargy
  • confusion   delirium
  • coma
• Muscle twitching or cramps
• Seizures
• Uremic frost -- deposits of white crystals in and on the skin
• Decreased sensation in the hands, feet, or other areas

Additional symptoms that may be associated with this disease:

• Excessive nighttime urination
• Excessive thirst
• Abnormally dark or light skin
• Paleness
• Nail abnormalities
• Breath odor
• High blood pressure
• Loss of appetite
• Agitation

There may be mild to severe high blood pressure. A neurologic examination may show polyneuropathy. Abnormal heart or lung sounds may be heard with a stethoscope.

A urinalysis may show protein or other abnormalities. An abnormal urinalysis may occur 6 months to 10 or more years before symptoms appear.

• Creatinine levels progressively increase
• BUN is progressively increased
• Creatinine clearance progressively decreases
• Potassium test may show elevated levels
• Arterial blood gas and blood chemistry analysis may show metabolic acidosis

Changes that indicate chronic renal failure, including both kidneys being smaller than normal, may be seen on:

• Renal or abdominal x-ray
• Abdominal CT scan
• Abdominal MRI
• Abdominal ultrasound

This disease may also alter the results of the following tests:

• Urinary casts
• Renal scan
• PTH
• Serum magnesium - test
• Erythropoietin

Review Date: 09/13/2005
Reviewed By: Robert Mushnick, M.D., Clinical Assistant Professor, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.