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 on 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 and may be a cause of denial.
Appearance
The patient may have difficulty breathing from complications of chronic renal failure like pulmonary edema and pericarditis. Peripheral edema is most often present.
Vitals
- Hypertension may be present and is a potential cause for renal damage.
- Tachypnea may be present.
Heart
Pre-cordial examination
- Left ventricular heave
Auscultation
- S4 may be heard.
Lungs
Auscultation
- Pericardial friction rub from pericarditis.
- Rales/Crackles from pulmonary edema
HEENT
Fundoscopy
- Fundoscopy is important in evaluating diabetic and hypertensive patients to look for retinal damage as an evidence of diabetic retinopathy or hypertensive retinopathy.
Neurologic examination
Extremities
- Peripheral edema may be present.