Chronic renal failure

Alternative names:

chronic kidney failure; chronic renal insufficiency; CRF; kidney failure - chronic; renal failure - chronic

Symptoms:

INITIAL SYMPTOMS (may be nonspecific)

• unintentional weight loss
• nausea, vomiting
• general ill feeling
• fatigue
• headache
• frequent hiccups
• generalized itching (pruritus)

LATER SYMPTOMS

• 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
• increased skin pigmentation--skin may appear yellow or brown
• 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:

• urination, excessive at night
• thirst, excessive
• skin, abnormally dark or light
• paleness
• nail abnormalities
• breath odor
• blood pressure, high
• appetite, loss
• agitation

Signs and tests:

Blood pressure may be high, with mild to severe hypertension. 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