signs and symptoms of chronic renal failure

Signs and symptoms of chronic renal failure

Early stages of CRF are often asymptomatic.
Symptoms are common when the serum urea concentrations exceed 40mmol/l but many patients develop uraemic symptoms at lower levels of serum urea.

Symptoms include:
malaise, loss of energy
loss of appetite
insomnia
nocturia and polyuria due to impaired concentrating ability
itching
nausea, vomiting and diarrhoea
paraesthesiae due to polyneuropathy
Bone pain due to metabolic bone disease
Paraesthesiae and tetany due to hypocalaemia
Symptoms due to salt and water retention- peripeheral or pulmonary oedema
Symptoms due to anaemia
Amenorrhoea in women, erectile dysfunction in men

In more advanced uraemia ( serum urea >50-60 mmol/l), symptoms are more severe, and CNS symptoms are common
mental slowing, clouding of consciousness,seizures
myoclonic twitching


anaemia: pallor, lethargy, breathlessness on exertion
platelet abnormality: epitaxis, bruising
skin: pigmentation, pruritus( itching)
GI tract: anorexia, nausea, vomiting, diarrhoea
Endocrine/ gonads: amenorrhoea, erectile dysfunction, infertility
CNS: coma, confusion, fits
CVS: uraemic pericarditis, hypertension, peripheral vascular disease, heart failure causing oedema
Renal: nocturia, polyuria, salt and water retention causing oedema
Renal osteodystrophy: osteomalacia, muscle weakness, bone path, hyperparathyroidism, osteosclerosis