Diagnosis of End-stage renal disease
End-stage renal disease Diagnosis: Book Excerpts
Diagnostic Tests for End-stage renal disease: Online Medical Books
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Chronic renal failure:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Diagnosis of chronic renal failure is based on clinical assessment, a history of chronic progressive debilitation, and gradual deterioration of renal function as determined by creatinine clearance tests. The following laboratory findings also aid in diagnosis:
❑ Blood studies show elevated blood urea nitrogen, serum creatinine, and potassium levels; decreased arterial pH and bicarbonate; and low hemoglobin (Hb) level and hematocrit (HCT).
❑ Urine specific gravity becomes fixed at 1.010; urinalysis may show proteinuria, glycosuria, erythrocytes, leukocytes, and casts, depending on the etiology.
❑ X-ray studies include kidney-ureter-bladder films, excretory urography, nephrotomography, renal scan, and renal arteriography.
❑ Renal or abdominal computed tomography scan, magnetic resonance imaging, or ultrasound indicate changes associated with chronic renal failure, including abnormally small size in both kidneys.
❑ Kidney biopsy allows histologic identification of the underlying pathology.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Introduction: Renal and Urologic Disorders:
Physical examination for renal disease
(Professional Guide to Diseases (Eighth Edition))
The first step in physical examination is careful observation of the patient’s overall appearance, because renal disease affects all body systems. Examine the patient’s skin for color, turgor, intactness, and texture; mucous membranes for color, secretions, odor, and intactness; eyes for periorbital edema and vision; general activity for motion, gait, and posture; muscle movement for motor function and general strength; and mental status for level of consciousness, orientation, and response to stimuli. (See Common renal symptoms.)
Renal disease causes distinctive changes in vital signs: hypertension due to fluid and electrolyte imbalances and hyperactivity of the renin-angiotensin system; a strong, fast, irregular pulse due to fluid and electrolyte imbalances; hyperventilation to compensate for metabolic acidosis; and an increased susceptibility to infection due to overall decreased resistance. Palpation and percussion may reveal little because the kidneys and bladder are difficult to palpate unless they are enlarged or distended.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Renal failure, acute:
Diagnosis
(Handbook of Diseases)
The patient’s history may include a disorder that can cause renal failure. Blood test results indicating intrinsic acute renal failure include elevated urea nitrogen, creatinine, and potassium levels; low bicarbonate and hemoglobin (Hb) levels; and low pH and hematocrit (HCT).
Urine specimens show casts, cellular debris, decreased specific gravity and, in glomerular diseases, proteinuria and urine osmolality close to serum osmolality. The urine sodium level is less than 20 mEq/L if oliguria results from decreased perfusion and more than 40 mEq/L if it results from an intrinsic problem.
Other studies include renal ultrasonography, kidney-ureter-bladder radiography, cautious use of excretory urography, renal scan, retrograde pyelography, and nephrotomography.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Renal failure, chronic:
Diagnosis
(Handbook of Diseases)
Clinical assessment, a history of chronic progressive debilitation, and gradual deterioration of renal function as determined by creatinine clearance tests lead to a diagnosis of chronic renal failure.
The following laboratory findings also aid in diagnosis:
❑ Blood studies show elevated blood urea nitrogen, creatinine, and potassium levels; decreased arterial pH and bicarbonate levels; and low hemoglobin (Hb) levels and hematocrit (HCT).
❑ Urine specific gravity becomes fixed at 1.010; urinalysis may show proteinuria, glycosuria, erythrocytes, leukocytes, and casts, depending on the cause.
❑ Renal or abdominal X-ray, abdominal computed tomography scan, magnetic resonance imaging, or ultrasonography shows reduced kidney size.
❑ X-ray studies include kidney-ureter-bladder radiography, excretory urography, nephrotomography, renal scan, and renal arteriography.
❑ Kidney biopsy allows histologic identification of underlying pathology.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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