Presentation
A 34-year-old man with severe kidney function loss secondary to renal TB initially presented with urinary symptoms, including dysuria and polacyuria. [ncbi.nlm.nih.gov]
Entire Body System
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Fatigue
Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia, nocturia, lassitude, fatigue, pruritus, decreased mental acuity, muscle twitches and cramps, water retention, undernutrition, peripheral neuropathies [msdmanuals.com]
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]
The Vitality and Physical functioning domains of the SF-36 and the FACT-An Total, Fatigue and Anemia subscales were identified as domains relevant to CKD-associated anemia. [ncbi.nlm.nih.gov]
Symptoms can include urinating at night, fatigue, nausea, itching, muscle twitching and cramps, loss of sensation, confusion, difficulty breathing, and yellow-brown skin. Diagnosis is by blood and urine tests. [merckmanuals.com]
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Weight Gain
Dialysis started one year later, and was followed by weight gain of about 5 kg. [ncbi.nlm.nih.gov]
"Exercise may have an array of health benefits to these patients ranging from keeping their diabetes under control, maintaining healthy muscles and blood vessels to controlling weight gains after a transplant that are associated with prescribed medications [sciencedaily.com]
Physical activity can help lower blood pressure, control diabetes, and prevent weight gain. Ask your health care provider about physical activities that would be right for you. Avoid certain drugs and supplements. [choosingwiselycanada.org]
For those taking prednisone for long periods of time, these effects can be significant, including weight gain (especially around the face and trunk), moodiness, sleep disturbances, cataracts, and osteoporosis (weakening of the bones). [kidshealth.org]
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Leg Edema
Symptoms can include: Dry, itchy skin Nausea and vomiting Loss of appetite Fatigue Weight loss or weight gain Headaches Swelling in the legs (edema) Trouble sleeping Changes in urination Metallic taste in the mouth Joint problems Muscle cramps Shortness [health.ucsd.edu]
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Constitutional Symptom
symptoms CKD progression poorly controlled hypertension electrolyte disturbance i anemia i metabolic complications i complications i i nephrolythiasis suspected renal artery stenosis genetic etiology of CKD rare etiology of CKD etiology requiring specialist [doi.org]
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Wound Infection
Manuka honey dressing: an effective treatment for chronic wound infections. Br J Oral Maxillofac Surg 2008;46(8):696-7. Mavric E, Wittmann S, Barth G, Henle T. [kjorl.org]
Gastrointestinal
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Nausea
A 69-year-old male was admitted to the hospital with a chief complaint of abdominal pain, nausea, and vomiting. He had an extensive past medical history, including diabetes mellitus type 2 and chronic kidney disease stage III. [ncbi.nlm.nih.gov]
Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia, nocturia, lassitude, fatigue, pruritus, decreased mental acuity, muscle twitches and cramps, water retention, undernutrition, peripheral neuropathies [msdmanuals.com]
Kidney Disease Symptoms More frequent urination, especially at night Feeling tired and having less energy Trouble sleeping Nausea Headaches Weight loss and/or loss of appetite Swelling in feet, ankles or around the eyes due to fluid buildup There are [mottchildren.org]
The symptoms of hypercalcemia include: Feeling tired Difficulty thinking clearly Loss of appetite Nausea Vomiting Constipation Increased thirst Increased urination Weight loss Other side effects of Vitamin D include: Diarrhea Nausea Swelling Allergic [emedicinehealth.com]
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Polydipsia
[…] intake to prevent disease such as nephrolithiasis; ( 2 ) those who need a high fluid intake to compensate for a underlying disease, such as renal or central diabetes insipidus or salt-wasting nephropathy; and ( 3 ) those who have conditions such as polydipsia [cjasn.asnjournals.org]
Cardiovascular
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Hypertension
AND chronic kidney disease Hypertensive heart AND chronic kidney disease with congestive heart failure Hypertensive heart and CKD Hypertensive heart and CKD, w CHF Hypertensive heart and kidney disease Hypertensive heart and kidney disease with chf Hypertensive [icd9data.com]
Most common was chronic kidney disease of unknown cause, associated with neither diabetes nor hypertension. [ncbi.nlm.nih.gov]
McClellan WTuttle EIssa A Racial differences in the incidence of hypertensive end-stage renal disease (ESRD) are not entirely explained by differences in the prevalence of hypertension. [doi.org]
Neurologic
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Lethargy
Symptoms of anaemia include: tiredness lethargy shortness of breath (dyspnoea) palpitations (awareness of heartbeat) Anaemia can occur because of many other conditions and your doctor will investigate to rule out any other possible causes. [hse.ie]
Case study 2 June, 83 years of age, is a female nursing home resident with a 3 month history of lethargy, anorexia and itch. [racgp.org.au]
Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). [en.wikipedia.org]
Specific symptoms usually develop only in severe CKD, and include anorexia, nausea, vomiting, fatigue, weakness, pruritus, lethargy, peripheral oedema, dyspnoea, insomnia, muscle cramps, pulmonary oedema, nocturia, polyuria and headache. [patient.info]
Workup
Kashani, Biomarkers for Early Detection of Acute Kidney Injury, The Journal of Applied Laboratory Medicine: An AACC Publication, September 2017, jalm.2017.023325; DOI: 10.1373/jalm.2017.023325 (May 1, 2017) Arora, P Chronic Kidney Disease Workup. [labtestsonline.it]
Other benefits of early nephrology referral include proper patient education regarding options for renal replacement therapy as well as pre-emptive transplantation, and timely workup and placement of an arteriovenous fistula in those patients opting for [en.wikipedia.org]
[…] stenosis, renal atheroembolic disease, atherosclerosis with aortorenal occlusion, and certain cases of necrotizing vasculitis (eg, polyarteritis nodosa) Renal biopsy: Can be useful in identifying intrarenal causes of AKI and directing targeted therapy See Workup [emedicine.com]
Serum
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Glomerular Filtration Rate Decreased
Her estimated glomerular filtration rate decreased from an admission value of 34 mL/min/1.73 m2 to 13 mL/min/1.73 m2. CT scan showed retroperitoneal haematoma. [ncbi.nlm.nih.gov]
Other Pathologies
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Lymphocytic Infiltrate
infiltration associated with glomerular atrophy and glomerular loss.[19] CKD in Sri Lanka is characterized by tubular proteinuria—usually alpha 1 and beta 2 microglobulin and elevated tubular proteinuria due to NGAL ( 300 ng/mg creatinine/dL)—without [medicc.org]
Treatment
Since there are limited treatments for CKD, others with CKD may benefit from acupuncture and herbal treatments. [ncbi.nlm.nih.gov]
Few studies have examined the safety and efficacy of pharmacotherapy for treatment of dyslipidemia in the CKD population, and ongoing studies such as the Study of Heart and Renal Protection (SHARP) should help clarify the current treatment guidelines. [doi.org]
Prognosis
The Kaplan-Meier survival curves demonstrated that patients with a higher TFF1 and TFF3 alone, or in combination with macroalbuminuria, had a significantly worse renal prognosis. [ncbi.nlm.nih.gov]
Chronic Kidney Disease Prognosis Consortium (CKD-PC) is a research group composed of investigators representing cohorts from around the world. Investigators share data for the purpose of collaborative meta-analyses to study prognosis in CKD. [jhsph.edu]
Etiology
Especially in children, early diagnosis and detection of the etiologic factors are important to improve their health outcomes. [ncbi.nlm.nih.gov]
Clinical presentation depends a lot on etiology. Children with chronic kidney disease can have growth disorder, edema and cola colored urine (due to RBC casts). [radiopaedia.org]
Epidemiology
Long Beach, the Department of Epidemiology, University of California, Los Angeles (UCLA), and the Los Angeles Biomedical Research Institute at Harbor–UCLA, Torrance — all in California (K.K. [doi.org]
Several recent epidemiologic studies have shown that obesity and the metabolic syndrome are independent predictors of CKD. [cjasn.asnjournals.org]
A cross-sectional analytical epidemiological study was conducted based on active screening for chronic kidney disease and risk factors in persons aged 18 years during 2009-2011. [ncbi.nlm.nih.gov]
Pathophysiology
Lowered hArg concentrations are associated with higher risk for these conditions, although a clear pathophysiological explanation for this association has not been established. [ncbi.nlm.nih.gov]
Prevention
Prevention It is not too ambitious to consider CKD prevention. Hypertension and diabetes are the major causes of CKD in developed nations. [jasn.asnjournals.org]
Treating the condition that is causing the problem may help prevent or delay CKD. People who have diabetes should control their blood sugar and blood pressure levels and should not smoke. [nlm.nih.gov]
Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. JAMA. 1998 ; 279 : 1615–1622. [circ.ahajournals.org]
Together these findings reveal a role for ERRγ in directing independent and HNF1β-integrated programs for energy production and use essential for normal renal function and the prevention of kidney disease. [ncbi.nlm.nih.gov]
Detection of an initial level of proteinuria equivalent to CVD prevention [ 6 ] See also the separate article on Prevention of Cardiovascular Disease. [patient.info]