Signs and Symptoms
- Clinicians need to search for specific signs of underlying renal disease.
- Severe anemia due to hemolytic-uremic syndrome
- Butterfly rash on face/musculoskeletal involvement in systemic lupus erythematosus
- Purpuric rash over buttocks and extensor surface of lower extremity in Henoch-Schönlein purpura.
- Palpable kidney may be due to:
- Renal vein thrombosis
- Polycystic kidney disease
- Multicystic dysplastic kidney
- Hydronephrosis
- Palpable bladder with weak urine stream or dribbling suggests obstruction.
- Sacral tuft of hair or myelomeningocele may be seen with neurogenic bladder (can cause obstructive uropathy/postrenal oliguria or anuria).
- Symptoms of prerenal cause
- Vomiting
- Diarrhea
- Hemorrhage
- Sepsis
- Decreased oral intake
- Increased thirst
- Palpitations
- Fatigue
- Clinical signs of dehydration
- Weight loss
- Symptoms of hypovolemia (ie, prerenal pathology)
- Tachycardia
- Dry mucous membranes
- Sunken eyes
- Orthostatic blood pressure changes
- Decreased skin turgor
- Hypotension
- Symptoms of intrinsic renal disease
- Gross hematuria
- Pharyngitis or impetigo a few weeks before the onset of gross hematuria
-
Hypertension
-
Edema
- Bloody diarrhea
- Often precedes hemolytic-uremic syndrome
- Younger children, particularly infants: signs of congestive heart failure
- Hepatomegaly
- Gallop rhythm
- Pulmonary edema
- Symptoms of systemic vasculitis (eg, systemic lupus erythematosus)
- May see history of fever, joint pains, and skin rash
- Recurrent sinusitis or lower respiratory tract infections may suggest Wegener granulomatosis.
- Hemoptysis may indicate pulmonary-renal syndrome, due to either:
- Goodpasture syndrome
- Microscopic polyangiitis
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