Medical History and Physical Exam for Acute Renal Failure
If your doctor suspects
acute renal failure, he or she will use your medical
history and a physical exam to help find out the cause. This will include a
review of your health history and hospital chart (if you are currently
hospitalized). Your doctor will look for:
- A history of other medical conditions that
increase your risk for acute renal failure, such as
diabetes,
high blood pressure,
chronic renal insufficiency,
heart failure, or liver disease.
- Other
recent problems or serious conditions, such as a
strep throat or other serious infection, a recent
blood transfusion, an enlarged prostate (benign prostatic hyperplasia),
kidney stones, certain forms of cancer, or a spinal
cord injury.
- Recent surgeries, X-rays, or angiography procedures
that use intravenous dye. Some dyes can damage the kidneys and lead to renal
failure.
- Records of any prescription or nonprescription medicines
you are taking. This is especially important if you are hospitalized, because
many medicines commonly used in hospitals, such as aminoglycoside antibiotics,
can damage the kidneys and lead to renal failure. Other problem medicines
include
nonsteroidal anti-inflammatory drugs such as
aspirin, ibuprofen, and ketoprofen.
- Recent
weight gain or loss. Weight gain from fluid retention may be caused by heart
failure or by reduced urine output. Sudden weight loss may be a sign of
dehydration.
- Fluid intake and output.
Reduced urine output (oliguria) occurs in about half of the people who have acute
renal failure.
- Changes in blood pressure. A sudden and prolonged
decrease in blood pressure is a common cause of acute renal failure, because it
reduces blood flow to the kidneys. Very high blood pressure (hypertensive
crisis) also may cause acute renal failure. New increases in blood pressure may
result from abnormal fluid buildup in the body (volume
overload).
- Problems with heart (cardiac) and lung (respiratory)
function.
- Abdominal (belly), pelvic, and rectal problems.
- Skin
conditions. Symptoms such as a rash, bruising, blue fingertips or toes, or
swelling in the arms, legs, and face may be signs of the degree of fluid buildup
and may suggest possible causes of acute renal failure.
- Other symptoms.
For example, damage to the kidneys or a blockage in the urinary tract may cause
pain in the sides and lower back (flank pain). Joint pain and swelling also may
suggest the presence of an undiagnosed disease, such as
lupus, that could be causing acute renal
failure.
Credits
| By | Healthwise Staff |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Specialist Medical Reviewer | Tushar J. Vachharajani, MD, FASN, FACP - Nephrology |
| Last Revised | May 10, 2011 |