I. Clinical Symptoms of Renal Diseases
Renal (kidney) diseases manifest through a combination of general, urinary, and systemic symptoms. These symptoms vary depending on whether the pathology is acute, chronic, glomerular, or tubular in nature.
1. General Symptoms
- Fatigue, malaise: Due to anemia (↓ erythropoietin).
- Loss of appetite, nausea, vomiting: Uremic toxins irritate the GI tract.
- Weight loss: Chronic catabolism in chronic kidney disease (CKD).
- Pallor: Normochromic normocytic anemia.
- Pruritus: Due to high urea or phosphate.
- Edema: Especially periorbital (around eyes), legs; from salt/water retention or proteinuria.
2. Urinary Symptoms
- Oliguria (<400 mL/day): Seen in acute kidney injury (AKI).
- Anuria (<100 mL/day): Late-stage obstruction or cortical necrosis.
- Polyuria: Often in early CKD or in tubulointerstitial nephritis.
- Nocturia: Impaired urine concentrating ability.
- Dysuria, frequency: Suggests infection.
- Hematuria (blood in urine): Seen in glomerulonephritis, stones, or tumors.
- Foamy urine: Proteinuria.
- Dark urine: Hemoglobinuria or myoglobinuria.
3. Systemic Signs
- Hypertension: Due to fluid overload or RAAS activation.
- Uremic signs: Pericarditis, encephalopathy, asterixis (flapping tremor).
- Bone pain or fractures: Renal osteodystrophy.
- Gout or arthropathy: Due to impaired uric acid excretion.
- Electrolyte imbalance: Hyperkalemia, hypocalcemia, metabolic acidosis.