Investigations

Renal function tests (most appropriate for the general practitioner):

• plasma creatinine

• creatinine clearance (more precise)

Plasma electrolytes

Anaemia lethargy pallor

HaematoEogical anaemia bruising epistaxis

Respiratoi y dyspnoea tachypnoea

Shin pruritus scratch marks pigmentation purpura

Nail changes proximal leuccmychia dista brownish d molorahon

Musculoskeletal muscle weakness bone pain

Periphery pe n p he raí ne .jropathy oedema

Fig. 27.1 Clinical features of chronic renal disease

Anaemia lethargy pallor

HaematoEogical anaemia bruising epistaxis

Respiratoi y dyspnoea tachypnoea

Shin pruritus scratch marks pigmentation purpura

Nail changes proximal leuccmychia dista brownish d molorahon

Musculoskeletal muscle weakness bone pain

Periphery pe n p he raí ne .jropathy oedema

• sodium, potassium, chloride, bicarbonate

• calcium and phosphate

Consider:

• magnesium, urate, glucose

• prescribed drug level

• cardiac studies

Determination of underlying cause

• imaging of urinary tract—ultrasound

• immunological tests

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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