Symptoms and signs

The symptoms and signs of CRF are summarised in Figure 27.1 . The common early presenting symptoms are generally non-specific and referable to the gastrointestinal tract, presumably due to the formation of ammonia in the upper GIT. Such symptoms include:

• tiredness lethargy

If a patient presents with these symptoms and has a sallow appearance due to combination of anaemia and brownish pigmentation, then CRF should be highly suspected.

wishus drowsiness confusion * twitching 1 severe f;ts f uraemia coma J

hyperparacnyioidisnn (secondary)

Cirdlovafufier heait failure hypertension pericarditis

Gastrolntatfinal trad anorexia, nausea vomiting hiccoughs

RjMUl polyuria nocturia

Beihal erectile impctnncs infertility amenorrTiofla h«maturia proteinuria

Fig. 27.1 Clinical features of chronic renal disease

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