Renal History

 

Presenting complaint

Patients with renal impairment are often asymptomatic, with the abnormality detected incidentally on blood or urine testing. However, the following symptoms should be asked about:

  • Urinary symptoms: frequency, incontinence, obstruction, dysuria, haematuria, cloudy, smelly.
  • Loin pain.
  • Peripheral oedema.
  • Systemic symptoms: fever, weight loss, rash, arthritis.

Past medical history

  • CVD and risk factors: hypertension, diabetes, PVD.
  • Gout
  • UTI, including a history of UTIs and/or enuresis in childhood.
  • Kidney stones.
  • Recent respiratory tract infection (post-streptococcal glomerulonephritis, IgA nephropathy).
  • Cancer

Drugs

Common drugs which may affect renal function:

  • NSAIDs
  • ACE inhibitors.
  • Diuretics
  • Antibiotics
  • Anticholinergics

Family history

  • Kidney disease
  • Diabetes
  • Hypertension

Social history

  • Smoking

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