INVESTIGATIONS OF A CASE WITH CHRONIC
RENAL FAILURE:
- Urine examination may show the following :
- Polyuria especially nocturia and anuria in terminal cases.
- Urine specific gravity is low and fixed to 1010 (osmolarity 300
mosm/l).
- Urine aspect is pale and watery.
- Albuminuria and granular casts.
- Blood Changes:
There is an increase in blood urea, creatinine and uric acid levels,
metabolic acidosis, normochromic normocytic anaemia, hyperkalaemia,
and hyperphosphataemia. Serum calcium may be normal or low in early
phases, but it becomes high in stage of tertiary hyperparathyroidism.
- Kidney Function Tests:
Marked impairment of the renal functions (increase in s. creatinine
and decrease in cr. clearance). Plasma creatinine is elevated once GFR is
decreased to less than 60 ml/min.
- Fundus Examination:
May show uraemic retinopathy.
- Investigations To Know The Cause Of Renal Failure :
Such as Plain X-ray for urinary tract (stone), ultrasonography
(obstruction), blood sugar (diabetes), and anti DNA (SLE). Renal biopsy
is indicated in cases with average kidney size and unknown etiology of
uraemia.
MANAGEMENT OF CHRONIC RENAL FAILURE :
