What is the focus of the clinical history to evaluate for chronic glomerulonephritis?

Updated: Feb 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The history should begin by focusing on cause-specific symptoms to determine the source of the chronic kidney disease (CKD) if this is unknown. Recognition of such symptoms facilitates the planning of further workup and management of the disease (if systemic).

The next step is to look for symptoms related to uremia to determine if renal replacement therapy is needed. The following symptoms suggest uremia:

  • Weakness and fatigue

  • Loss of energy, appetite, and weight

  • Pruritus

  • Early morning nausea and vomiting

  • Change in taste sensation

  • Reversal in sleep pattern (ie, sleepiness in daytime and wakefulness at night)

  • Peripheral neuropathy

  • Seizures

  • Tremors

The presence of edema and hypertension suggests volume retention. Dyspnea or chest pain that varies with position suggests fluid overload and pericarditis, respectively. Leg cramps may suggest hypocalcemia or other electrolyte abnormalities. Weakness, lethargy, and fatigue may be due to anemia.


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