Kidney failure, unlike disease of many other organs, does not lead to symptoms that point to the site of the problem. Pain in the kidney region, for example, is an unusual complaint, and contrary to what you might expect, patients with chronic kidney failure rarely note changes in urination. There is no change perceptible to the patient in the volume, color, appearance, or odor of the urine. Some persons with early renal insufficiency get up to urinate during the night more frequently, but this is by no means universal and has so many other causes that it cannot be considered a symptom of kidney impairment. While both the minimal volume of urine (during dehydration) and the maximal volume of urine (formed during water loading) are progressively reduced as kidney impairment becomes more severe, patients with chronic kidney failure almost never notice the change. Patients who develop the nephrotic syndrome (see Chapter 18) often notice foamy urine (due to its high protein content), whether they also have kidney failure or not. Although the symptoms of chronic renal failure are well known and are believed to be due to the biochemical abnormalities and the decrease in numbers of red cells in the blood (anemia) that characterize renal failure, there have been few attempts to relate these symptoms to specific abnormalities in a measured way.
Was this article helpful?