Acute kidney injury physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Patients with acute kidney injury usually appear ill. Physical examination of patients with acute kidney injury is usually remarkable for hypotension, edema of the lower extremities, maculopapular rash and rales on chest ausculatation.
Physical Examination
Physical examination of patients with acute kidney injury is usually remarkable for hypotension, edema of the lower extremities, maculopapular rash and rales on chest ausculatation.[1][2][3][4][5][6]
Appearance of the Patient
- Patients with acute kidney injury usually appear ill.
Vital Signs
- Bradycardia with regular pulse
- Low blood pressure with normal pulse pressure
Skin
- Livedo reticularis
- Digital ischemia
- Butterfly rash
- Palpable purpura
- Maculopapular rash
- Track marks
HEENT
- Keratitis
- Iritis
- Uveitis
- Dry conjunctivae
- Jaundice
- Band keratopathy
- Retinopathy
- Hearing loss
- Mucosal or cartilaginous ulcerations
Neck
- Neck examination of patients with acute kidney injury is usually normal.
Lungs
Heart
- Irregular rhythms (ie, atrial fibrillation)
- Murmurs
- Pericardial friction rub
- Increased jugulovenous distention, rales, S3
Abdomen
- Pulsatile mass or bruit
- Abdominal or costovertebral angle tenderness
- Pelvic, rectal masses
- Prostatic hypertrophy
- Distended bladder
Back
- Back examination of patients with acute kidney injury is usually normal.
Genitourinary
- Genitourinary examination of patients with acute kidney injury is usually normal.
Neuromuscular
- Neuromuscular examination of patients with acute kidney injury is usually normal.
Extremities
- Edema of the lower extremities
References
- ↑ Kellum JA, Lameire N (February 2013). "Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1)". Crit Care. 17 (1): 204. doi:10.1186/cc11454. PMC 4057151. PMID 23394211.
- ↑ Ostermann M, Joannidis M (September 2016). "Acute kidney injury 2016: diagnosis and diagnostic workup". Crit Care. 20 (1): 299. doi:10.1186/s13054-016-1478-z. PMC 5037640. PMID 27670788.
- ↑ Anderson RJ, Barry DW (March 2004). "Clinical and laboratory diagnosis of acute renal failure". Best Pract Res Clin Anaesthesiol. 18 (1): 1–20. PMID 14760871.
- ↑ Himmelfarb J, Joannidis M, Molitoris B, Schietz M, Okusa MD, Warnock D, Laghi F, Goldstein SL, Prielipp R, Parikh CR, Pannu N, Lobo SM, Shah S, D'Intini V, Kellum JA (July 2008). "Evaluation and initial management of acute kidney injury". Clin J Am Soc Nephrol. 3 (4): 962–7. doi:10.2215/CJN.04971107. PMC 2440262. PMID 18354074.
- ↑ Makris K, Spanou L (December 2016). "Acute Kidney Injury: Diagnostic Approaches and Controversies". Clin Biochem Rev. 37 (4): 153–175. PMC 5242479. PMID 28167845.
- ↑ Chen KP, Cavender S, Lee J, Feng M, Mark RG, Celi LA, Mukamal KJ, Danziger J (April 2016). "Peripheral Edema, Central Venous Pressure, and Risk of AKI in Critical Illness". Clin J Am Soc Nephrol. 11 (4): 602–8. doi:10.2215/CJN.08080715. PMC 4822669. PMID 26787777.