By Michael Boulton-Jones MB, B.CHIR, MRCP (auth.)
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Additional info for Acute and Chronic Renal Failure
However, many patients may report no more than a slight discomfort. Urethral obstruction leads to painful distension of the bladder. Stasis of the urine predisposes to infection, which may dominate the clinical presentation. Obstruction of the Renal Tract 47 On examination, one or both kidneys may be tender or the bladder palpable. The external meatus should always be inspected for stenosis. Pelvic examination may lead to a diagnosis of intrapelvic malignancy or prostatic hypertrophy. Patients tend to be fluid overloaded and modest hypertension is commonly seen.
There is a higher incidence of renal osteodystrophy, perhaps because the natural history of the disease is more prolonged and these patients are often uraemic during puberty (see two other titles in this Topic Pack: Sharpstone, 1980, and Walls, 1980). Table 13. Presenting symptoms of polycystic renal disease. Abdominal masses Hypertension Urinary tract infection Haematuria Pain Chronic renal failure Causes 55 Polycystic Renal Disease Polycystic renal disease is inherited as an autosomal dominant, although 30 per cent of patients have no apparent family history.
The mortality associated with the main clinical subgroups of patients described in various series is shown in Table 9. It can be seen that patients presenting with an obstetric cause of A TN almost always survive, whereas the mortality of surgical cases is several times higher. Groups of patients with a particularly bad or good prognosis are listed in Table 10. 36 Acute and Chronic Renal Failure Table 10. A TN prognosis. g. , Prescribing for patients with renal failure, Br. Med. , 1977, 2, 36. 3.
Acute and Chronic Renal Failure by Michael Boulton-Jones MB, B.CHIR, MRCP (auth.)