Pathology: Progressive, irreversible renal disease with abnormal eGFR for >3 months
Aetiology: Diabetes mellitus, hypertension, HIV, myeloma, Autosomal dominant polycystic kidney disease and IgA nephropathy.
Symptoms: Oliguria, Malaise, lethargy, confusion, nausea, seizure, pruritus, purpura, breathlessness, pericarditis, bleeding
Signs: Reduced urine output, rash, peripheral oedema, arrhythmias, signs of heart failure, pallor, bruising and skin pigmentation
Investigations: Bloods: FBC (normocytic anaemia), U&E (hyperkalaemia, raised urea and creatinine, hypocalcaemia, hyperphosphataemia)
Imaging: Chest x-ray to rule out fluid overload and bone scans
Treatment: Medical: Calcium and Vitamin D supplementation, Dietary restriction of
phosphate, Dialysis for severe symptoms
Surgical: Kidney Transplant
Complications: Hyperkalaemia, fluid overload, uraemia, renal osteodystrophy, hypertension
Prognosis: 50% of patients with chronic renal failure will require dialysis
