The Renal Examination
The renal examination may provide clues as to the cause and complications of a patient's renal dysfunction. Fluid balance is often difficult in renal failure patients and the examination can be used to assess current fluid status. The renal exam may also suggest the type of treatment the patient is receiving, whether it be via a fistula, vascath or peritoneal dialysis catheter.
The Patient
The Hands
The Arms
The Face
The Neck
The Chest
The Back
The Abdomen
The Legs
Colour
Redness, pallor
Temperature
Feel with the back of the hand
Peripheral Oedema
Pitting vs. non-pitting - apply pressure for 15 sec
Trophic Changes
Thin / dry / shiny skin, absence of hair, poor nail growth
Ulceration
White (arterial) / red (venous) / neuropathic
Lower Limb Pulses
Femoral, popliteal, posterior tibial, dorsalis pedis
Lower Limb Sensation
Peripheral neuropathy