Important features in kidney disease evaluation
What important features need to be elicited in the history of patients referred for kidney disease evaluation?
• Previous diagnosis of kidney disease (e.g., previous documentation of BUN and serum creatinine values)
• History of asymptomatic urinary abnormalities (e.g., hematuria, proteinuria)
• History of alterations in urinary frequency or urgency, etc.
• Change in the urinary character or appearance (e.g., smell, color, frothy appearance)
• History of diabetes (duration, severity, end-organ damage)
• History of hypertension (including cardiac history)
• Previous exposure to nephrotoxic medications (e.g., nonsteroidal antiinflammatory drugs [NSAIDs], antibiotics such as aminoglycosides)
• Previous adverse reactions to renin-angiotensin-aldosterone system blocking agents (e.g., angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists)
• Recent gastrointestinal endoscopic procedures requiring bowel cleansing (risk of acute phosphate nephropathy in those who use phosphate-containing enema)
• Recent exposure to contrast-requiring procedures (risk of contrast-induced acute kidney injury)
• Recent systemic infections or intercurrent illnesses
• Family history of kidney disease or any relative requiring some form of renal replacement therapy (e.g., polycystic kidney disease [PKD], Alport syndrome)
• History of autoimmune diseases
• Recent changes in dose of a medication, or any new medication recently started
• Any over-the-counter medications used (e.g., NSAIDs) and/or herbal, natural supplements