Important features in kidney disease evaluation

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

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