Abstract
In this chapter we explain:
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How to assess a patient’s fluid balance
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Fluid overload in chronic kidney disease
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How to use diuretics
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Common signs of vasculitis
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The importance of examining the abdomen
This chapter is placed after the chapters on history, height, weight, blood pressure and urine testing because the physical examination should be tailored to the information gathered from those parts of the patient assessment. The blood pressure and urinalysis may have been tested before you see the patient. If not, include them as part of your examination.
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References
Fortes MB, Owen JA, Raymond-Barker P, Bishop C, Elghenzai S, Oliver SJ, Walsh NP. Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. J Am Med Dir Assoc. 2015;16(3):221–8. http://www.ncbi.nlm.nih.gov/pubmed/25444573.
Papke RL, Smith-Maxwell C. High throughput electrophysiology with Xenopus oocytes. Comb Chem High Throughput Screen. 2009;12(1):38–50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005249/.
Schork A, Woern M, Kalbacher H, Voelter W, Nacken R, Bertog M, Haerteis S, Korbmacher C, Heyne N, Peter A, Häring HU, Artunc F. Association of plasminuria with overhydration in patients with CKD. Clin J Am Soc Nephrol. 2016;11(5):761–9. https://doi.org/10.2215/CJN.12261115. Epub 2016 Mar 1. http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=26933188.
Philipson H, Ekman I, Forslund HB, Swedberg K, Schaufelberger M. Salt and fluid restriction is effective in patients with chronic heart failure. Eur J Heart Fail. 2013;15(11):1304–10. https://doi.org/10.1093/eurjhf/hft097. Epub 2013 Jun 19. http://onlinelibrary.wiley.com/doi/10.1093/eurjhf/hft097/full.
Konerman MC, Hummel SL. Sodium restriction in heart failure: benefit or harm? Curr Treat Options Cardiovasc Med. 2014;16(2):286. https://doi.org/10.1007/s11936-013-0286-x. http://onlinelibrary.wiley.com/doi/10.1093/eurjhf/hft097/full.
Vegter S, Perna A, Postma MJ, Navis G, Remuzzi G, Ruggenenti P. Sodium intake, ACE inhibition, and progression to ESRD. J Am Soc Nephrol. 2012;23(1):165–73. https://doi.org/10.1681/ASN.2011040430. Epub 2011 Dec 1. http://jasn.asnjournals.org/content/23/1/165.long.
Ellison DH. Clinical pharmacology in diuretic use. Clin J Am Soc Nephrol. 2019;14:1248–57. https://doi.org/10.2215/CJN.09630818. https://cjasn.asnjournals.org/content/clinjasn/14/8/1248.full.pdf.
Anisman SD, Stephen B, Erickson SB, Morden NE. How to prescribe loop diuretics in oedema. BMJ. 2019;364:l359. https://doi.org/10.1136/bmj.l359. https://www.bmj.com/content/bmj/364/bmj.l359.full.pdf.
Unruh ML, Pankratz S, Demko JE, Ray EC, Hughey RP, Kleyman TR. Trial of amiloride in type 2 diabetes with proteinuria. Kidney Int Rep. 2017;2(5):893–904. https://doi.org/10.1016/j.ekir.2017.05.008. https://www.sciencedirect.com/science/article/pii/S2468024917301262.
Krijnen P, van Jaarsveld BC, Steyerberg EW, Man in ‘t Veld AJ, Schalekamp MA, Habbema JD. A clinical prediction rule for renal artery stenosis. Ann Intern Med. 1998;129(9):705–11. http://annals.org/article.aspx?articleid=711773.
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Rayner, H.C., Thomas, M.E., Milford, D.V. (2020). Examine the Patient: Physical Signs Related to Kidney Diseases. In: Understanding Kidney Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-43027-6_13
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DOI: https://doi.org/10.1007/978-3-030-43027-6_13
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