Which of the following sign(s) and symptom(s) is/are commonly reported with kidney failure?

I. Vomiting and diarrhea
II. Anemia
III. Nocturnal urination

a. I only
b. I and II only
c. II and III only
d. All

Answer: (d), All.

Symptoms of kidney failure include:

(a). High levels of urea in the blood, which can result in:

1. Vomiting and/or diarrhea, which may lead to dehydration
2. Nausea
3. Weight loss
4. Nocturnal urination
5. More frequent urination, or in greater amounts than usual, with pale urine
6. Less frequent urination, or in smaller amounts than usual, with dark coloured urine
7. Blood in the urine
8. Pressure, or difficulty urinating
9. Unusual amounts of urination, usually in large quantities

(b). Muscle cramps (caused by low levels of calcium which can be associated with hyperphosphatemia)

(c). A build up of potassium in the blood that diseased kidneys cannot filter out (called hyperkalemia) may cause:

1.Abnormal heart rhythms
2. Muscle paralysis

(d). Failure of kidneys to remove excess fluid may cause:

1. Swelling of the legs, ankles, feet, face and/or hands
2. Shortness of breath due to extra fluid on the lungs (may also be caused by anemia)

(e) Healthy kidneys produce the hormone erythropoietin that stimulates the bone marrow to make oxygen-carrying red blood cells. As the kidneys fail, they produce less erythropoietin, resulting in decreased production of red blood cells to replace the natural breakdown of old red blood cells. As a result, the blood carries less hemoglobin, a condition known as anemia. This can result in:

1. Feeling tired and/or weak
2. Memory problems
3. Difficulty concentrating
4. Dizziness
5. Low blood pressure