Symptoms:

Initial symptoms may include the following:

• Fatigue
• Frequent hiccups
• General ill feeling
• Generalized itching (pruritus)
• Headache
• Nausea, vomiting
• Unintentional weight loss

Later symptoms may include the following:

• Blood in the vomit or in stools
• Decreased alertness, including drowsiness,confusion, delirium, orcoma
• Decreased sensation in the hands, feet, or other areas
• Easy bruising or bleeding
• Increased or decreased urine output
• Muscle twitching or cramps
• Seizures
• White crystals in and on the skin (uremic frost)

Additional symptoms that may be associated with this disease:

• Abnormally dark or light skin
• Agitation
• Breath odor
• Excessive nighttime urination
• Excessive thirst
• High blood pressure
• Loss of appetite
• Nail abnormalities
• Paleness

Signs and tests:

There may be mild to severe high blood pressure. A neurologic examination may show polyneuropathy. Abnormal heart or lung sounds may be heard with a stethoscope.

A urinalysis may show protein or other abnormalities. An abnormal urinalysis may occur 6 months to 10 or more years before symptoms appear.

• Creatinine levels progressively increase.
• BUN is progressively increased.
• Creatinine clearance progressively decreases.
• Potassium test may show elevated levels.
• Arterial blood gas and blood chemistry analysis may show metabolic acidosis.

Signs of chronic renal failure, including both kidneys being smaller than normal, may be seen on:

• Abdominal CT scan
• Abdominal MRI
• Abdominal ultrasound
• X-rays of the kidneys and abdomen

This disease may also alter the results of the following tests:

• Erythropoietin
• PTH
• Renal scan
• Serum magnesium - test
• Urinary casts