Generally, patients will present with renal problems in two ways—incidentally during a routine exam and/or evidence of hypertension, edema, and hematuria. Evaluation must consider (1) estimation of disease duration, (2) urinalysis, and (3) assessment of the glomerular filtration rate (GFR).

Acute renal failure is a very common entity. It is due to a rapid decrease in renal function, possibly over days or weeks, leading to an increase in nitrogenous products within the blood. This may result from trauma, severe illness, or surgery. A rapid, progressive intrinsic renal disease can lead to acute renal failure very rapidly. It goes into three phases: prerenal due to inadequate renal perfusion, possibly due to depletion by cardiovascular disease; renal due to renal damage or disease—the most common cause being the ...