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Distinguishing acute and chronic renal failure

Authoring team

When a patient presents with renal failure the clinician should attempt to distinguish acute from chronic renal disease.

The following characteristics make chronic renal failure more likely:

  • ill health in the previous few months
  • poor urine concentration for months e.g. nocturia, polyuria and thirst
  • normochromic anaemia
  • stunted growth
  • a history of nephritic or nephrotic syndromes
  • isolated hypertension
  • diabetes mellitus
  • renal calculi
  • shrunken kidneys
  • polycystic kidneys

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