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Blood tests include:

  • urea, which increases
  • calcium, which is low:
    • secondary to renal phosphate retention and acquired vitamin D resistance
    • lack of activated vitamin D leads to reduced calcium absorption from the gut
  • hyperphosphataemia - due to reduced excretion
  • acidosis
  • uric acid - often raised - however clinical gout rarely occurs
  • reduced creatinine clearance

Other important investigations include:

  • renal imaging
  • the gold standard is renal biopsy

A diabetic patient should be screened for diabetic retinopathy. The presence of diabetic retinopathy in a diabetic patient with chronic renal failure is suggestive of diabetic glomerulosclerosis.

An ECG will demonstrate cardiac arrhythmias caused by electrolyte imbalance.

Last reviewed 01/2018