Acute tubular necrosis physical examination

On physical examination, patients with acute tubular necrosis may show the findings of volume depletion. They usually appear ill, dehydrated, and lethargic. Common physical examination findings of acute tubular necrosis include orthostatic hypotension and other signs of hypovolemia (dry mucous membranes, sunken eyes, poor skin turgor and delayed capillary refill, and decreased jugular venous pressure).

• Patients with acute tubular necrosis may appear ill, dehydrated, or lethargic depending on the severity of renal hypoperfusion and damage.

• Hypotension
• Fever
• Orthostasis
• Tachycardia or bradycardia
• Tachypnea

Skin examination of patients with acute tubular necrosis may show following findings:

• Diminished skin turgor
• Dry mucous membranes
• Delayed capillary refill

• Sunken eyes
• Facial edema

• Pulmonary examination of patients with acute tubular necrosis is usually normal. Bilateral crackles may be found on auscultation due to pulmonary edema.
• Tachypnea may be caused by metabolic acidosis as a result of severe volume depletion.

• Hypotension
• Tachycardia/ Bradycardia
• Decreased jugular venous pressure
• Arrhythmias

Abdominal examination of patients with acute tubular necrosis may show following findings:

• Abdominal distention

• Muscle weakness and convulsions because of moderate to severe electrolyte imbalance.
• Changes in sensorium
• Muscle tenderness

• Cool extremities
• Pitting edema