There are no pathognomonic symptoms associated with chronic renal failure. Malaise, nausea, unintentional weight loss, pruritus, lower extremity edema, and sleep disorders are common non-specific symptoms of chronic renal failure.

• Pruritus

• Anorexia
• Fatigue
• Nausea (especially in the morning)
• Sleep disturbances and sleep apnea
• Hiccups
• Dry mouth
• Headache
• Reduced sense of smell and taste
• Lower extremity cramps and edema
• Restless legs
• Extremity numbness, paresthesias, and weakness (sensorimotor peripheral neuropathy)
• Seizures
• Decreased mental acquity
• Coma

• Chest pain (uremic pericarditis)

• Abdominal distention (serositis)
• Abdominal discomfort

• Skin pallor
• Bleeding tendency

• Unintentional weight loss
• Amenorrhea
• Sexual dysfunction
  • Loss of libido
  • Impotence
• Failure to thrive (in children)

• Renal diseases
• History of dialysis or renal transplantation
• History of hearing loss (Alport’s syndrome)
• History of inborn errors of metabolism (Fabry disease or cystinuria)

• History of excessive NSAID use
• Chronic exposure to nephrotoxic agents (e.g. heavy metals)

• the first step in genetic diagnosis is
  • obtaining gf a comprehensive phenotyping.
  • detailed family history
  • three generation family pedigree.
• The diagnostic yield of genetic testing in CKD is variable and depends on the disease phenotype, associated coexisting conditions, ethnicity, consanguinity, family history, and age at onset.( table 1)
• Analyses of single kidney disease genes are currently being supplanted by large gene panels, exome sequencing, and whole-genome sequencing.