| The signs and symptoms of renal insufficiency | | | | Disease |
| may be similar to those of renal failure, depending | | | | In the early stages of peripheral vascular disease, |
| on the degree of kidney involvement. If your | | | | your patient may experience pain in the calves or |
| patient's kidneys lose the ability to concentrate | | | | buttocks when walking, depending on the level of |
| urine, he may develop polyuria and nocturia. If his | | | | the vascular occlusion. Usually, this pain, called |
| renal disease is untreated and renal failure | | | | claudication, disappears with rest. |
| progresses, he may develop oliguria. His urine may | | | | You can determine the level of the occlusion by |
| have a low specific gravity and a high sodium | | | | palpating the patient's peripheral pulses. If his |
| concentration. Also, it may be bloody or tea | | | | femoral pulse is diminished, he may have aorto |
| colored and contain casts and high concentrations | | | | iliac disease. If his popliteal pulse is absent, he may |
| of red blood cells (RBCs) and white blood cells | | | | have a femoral-arterial occlusion. |
| (WBCs). | | | | As the disease progresses, the pain will |
| Your patient may have a low serum sodium level | | | | increasingly limit a patient's activity, and he'll feel |
| because of his kidneys' inability to reabsorb | | | | pain at rest. The pain may disrupt his sleep, |
| sodium. He also may have a low serum calcium | | | | causing him to sleep with his legs in a dependent |
| level caused by reduced renal absorption. And his | | | | position. However, this position further |
| serum potassium and phosphate levels may be | | | | compromises venous return, decreasing blood |
| elevated because of reduced renal excretion of | | | | flow to his legs. |
| potassium and phosphate. | | | | He also may experience numbness and tingling |
| If he has elevated blood urea nitrogen (BUN) and | | | | caused by ischemic nerve tissue in the affected |
| creatinine levels, his renal disease may result in | | | | leg. The skin of the affected leg may be hairless, |
| azotemia. If his kidneys lose their ability to | | | | cold to the touch, dry, and shiny. The toenails |
| produce erythropoietin, he may become anemic. | | | | may be hypertrophied. When the affected leg is |
| Your patient's renal disease also may cause signs | | | | elevated, it may be pale. When it's in a dependent |
| in other body systems. He may have jugular vein | | | | position, it may be ruborous (deep red-blue-purple). |
| distention, a full and bounding pulse, peripheral | | | | If peripheral vascular disease results in severe |
| edema, pulmonary edema, and heart failure. He | | | | ischemia, painful ulcers may form at pressure |
| may show signs of metabolic acidosis, including | | | | sites and over bony prominences, such as the |
| Kussmaul's respirations. And he may develop | | | | heel, ankle, toes, and dorsum of the foot. Usually, |
| anorexia, nausea, vomiting, diarrhea, lethargy, and | | | | these ulcers are round, well circumscribed, and |
| difficulty concentrating. | | | | pale gray. They also may be covered with black |
| Signs and Symptoms of Peripheral Vascular | | | | eschar. |