慢性肾衰竭误诊为肾外系统疾病临床分析OACSTPCD

Objective To explore the causes and preventive measures of chronic renal failure(CRF)misdiagnosed as extrarenal system disease.Methods The clinical data of 14 patients with CRF who were misdiagnosed as multiple extra-renal system diseases from February 2021 to March 2023 were retrospectively analyzed.Results The main symptoms of 4 pa-tients were loss of appetite,nausea and vomiting,abdominal discomfort and black stool.Gastroscopy showed hyperemia of gas-tric mucosa and scattered erosive focus or hemorrhagic spot,which was misdiagnosed as chronic gastritis.No improvement was found after corresponding treatment,and CRF was confirmed by renal function examination.The main symptoms of 4 patients were dry skin,pruritus,withered hair and rash.They were misdiagnosed as pruritus.However,after treatment with traditional Chinese medicine,no improvement was reported.CRF was confirmed by renal function examination.Two patients presented with fatigue,weakness,dizziness,pale face,and decreased hemoglobin,who,therefore,were misdiagnosed with anemia.However,the corresponding treatment was not effective,and CRF was confirmed by urine routine and renal function examina-tion.The main symptoms of 3 patients were headache,dizziness,elevated blood pressure,chest tightness and palpitation,which were misdiagnosed as primary hypertension.After changing antihypertensive drugs,the effect was not favorable.CRF was confirmed by urine routine and renal function examination.One patient presented with blurry vision in both eyes and was misdiagnosed as retinal edema in both eyes.After hypertension was found,color ultrasound of urinary system and renal needle biopsy were performed,and CRF was confirmed.The misdiagnosis lasted 1-5 months.Fourteen patients were discharged from hospital after 1-3 months of treatment following diagnosis.Based on follow-up of 6 months to 1 year after discharge,13 patients had stable condition and 1 patient was lost to follow-up.Conclusion The early symptoms of CRF are complex and varied,and a variety of extrarenal system symptoms may appear.If the patient presented with mild kidney symptoms and only one extraren-al system symptom as the main manifestation,the attending physician has insufficient understanding of the symptoms of the ex-trarenal system of the disease,the inquiry and physical examination are not careful,and the relevant medical and technical ex-amination is not performed early,it is more likely to lead to misdiagnosis.Strengthening the understanding of the symptoms of the extrarenal system of this disease,careful physical examination,detailed inquiry,careful differential diagnosis,and early examination are helpful to improve the early diagnosis rate of this disease.