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Although some patients with kidney disease experience hypertension, edema, nausea, or hematuria that may lead to its discovery, kidney disease is often discovered incidentally during a routine medical evaluation. The initial approach to kidney disease is to assess the cause and severity of renal abnormalities. In all cases, this evaluation includes (1) estimation of disease duration, (2) careful examination of the urine, and (3) assessment of the glomerular filtration rate (GFR). The history and physical examination, though equally important, are variable among renal syndromes—thus, specific symptoms and signs are discussed under each disease entity.

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