GENERAL EXAMINATION CLINICAL SYMPTOMS On observation kindly check for symptoms like: 1. Decreased level of consciousness: seen in end-stage renal disease (ESRD). 2. Obvious scars: check previous abdominal surgery. 3. Pallor: Suggestive of underlying anaemia (e.g. erythropoietin deficiency). 4. Shortness of breath: may be due to pulmonary oedema secondary to advanced renal disease. 5. Oedema: typically presents as swelling of the limbs (e.g. pedal oedema) and abdomen (i.e. ascites). In the context of a renal system examination, possible causes could include nephrotic syndrome and end-stage renal disease (due to anuria). 6. Cachexia: muscle loss that is not entirely reversed with nutritional supplementation associated with end-stage renal failure due to protein-energy wasting (PEW). 7. Uraemic complexion: a yellow colour of the skin caused by uraemia in advanced chronic kidney disease. 8. Cushingoid appearance: facial puffiness and weight gain may be due to the use of high dose corticosteroids for renal transplant immunosuppression or glomerulonephritis.