Your 60 year old male is complaining of weakness, altered mental status, generalized swelling, increased heart rate, increased blood pressure, and a decrease in urine output. Your patient is most likely suffering from:

• A. Heart attack
• B. Liver failure
• C. Diabetes mellitus
• D. Renal failure

Answer: (D)

Kidneys failing to filter wastes and manage fluids allows toxins to accumulate and fluids to build up in the body, producing edema, reduced urine output, altered mental status, and high blood pressure. The decreased urine output is a direct sign that the kidneys aren’t producing enough urine. Fluid retention leads to generalized swelling (edema). Toxin buildup from impaired filtration can alter brain function, causing confusion or other mental status changes. Volume overload and activation of systems that raise blood pressure contribute to the hypertension, and the heart often responds with a faster pulse. While other conditions can share some symptoms, this combination—oliguria, edema, mental status changes from uremia, and hypertension—is most consistent with renal failure.