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Doctors also commonly look for and might find the following: Uremic frost (a whitish deposit of urea crystals on the skin) Uremic fetor (breath smelling like urine) Gum changes, small red or purple spots caused by bleeding into the skin, changes in tooth enamel, or bleeding gums Murmur due to inflammation of the pericardiuman outer layer of the heart Lung fluid overload Swelling in extremities High blood pressure to the point of being dangerous Facial swelling Asterixisa movement disorder Papilledemaswelling in the optic nerve at the back of the eye Testing for Uremia Diagnosing kidney failure often depends on irregularities in your glomerular filtration rate (GFR) or the ability of your kidneys to clear creatinine, a waste product, from your blood

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and patients taking medications that interact with local anesthetics