Chapter 045. Azotemia and Urinary Abnormalities Normal kidney functions occur through numerous cellular processes to maintain body homeostasis. Disturbances in any of these functions can lead to a constellation of abnormalities that may be detrimental to survival. The clinical manifestations of these disorders will depend upon the pathophysiology of the renal injury and will often be initially identified as a complex of symptoms, abnormal physical findings, and laboratory changes that together make possible the identification of specific syndromes. These renal syndromes (Table 45-1) may arise as the consequence of a systemic illness or can occur as a primary renal disease. Nephrologic.