Which characteristic might indicate kidney issues during a HEENT assessment?

The characteristic that indicates kidney issues during a HEENT assessment is the ammonia smell. When the kidneys are not functioning properly, there can be a buildup of nitrogenous waste products in the blood, which can lead to a strong ammonia odor emanating from the breath or body. This finding is often associated with conditions like uremia, where waste materials are not being adequately excreted by the kidneys, resulting in elevation of urea and other waste products.

In contrast, a fruity smell is commonly associated with conditions like diabetic ketoacidosis, where the body produces excess ketones. A rotten smell may indicate necrosis or infection, but it's not specific to kidney function. Increased salivation largely pertains to oral health or certain systemic issues but does not directly relate to kidney problems. Hence, the ammonia smell is the most indicative sign when considering kidney issues in a HEENT assessment context.