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==Contrast Induced Nephropathy Differential Diagnosis==
==Contrast Induced Nephropathy Differential Diagnosis==


Multiple Conditions should be considered in differentiating CIN include the following
*[[Acute tubular necrosis]]:a medical condition involving the death of tubular cells that form the tubule and transports urine to the ureters. the occurrence of Ischemia can be from endogenous toxins, such as  free hemoglobin or myoglobin, or from exogenous toxins, such as antibiotics, chemotherapeutic agents, and heavy metals


:Atheroembolic [[renal failure]] - More than 1 week after contrast, blue toes, [[livedo reticularis]], transient [[eosinophilia]], prolonged course, and lower recovery
*Atheroembolic [[renal failure]]: which usually occur after 7 days of contrast exposure with a prolonged course.  Manifestation of thromboembolism include blue toes and [[Livedoid vasculitis]],which is due to embolism induced obstruction of capillaries.  Transient [[eosinophilia]] have been associated with thromboembolism.
    
    
:[[Acute renal failure]] (includes prerenal and postrenal [[azotemia]]) - There may also be associated dehydration from aggressive diuresis, exacerbated by preexisting fluid depletionTthe acute renal failure is usually oliguric, and recovery is anticipated in 2-3 weeks
*[[Acute renal failure]]: causes are numerous and include low blood volume from any cause, exposure to substances harmful to the kidney, and obstruction of the urinary tract. AKI is diagnosed on the basis of characteristic laboratory findings, such as elevated blood urea nitrogen and creatinine, or inability of the kidneys to produce sufficient amounts of urine.  acute renal failure is usually oliguric, and recovery occur in 2-3 weeks.
:[[Acute interstitial nephritis]] (triad of fever, skin rash, and eosinophilia) - Also eosinophiluria may be present. The nephritis is usually from drugs such as penicillin, cephalosporins, and nonsteroidal anti-inflammatory drugs (NSAIDs)   


:[[Acute tubular necrosis]] - Ischemia from prerenal causes, endogenous toxins, such as hemoglobin, myoglobin, and light chains.  Exogenous toxins, such as antibiotics, chemotherapeutic agents, organic solvents, and heavy metals
*[[Acute interstitial nephritis]]: this disease can be either acute or chronic.  Chronic cases eventually ending in kidney failure.  Manifestations include fever, skin rash, eosinophilia, and eosinophiluria.
 
*[[Acute tubular necrosis]]- a medical condition involving the death of tubular cells that form the tubule and transports urine to the ureters. the occurrence of Ischemia can be from endogenous toxins, such as free hemoglobin or myoglobin, and light chains, or from exogenous toxins, such as antibiotics, chemotherapeutic agents, organic solvents, and heavy metals


==References==
==References==

Latest revision as of 16:03, 16 September 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]

Overview

The differential diagnosis includes atheroembolic renal failure, acute renal failure, acute interstitial nephritis, and acute tubular necrosis.

Contrast Induced Nephropathy Differential Diagnosis

  • Acute tubular necrosis:a medical condition involving the death of tubular cells that form the tubule and transports urine to the ureters. the occurrence of Ischemia can be from endogenous toxins, such as free hemoglobin or myoglobin, or from exogenous toxins, such as antibiotics, chemotherapeutic agents, and heavy metals
  • Atheroembolic renal failure: which usually occur after 7 days of contrast exposure with a prolonged course. Manifestation of thromboembolism include blue toes and Livedoid vasculitis,which is due to embolism induced obstruction of capillaries. Transient eosinophilia have been associated with thromboembolism.
  • Acute renal failure: causes are numerous and include low blood volume from any cause, exposure to substances harmful to the kidney, and obstruction of the urinary tract. AKI is diagnosed on the basis of characteristic laboratory findings, such as elevated blood urea nitrogen and creatinine, or inability of the kidneys to produce sufficient amounts of urine. acute renal failure is usually oliguric, and recovery occur in 2-3 weeks.
  • Acute interstitial nephritis: this disease can be either acute or chronic. Chronic cases eventually ending in kidney failure. Manifestations include fever, skin rash, eosinophilia, and eosinophiluria.
  • Acute tubular necrosis- a medical condition involving the death of tubular cells that form the tubule and transports urine to the ureters. the occurrence of Ischemia can be from endogenous toxins, such as free hemoglobin or myoglobin, and light chains, or from exogenous toxins, such as antibiotics, chemotherapeutic agents, organic solvents, and heavy metals

References

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