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{{CMG}}; {{AE}} {{Anmol}}
{{CMG}}; {{AE}} {{Anmol}}
==Differential Oliguria==
 
==Tables==
{| class="wikitable"
{| class="wikitable"
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Classification by etiology
|+
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Etiology
!Diagnosis
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Clinical manifestations
!Lab findings
! colspan="11" style="background:#4479BA; color: #FFFFFF;" |Paraclinical findings
!
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Comments
!
|-
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Symptoms and signs
! colspan="6" style="background:#4479BA; color: #FFFFFF;" |Lab findings
! colspan="5" style="background:#4479BA; color: #FFFFFF;" |Imaging
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" |Fatigue/Lethargy
! align="center" style="background:#4479BA; color: #FFFFFF;" |Thirst
! align="center" style="background:#4479BA; color: #FFFFFF;" |Dizziness/Confusion
! align="center" style="background:#4479BA; color: #FFFFFF;" |Muscle weakness/cramp
! align="center" style="background:#4479BA; color: #FFFFFF;" |Somatic/visceral pain
! align="center" style="background:#4479BA; color: #FFFFFF;" |Vomiting
! align="center" style="background:#4479BA; color: #FFFFFF;" |Diarrhea
! align="center" style="background:#4479BA; color: #FFFFFF;" |Tachypnea
! align="center" style="background:#4479BA; color: #FFFFFF;" |Haematuria/Proteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" |Edema
! align="center" style="background:#4479BA; color: #FFFFFF;" |Blood tests
! align="center" style="background:#4479BA; color: #FFFFFF;" |Renal Funtion test
! align="center" style="background:#4479BA; color: #FFFFFF;" |Electrolytes
! align="center" style="background:#4479BA; color: #FFFFFF;" |Urine analysis
! align="center" style="background:#4479BA; color: #FFFFFF;" |ABG
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" |Ultrasound
! align="center" style="background:#4479BA; color: #FFFFFF;" |X-ray
! align="center" style="background:#4479BA; color: #FFFFFF;" |CT
! align="center" style="background:#4479BA; color: #FFFFFF;" |MRI
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other
|-
! rowspan="8" style="background:#4479BA; color: #FFFFFF;" |Prerenal
|[[Myocarditis]]<ref name="pmid3974674">{{cite journal |vauthors=Dec GW, Palacios IF, Fallon JT, Aretz HT, Mills J, Lee DC, Johnson RA |title=Active myocarditis in the spectrum of acute dilated cardiomyopathies. Clinical features, histologic correlates, and clinical outcome |journal=N. Engl. J. Med. |volume=312 |issue=14 |pages=885–90 |date=April 1985 |pmid=3974674 |doi=10.1056/NEJM198504043121404 |url=}}</ref><ref name="pmid2660415">{{cite journal |vauthors=O'Connell JB, Mason JW |title=Diagnosing and treating active myocarditis |journal=West. J. Med. |volume=150 |issue=4 |pages=431–5 |date=April 1989 |pmid=2660415 |pmc=1026578 |doi= |url=}}</ref><ref name="pmid8198397">{{cite journal |vauthors=Olinde KD, O'Connell JB |title=Inflammatory heart disease: pathogenesis, clinical manifestations, and treatment of myocarditis |journal=Annu. Rev. Med. |volume=45 |issue= |pages=481–90 |date=1994 |pmid=8198397 |doi=10.1146/annurev.med.45.1.481 |url=}}</ref><ref name="pmid16449736">{{cite journal |vauthors=Baughman KL |title=Diagnosis of myocarditis: death of Dallas criteria |journal=Circulation |volume=113 |issue=4 |pages=593–5 |date=January 2006 |pmid=16449736 |doi=10.1161/CIRCULATIONAHA.105.589663 |url=}}</ref>
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|<nowiki>-</nowiki>
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* [[Leukocytosis]] may be with [[eosinophilia]]
* Elevated [[ESR]] and [[CRP]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Screening for rheumatic origin of disease
* [[Cardiac enzymes]] to rule out infraction
* Serum viral antibodies to rule out [[viral myocarditis]], including:
** Coxsackie virus group B
** Human immunodeficiency virus ([[HIV]]),
** [[Cytomegalovirus]]
** [[Ebstein-Barr virus]]
** [[Hepatitis]] virus
** [[Influenza]] virus
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Gadolinium-enhanced [[magnetic resonance imaging]] can detect inflammatory [[edema]]
* Delayed-enhanced MRI has also been to assess the degree of scarring
|
* Endomyocardial biopsy is the gold standard for the diagnosis of [[myocarditis]]
* Echocardiography is useful for the following:
** Exclusion of [[amyloidosis]], congenital and/or valvular diseases
** Assessment of cardiac dysfunction
** Detection of inflammatory origin, wall motion abnormalities, wall thickening, and [[pericardial effusion]]
** Distinction between fulminant and acute [[myocarditis]]
* Scintigraphy is useful for detecting myocardial inflammation
* [[ECG]] is non-specific but may detect the following:
**Heart block
** Ventricular [[arrhythmia]]s
** Injury patterns, including those of myocardial [[ischemia]] and [[pericarditis]]
|
|-
|[[Peritonitis]]<ref name="pmid9798013">{{cite journal |vauthors=Such J, Runyon BA |title=Spontaneous bacterial peritonitis |journal=Clin. Infect. Dis. |volume=27 |issue=4 |pages=669–74; quiz 675–6 |date=October 1998 |pmid=9798013 |doi= |url=}}</ref><ref name="pmid2210672">{{cite journal |vauthors=Runyon BA |title=Monomicrobial nonneutrocytic bacterascites: a variant of spontaneous bacterial peritonitis |journal=Hepatology |volume=12 |issue=4 Pt 1 |pages=710–5 |date=October 1990 |pmid=2210672 |doi= |url=}}</ref>
|<nowiki>+/-</nowiki>
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|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
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|
* Peritoneal fluid analysis is the most important component of diagnosis and demonstrates the following:
** Ascitic fluid [[neutrophil]] count > 500 cells/µL
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|-
|[[Perinatal asphyxia]]<ref name="pmid23149172">{{cite journal |vauthors=Selewski DT, Jordan BK, Askenazi DJ, Dechert RE, Sarkar S |title=Acute kidney injury in asphyxiated newborns treated with therapeutic hypothermia |journal=J. Pediatr. |volume=162 |issue=4 |pages=725–729.e1 |date=April 2013 |pmid=23149172 |doi=10.1016/j.jpeds.2012.10.002 |url=}}</ref><ref name="pmid21238703">{{cite journal |vauthors=Durkan AM, Alexander RT |title=Acute kidney injury post neonatal asphyxia |journal=J. Pediatr. |volume=158 |issue=2 Suppl |pages=e29–33 |date=February 2011 |pmid=21238703 |doi=10.1016/j.jpeds.2010.11.010 |url=}}</ref><ref name="pmid8747112">{{cite journal |vauthors=Karlowicz MG, Adelman RD |title=Nonoliguric and oliguric acute renal failure in asphyxiated term neonates |journal=Pediatr. Nephrol. |volume=9 |issue=6 |pages=718–22 |date=December 1995 |pmid=8747112 |doi= |url=}}</ref>
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* May indicate [[infection]], [[hemorrhage]] or [[thrombocytopenia]]
|
* Decreased [[glomerular filtration rate]]
* Elevated [[creatinine]] >1.5 mg/dL
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Elevated cardiac [[troponin]] T and I levels are specific for cardiac dysfunction
* Neutrophil gelatinase-associated lipocalin is under investigation as a biomarker for [[acute kidney injury]]
* Fetal umbilical artery pH <7.0
* Elevated liver [[transaminases]]
* Coagulation profile should be carried out
|<nowiki>-</nowiki>
|
* Cranial [[ultrasound]] may indicate the following:
** Focal [[hemorrhage]]
** Ventricular [[dilatation]]
** White matter damage
** [[Cerebral edema]]
** Cystic lesions
|
* X -ray may demonstrate the following:
** [[Cardiomegaly]]
** Hazy lung fields indicating [[pulmonary edema]]
|<nowiki>-</nowiki>
|
* Acute brain injury may be seen on MRI
|
* ECG may demonstrate [[ischemia]] with changes in the ST segment
* Echocardiography may demonstrate the following:
** Decreased left ventricular [[ejection fraction]]
** Right-to-left atrial shunting
|
* [[Apgar score]] is very important during assessment
|-
|[[Polycythemia]]<ref name="pmid9025165">{{cite journal |vauthors=Gregg XT, Prchal JT |title=Erythropoietin receptor mutations and human disease |journal=Semin. Hematol. |volume=34 |issue=1 |pages=70–6 |date=January 1997 |pmid=9025165 |doi= |url=}}</ref><ref name="pmid9292543">{{cite journal |vauthors=Kralovics R, Indrak K, Stopka T, Berman BW, Prchal JF, Prchal JT |title=Two new EPO receptor mutations: truncated EPO receptors are most frequently associated with primary familial and congenital polycythemias |journal=Blood |volume=90 |issue=5 |pages=2057–61 |date=September 1997 |pmid=9292543 |doi= |url=}}</ref><ref name="pmid2297568">{{cite journal |vauthors=Da Silva JL, Lacombe C, Bruneval P, Casadevall N, Leporrier M, Camilleri JP, Bariety J, Tambourin P, Varet B |title=Tumor cells are the site of erythropoietin synthesis in human renal cancers associated with polycythemia |journal=Blood |volume=75 |issue=3 |pages=577–82 |date=February 1990 |pmid=2297568 |doi= |url=}}</ref><ref name="pmid8855223">{{cite journal |vauthors=Iliopoulos O, Levy AP, Jiang C, Kaelin WG, Goldberg MA |title=Negative regulation of hypoxia-inducible genes by the von Hippel-Lindau protein |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=93 |issue=20 |pages=10595–9 |date=October 1996 |pmid=8855223 |pmc=38198 |doi= |url=}}</ref><ref name="pmid11986208">{{cite journal |vauthors=Wiesener MS, Seyfarth M, Warnecke C, Jürgensen JS, Rosenberger C, Morgan NV, Maher ER, Frei U, Eckardt KU |title=Paraneoplastic erythrocytosis associated with an inactivating point mutation of the von Hippel-Lindau gene in a renal cell carcinoma |journal=Blood |volume=99 |issue=10 |pages=3562–5 |date=May 2002 |pmid=11986208 |doi= |url=}}</ref>
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|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Hematocrit]] > 49% in men
* [[Hematocrit]] > 48% in women
* [[Hemoglobin]] > 16.5 g/dL in men
* [[Hemoglobin]] > 16 g/dL in women
* Total [[red blood cell]] mass ≥ 36 mL/kg in males
* Total [[red blood cell]] mass ≥ 32 mL/kg in females
* [[Thrombocytosis]] > 400,000/μL
* [[Leukocytosis]] with predominant [[neutrophil]]s > 12,000/μL
* Leukocyte [[alkaline phosphatase]] >100 U/L
* Serum vitamin B-12 concentration >900 pg/mL
* [[Hyperuricemia]] may be present
|
* Decreased [[erythropoietin]]
|<nowiki>-</nowiki>
|
* Oxygen saturation ≥ 92%
|<nowiki>-</nowiki>
|
* May demonstrate [[splenomegaly]]
|
* May demonstrate [[splenomegaly]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[JAK2]] mutation
* Bone marrow [[biopsy]] demonstrates:
** Hypercellularity with [[hyperplasia]] of the erythroid, granulocytic, and megakaryocytic cell lines
** [[Myelofibrosis]] may also be present
** [[Prothrombin time]] and [[activated partial thromboplastin time]] may be prolonged
|
* [[Phlebotomy]] is the usual form of treatment
|-
|[[Respiratory distress syndrome]]<ref name="pmid26542877">{{cite journal |vauthors=Hooper SB, Te Pas AB, Kitchen MJ |title=Respiratory transition in the newborn: a three-phase process |journal=Arch. Dis. Child. Fetal Neonatal Ed. |volume=101 |issue=3 |pages=F266–71 |date=May 2016 |pmid=26542877 |doi=10.1136/archdischild-2013-305704 |url=}}</ref><ref name="pmid17382123">{{cite journal |vauthors=Mariani G, Dik PB, Ezquer A, Aguirre A, Esteban ML, Perez C, Fernandez Jonusas S, Fustiñana C |title=Pre-ductal and post-ductal O2 saturation in healthy term neonates after birth |journal=J. Pediatr. |volume=150 |issue=4 |pages=418–21 |date=April 2007 |pmid=17382123 |doi=10.1016/j.jpeds.2006.12.015 |url=}}</ref><ref name="pmid16549212">{{cite journal |vauthors=Jain L, Eaton DC |title=Physiology of fetal lung fluid clearance and the effect of labor |journal=Semin. Perinatol. |volume=30 |issue=1 |pages=34–43 |date=February 2006 |pmid=16549212 |doi=10.1053/j.semperi.2006.01.006 |url=}}</ref><ref name="pmid10764292">{{cite journal |vauthors=Avery ME |title=Surfactant deficiency in hyaline membrane disease: the story of discovery |journal=Am. J. Respir. Crit. Care Med. |volume=161 |issue=4 Pt 1 |pages=1074–5 |date=April 2000 |pmid=10764292 |doi=10.1164/ajrccm.161.4.16142 |url=}}</ref>
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|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
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|<nowiki>+</nowiki>
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* Metabolic and respiratory [[acidosis]] may occur with [[hypoxia]]
|
* Pulse oximetry is useful in diagnosis
|<nowiki>-</nowiki>
|
* Demonstrates the following:
** Bilateral, diffuse, reticular granular or ground-glass appearance
** Poor lung expansion
** [[Cardiomegaly]] may or may not be present
** Streaky opacities may indicate [[pneumonia]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Echocardiography]] is useful in diagnosing [[patent ductus arteriosus]]
|
|-
|[[Shock]]<ref name="pmid24171518">{{cite journal |vauthors=Vincent JL, De Backer D |title=Circulatory shock |journal=N. Engl. J. Med. |volume=369 |issue=18 |pages=1726–34 |date=October 2013 |pmid=24171518 |doi=10.1056/NEJMra1208943 |url=}}</ref><ref name="pmid7588190">{{cite journal |vauthors=Rodgers KG |title=Cardiovascular shock |journal=Emerg. Med. Clin. North Am. |volume=13 |issue=4 |pages=793–810 |date=November 1995 |pmid=7588190 |doi= |url=}}</ref><ref name="pmid26903335">{{cite journal |vauthors=Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, Rubenfeld G, Kahn JM, Shankar-Hari M, Singer M, Deutschman CS, Escobar GJ, Angus DC |title=Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) |journal=JAMA |volume=315 |issue=8 |pages=762–74 |date=February 2016 |pmid=26903335 |pmc=5433435 |doi=10.1001/jama.2016.0288 |url=}}</ref><ref name="pmid26158402">{{cite journal |vauthors=Churpek MM, Zadravecz FJ, Winslow C, Howell MD, Edelson DP |title=Incidence and Prognostic Value of the Systemic Inflammatory Response Syndrome and Organ Dysfunctions in Ward Patients |journal=Am. J. Respir. Crit. Care Med. |volume=192 |issue=8 |pages=958–64 |date=October 2015 |pmid=26158402 |pmc=4642209 |doi=10.1164/rccm.201502-0275OC |url=}}</ref>
 
- Anaphylactic
 
- Cardiogenic
 
- Hypotensive
 
- Septic
 
- Toxic
 
|<nowiki>+/-</nowiki>
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|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
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|<nowiki>-</nowiki>
|
* Elevated [[hemotocrit]] value may indicate [[hypovolemic shock]]
* [[Anemia]] and/or [[thrombocytopenia]] may indicate [[hemorrhagic shock]]
* Elevated [[eosinophils]] may indicate [[anaphylactic shock]]
* Elevated [[leukocytes]] may suggest [[septic shock]]
* A low white count with bandemia may suggest an undifferentiated shock
|
* Elevated [[BUN]] and [[creatinine]]
* Decreased GFR
|
* [[Hypernatremia]] or [[hyponatremia]]
* [[Hypokalemia]] or [[hyperkalemia]]
* [[Hypochloremia]]
|<nowiki>-</nowiki>
|
* Elevated serum [[lactate]]
|
* Cross matching and blood typing of blood is important for [[blood transfusion]]
* Prolonged [[prothrombin]] and [[activated partial thromboplastin time]] may indicate [[hemorrhagic shock]]
* Elevated liver [[transaminases]]
* In [[cardiogenic shock]]:
** Elevated [[troponin]] I or [[troponin]] T levels
** Elevated [[creatine phosphokinase]]
** Elevated [[brain natriuretic peptide]], or N-terminal pro-brain natriuretic peptide
* [[Disseminated intravascular coagulopathy]] may occur as a complication, and is determined through elevated [[fibrin split products]] and [[D-dimer]] level with low [[fibrinogen]] level
|
* RUSH (Rapid [[ultrasound]] in shock) may detect the following:
** [[Pulmonary embolism]]
** [[Pericardial effusion]]
** [[Cardiac tamponade]]
** Reduced contractility of the right and left ventricle
** [[Pneumothorax]]
** [[Pulmonary edema]]
** Thoracic or [[abdominal aortic aneurysm]]
|
* May demonstrate the following:
** [[Pneumonia]]
** [[Pneumothorax]]
** [[Pulmonary edema]]
** Widened [[mediastinum]]
** Free air under the [[diaphragm]]
* May also determine etiology of [[shock]], such as:
** Intestinal obstruction
** [[Bowel perforation]]
|
* Can determine etiology of [[shock]], such as:
** Traumatic brain injury,
** [[Stroke]]
** Spinal injury
** [[Pneumonia]]
** [[Pneumothorax]]
** Ruptured [[aneurysm]]
** [[Aortic dissection]]
** Intestinal obstruction
** Bowel perforation
** [[Abscess]]
** [[Pulmonary embolism]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|-
|Third space losses<ref name="pmid10086438">{{cite journal |vauthors=McGee S, Abernethy WB, Simel DL |title=The rational clinical examination. Is this patient hypovolemic? |journal=JAMA |volume=281 |issue=11 |pages=1022–9 |date=March 1999 |pmid=10086438 |doi= |url=}}</ref><ref name="pmid5336422">{{cite journal |vauthors=Cohn JN |title=Blood pressure measurement in shock. Mechanism of inaccuracy in ausculatory and palpatory methods |journal=JAMA |volume=199 |issue=13 |pages=118–22 |date=March 1967 |pmid=5336422 |doi= |url=}}</ref><ref name="pmid17060544">{{cite journal |vauthors=Vinayak AG, Levitt J, Gehlbach B, Pohlman AS, Hall JB, Kress JP |title=Usefulness of the external jugular vein examination in detecting abnormal central venous pressure in critically ill patients |journal=Arch. Intern. Med. |volume=166 |issue=19 |pages=2132–7 |date=October 2006 |pmid=17060544 |doi=10.1001/archinte.166.19.2132 |url=}}</ref>
- Capillary leak
 
- [[Surgery]]
 
- [[Trauma]]
|<nowiki>+/-</nowiki>
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|<nowiki>-</nowiki>
|
* [[Normocytic normochromic anemia]]
* Decreased [[hematocrit]]
|
* Elevated [[BUN]] and [[creatinine]]
* Elevated GFR
|
* May demonstrate [[proteinuria]] or [[hematuria]]
|
* Elevated [[lactate dehydrogenase]]
* Elevated [[alkaline phosphatase]]
* Hypo or [[hypernatremia]]
* Hypo or [[hyperkalemia]]
|
* May visualize fluid collections
|
* More accurately visualize the following:
** Margins of trauma
** Fluid collection
|
* Useful for diagnosis of soft tissue injury
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|-
|[[Toxic megacolon]]<ref name="pmid5305933">{{cite journal |vauthors=Jalan KN, Sircus W, Card WI, Falconer CW, Bruce CB, Crean GP, McManus JP, Small WP, Smith AN |title=An experience of ulcerative colitis. I. Toxic dilation in 55 cases |journal=Gastroenterology |volume=57 |issue=1 |pages=68–82 |date=July 1969 |pmid=5305933 |doi= |url=}}</ref><ref name="pmid7555415">{{cite journal |vauthors=Trudel JL, Deschênes M, Mayrand S, Barkun AN |title=Toxic megacolon complicating pseudomembranous enterocolitis |journal=Dis. Colon Rectum |volume=38 |issue=10 |pages=1033–8 |date=October 1995 |pmid=7555415 |doi= |url=}}</ref><ref name="pmid14638335">{{cite journal |vauthors=Gan SI, Beck PL |title=A new look at toxic megacolon: an update and review of incidence, etiology, pathogenesis, and management |journal=Am. J. Gastroenterol. |volume=98 |issue=11 |pages=2363–71 |date=November 2003 |pmid=14638335 |doi=10.1111/j.1572-0241.2003.07696.x |url=}}</ref><ref name="pmid12067">{{cite journal |vauthors=Caprilli R, Vernia P, Colaneri O, Torsoli A |title=Blood pH: a test for assessment of severity in proctocolitis |journal=Gut |volume=17 |issue=10 |pages=763–9 |date=October 1976 |pmid=12067 |pmc=1411181 |doi= |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
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|
* [[Leukocytosis]] with left shift
* [[Anemia]] (if [[diarrhea]] is present)
|
* [[Creatinine]] and [[BUN]] may be elevated
|<nowiki>-</nowiki>
|
* [[Hyponatremia]] is common
|
* Elevated [[ESR]] and [[CRP]]
|
* Ultrasound may demonstrate the following:
** Loss of haustra
** Hypoechoic and thick bowel walls
** Dilated [[colon]] > 6cm
** Dilatation of ileal loops
** Presence of intraluminal gas and fluid
|
* The following is noted with x-ray:
* Dilated [[colon]]
* Loss of haustra
* Soft tissue masses
* Segmental parietal thinning
* Free intraperitoneal air
|
* May demonstrate the following:
** Bowel perforation
** [[Abscess]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Endoscopy]] and [[colonoscopy]] can aid diagnosis
|
|-
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Classification by etiology
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Etiology
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Clinical manifestations
! colspan="11" style="background:#4479BA; color: #FFFFFF;" |Paraclinical findings
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" |Comments
|-
! colspan="10" style="background:#4479BA; color: #FFFFFF;" |Symptoms and signs
! colspan="6" style="background:#4479BA; color: #FFFFFF;" |Lab findings
! colspan="5" style="background:#4479BA; color: #FFFFFF;" |Imaging
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" |Fatigue/Lethargy
! align="center" style="background:#4479BA; color: #FFFFFF;" |Thirst
! align="center" style="background:#4479BA; color: #FFFFFF;" |Dizziness/Confusion
! align="center" style="background:#4479BA; color: #FFFFFF;" |Muscle weakness/cramp
! align="center" style="background:#4479BA; color: #FFFFFF;" |Somatic/visceral pain
! align="center" style="background:#4479BA; color: #FFFFFF;" |Vomiting
! align="center" style="background:#4479BA; color: #FFFFFF;" |Diarrhea
! align="center" style="background:#4479BA; color: #FFFFFF;" |Tachypnea
! align="center" style="background:#4479BA; color: #FFFFFF;" |Haematuria/Proteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" |Edema
| align="center" style="background:#4479BA; color: #FFFFFF;" |CBC
| align="center" style="background:#4479BA; color: #FFFFFF;" |KFT
| align="center" style="background:#4479BA; color: #FFFFFF;" |Electrolytes
| align="center" style="background:#4479BA; color: #FFFFFF;" |Urine analysis
| align="center" style="background:#4479BA; color: #FFFFFF;" |ABG
| align="center" style="background:#4479BA; color: #FFFFFF;" |Other
| align="center" style="background:#4479BA; color: #FFFFFF;" |Ultrasound
| align="center" style="background:#4479BA; color: #FFFFFF;" |X-ray
| align="center" style="background:#4479BA; color: #FFFFFF;" |CT
| align="center" style="background:#4479BA; color: #FFFFFF;" |MRI
| align="center" style="background:#4479BA; color: #FFFFFF;" |Other
|-
! rowspan="14" style="background:#4479BA; color: #FFFFFF;" |Intrinsic renal
|[[Acute interstitial nephritis]]<ref name="pmid11020015">{{cite journal |vauthors=Schwarz A, Krause PH, Kunzendorf U, Keller F, Distler A |title=The outcome of acute interstitial nephritis: risk factors for the transition from acute to chronic interstitial nephritis |journal=Clin. Nephrol. |volume=54 |issue=3 |pages=179–90 |date=September 2000 |pmid=11020015 |doi= |url=}}</ref><ref name="pmid20336051">{{cite journal |vauthors=Praga M, González E |title=Acute interstitial nephritis |journal=Kidney Int. |volume=77 |issue=11 |pages=956–61 |date=June 2010 |pmid=20336051 |doi=10.1038/ki.2010.89 |url=}}</ref><ref name="pmid2113219">{{cite journal |vauthors=Buysen JG, Houthoff HJ, Krediet RT, Arisz L |title=Acute interstitial nephritis: a clinical and morphological study in 27 patients |journal=Nephrol. Dial. Transplant. |volume=5 |issue=2 |pages=94–9 |date=1990 |pmid=2113219 |doi= |url=}}</ref><ref name="pmid11473672">{{cite journal |vauthors=Rossert J |title=Drug-induced acute interstitial nephritis |journal=Kidney Int. |volume=60 |issue=2 |pages=804–17 |date=August 2001 |pmid=11473672 |doi=10.1046/j.1523-1755.2001.060002804.x |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Eosinophilia]] may be present
|
* Elevated [[creatinine]]
* High fractional [[sodium]] excretion
|<nowiki>-</nowiki>
|
* Eosinophiluria
* [[Sterile pyuria]]
* [[Microscopic hematuria]]
* [[Proteinuria]]
* Red cell or white cell casts
|<nowiki>-</nowiki>
|
* Patients with immunoglobulin G4 - related disease may have elevated serum total IgG and/or IgG4 levels
|
* [[Ultrasound]] demonstrates normal-sized kidneys
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* History of long term [[analgesic]] use is common
|-
|[[Acute tubular necrosis]]<ref name="pmid22890468">{{cite journal |vauthors=Khwaja A |title=KDIGO clinical practice guidelines for acute kidney injury |journal=Nephron Clin Pract |volume=120 |issue=4 |pages=c179–84 |date=2012 |pmid=22890468 |doi=10.1159/000339789 |url=}}</ref><ref name="pmid15680458">{{cite journal |vauthors=Lameire N, Van Biesen W, Vanholder R |title=Acute renal failure |journal=Lancet |volume=365 |issue=9457 |pages=417–30 |date=2005 |pmid=15680458 |doi=10.1016/S0140-6736(05)17831-3 |url=}}</ref><ref name="pmid17507907">{{cite journal |vauthors=Hsu CY, McCulloch CE, Fan D, Ordoñez JD, Chertow GM, Go AS |title=Community-based incidence of acute renal failure |journal=Kidney Int. |volume=72 |issue=2 |pages=208–12 |date=July 2007 |pmid=17507907 |pmc=2673495 |doi=10.1038/sj.ki.5002297 |url=}}</ref><ref name="pmid16495376">{{cite journal |vauthors=Waikar SS, Curhan GC, Wald R, McCarthy EP, Chertow GM |title=Declining mortality in patients with acute renal failure, 1988 to 2002 |journal=J. Am. Soc. Nephrol. |volume=17 |issue=4 |pages=1143–50 |date=April 2006 |pmid=16495376 |doi=10.1681/ASN.2005091017 |url=}}</ref><ref name="pmid16106006">{{cite journal |vauthors=Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C |title=Acute renal failure in critically ill patients: a multinational, multicenter study |journal=JAMA |volume=294 |issue=7 |pages=813–8 |date=August 2005 |pmid=16106006 |doi=10.1001/jama.294.7.813 |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Anemia]]
|
* Elevated [[creatinine]]
* Elevated [[BUN]]
* Elevated fractional excretion of [[sodium]]
|
* [[Hyponatremia]]
* [[Hyperkalemia]]
* [[Hypermagnesemia]]
* [[Hypocalcemia]]
* [[Hyperphosphatemia]]
|
* Pigmented, muddy brown, granular casts
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Ultrasound can determine:
** [[Obstructive uropathy]]
** Renal size
** Cortical thickness
** [[Hydronephrosis]]
|
* May be useful in cases with [[nephrolithiasis]]
|
* May be useful in cases with [[nephrolithiasis]]
* May also determine area of obstruction
|
* May also determine area of obstruction
|
* Renal biopsy may demonstrate the following:
** Loss of tubular cells or the denuded tubules
** Swollen tubular cells
** Loss of the cell brush border
* Useful kidney function biomarkers:
** Neutrophil gelatinase-associated lipocalin
** Interleukin-18
** Kidney injury molecule 1
** Cystatin C
** Sodium/hydrogen exchanger isoform 3
|
* [[Furosemide]] stress testing can predict stage
|-
|[[Cancer]]<ref name="pmid16360438">{{cite journal |vauthors=Gudbjartsson T, Thoroddsen A, Petursdottir V, Hardarson S, Magnusson J, Einarsson GV |title=Effect of incidental detection for survival of patients with renal cell carcinoma: results of population-based study of 701 patients |journal=Urology |volume=66 |issue=6 |pages=1186–91 |date=December 2005 |pmid=16360438 |doi=10.1016/j.urology.2005.07.009 |url=}}</ref><ref name="pmid5125665">{{cite journal |vauthors=Skinner DG, Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF |title=Diagnosis and management of renal cell carcinoma. A clinical and pathologic study of 309 cases |journal=Cancer |volume=28 |issue=5 |pages=1165–77 |date=November 1971 |pmid=5125665 |doi= |url=}}</ref><ref name="pmid788291">{{cite journal |vauthors=Gibbons RP, Monte JE, Correa RJ, Mason JT |title=Manifestations of renal cell carcinoma |journal=Urology |volume=8 |issue=3 |pages=201–6 |date=September 1976 |pmid=788291 |doi= |url=}}</ref><ref name="pmid7124769">{{cite journal |vauthors=Pras M, Franklin EC, Shibolet S, Frangione B |title=Amyloidosis associated with renal cell carcinoma of the AA type |journal=Am. J. Med. |volume=73 |issue=3 |pages=426–8 |date=September 1982 |pmid=7124769 |doi= |url=}}</ref><ref name="pmid4595951">{{cite journal |vauthors=Chisholm GD |title=Nephrogenic ridge tumors and their syndromes |journal=Ann. N. Y. Acad. Sci. |volume=230 |issue= |pages=403–23 |date=1974 |pmid=4595951 |doi= |url=}}</ref>
- [[Renal cell carcinoma]]
 
- [[Metastatic cancer]]
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|
* May reveal normocytic or [[microcytic anemia]]
* [[Leukocytosis]] or [[lymphocytosis]]
* Elevated [[reticulocytes]]
* [[Thrombocytopenia]]
* [[Leukopenia]]
* Blast cells
|
* Elevated [[BUN]]
* Elevated [[creatinine]]
* Decreased GFR
* Decreased or increased production of [[erythropoietin]]
|
* [[Hyponatremia]]
* [[Hypomagnesemia]]
* Hyper or [[hypocalcemia]]
* [[Hypophosphatemia]]
* Hyper or [[hypokalemia]]
|
* Gross [[hematuria]]
|<nowiki>-</nowiki>
|
* Elevated liver [[transaminases]]
|
* Ultrasound can detect fluid collection and morphologic change
* Flank mass
|
* Can delineate [[tumor]], visualize [[calcification]] and widened mediastinae
* [[Barium]] contrast may show filling defects
|
* May accurately visualize metastasis and determine staging
* Distinguish cystic from solid masses
* Determine [[lymph node]], [[renal vein]], and [[inferior vena cava]] involvement
|
* May determine soft tissue invasion and staging
|
* Percutaneous cyst puncture may aid diagnosis of malignant cystic lesions
|
* Histology can determine type of [[cancer]]
* [[Renal cell carcinoma]] can be divided into the following types:
** Clear cell (75%)
** Chromophilic (15%)
** Chromophobic (5%)
** Oncocytoma (3%)
** Collecting duct (2%)
|-
|[[Chronic kidney failure]]<ref name="pmid20054047">{{cite journal |vauthors=Abboud H, Henrich WL |title=Clinical practice. Stage IV chronic kidney disease |journal=N. Engl. J. Med. |volume=362 |issue=1 |pages=56–65 |date=January 2010 |pmid=20054047 |doi=10.1056/NEJMcp0906797 |url=}}</ref><ref name="pmid28614683">{{cite journal |vauthors=Denic A, Mathew J, Lerman LO, Lieske JC, Larson JJ, Alexander MP, Poggio E, Glassock RJ, Rule AD |title=Single-Nephron Glomerular Filtration Rate in Healthy Adults |journal=N. Engl. J. Med. |volume=376 |issue=24 |pages=2349–2357 |date=June 2017 |pmid=28614683 |pmc=5664219 |doi=10.1056/NEJMoa1614329 |url=}}</ref><ref name="pmid15738453">{{cite journal |vauthors=Sarnak MJ, Greene T, Wang X, Beck G, Kusek JW, Collins AJ, Levey AS |title=The effect of a lower target blood pressure on the progression of kidney disease: long-term follow-up of the modification of diet in renal disease study |journal=Ann. Intern. Med. |volume=142 |issue=5 |pages=342–51 |date=March 2005 |pmid=15738453 |doi= |url=}}</ref><ref name="pmid16408129">{{cite journal |vauthors=Eriksen BO, Ingebretsen OC |title=The progression of chronic kidney disease: a 10-year population-based study of the effects of gender and age |journal=Kidney Int. |volume=69 |issue=2 |pages=375–82 |date=January 2006 |pmid=16408129 |doi=10.1038/sj.ki.5000058 |url=}}</ref><ref name="pmid16790511">{{cite journal |vauthors=Hallan SI, Coresh J, Astor BC, Asberg A, Powe NR, Romundstad S, Hallan HA, Lydersen S, Holmen J |title=International comparison of the relationship of chronic kidney disease prevalence and ESRD risk |journal=J. Am. Soc. Nephrol. |volume=17 |issue=8 |pages=2275–84 |date=August 2006 |pmid=16790511 |doi=10.1681/ASN.2005121273 |url=}}</ref><ref name="pmid15262664">{{cite journal |vauthors=Hsu CY, Vittinghoff E, Lin F, Shlipak MG |title=The incidence of end-stage renal disease is increasing faster than the prevalence of chronic renal insufficiency |journal=Ann. Intern. Med. |volume=141 |issue=2 |pages=95–101 |date=July 2004 |pmid=15262664 |doi= |url=}}</ref>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Anemia]] is present
|
* Elevated [[creatinine]]
* Elevated [[BUN]]
* Decreased GFR
|
* [[Hyperkalemia]]
|
* [[Hypoalbuminuria]]
|
* Low [[bicarbonate]]
|
* To determine renal bone disease, the following may be performed:
** Serum [[phosphate]]
** 25 - hydroxyvitamin D
** [[Alkaline phosphatase]]
** [[Parathyroid hormone]]
* To determine kidney function, C - cystatin may be measured
|
* May indicate [[hydronephrosis]]
* [[Retroperitoneal fibrosis]]
* Mass
* Enlarged or shrunken kidneys
|
* May demonstrate [[nephrolithiasis]]
* Retrograde pyelogram may determine obstruction
|
* May determine renal masses, stones, and cysts
|
* Useful in those who are contraindicated for intravenous contrast
* May determine [[renal vein thrombosis]]
* Magnetic resonance [[angiography]] can diagnose [[renal artery stenosis]]
|
* Percutaneous renal [[biopsy]] is also useful in diagnosis
|
|-
|[[Congenital kidney disease]]<ref name="pmid12197558">{{cite journal |vauthors=Queisser-Luft A, Stolz G, Wiesel A, Schlaefer K, Spranger J |title=Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990-1998) |journal=Arch. Gynecol. Obstet. |volume=266 |issue=3 |pages=163–7 |date=July 2002 |pmid=12197558 |doi= |url=}}</ref><ref name="pmid19536081">{{cite journal |vauthors=Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, Innocenti ML, Somenzi D, Trivelli A, Caridi G, Izzi C, Scolari F, Mattioli G, Allegri L, Ghiggeri GM |title=Renal outcome in patients with congenital anomalies of the kidney and urinary tract |journal=Kidney Int. |volume=76 |issue=5 |pages=528–33 |date=September 2009 |pmid=19536081 |doi=10.1038/ki.2009.220 |url=}}</ref><ref name="pmid11992035">{{cite journal |vauthors=Glassberg KI |title=Normal and abnormal development of the kidney: a clinician's interpretation of current knowledge |journal=J. Urol. |volume=167 |issue=6 |pages=2339–50; discussion 2350–1 |date=June 2002 |pmid=11992035 |doi= |url=}}</ref><ref name="pmid19685083">{{cite journal |vauthors=Tabatabaeifar M, Schlingmann KP, Litwin M, Emre S, Bakkaloglu A, Mehls O, Antignac C, Schaefer F, Weber S |title=Functional analysis of BMP4 mutations identified in pediatric CAKUT patients |journal=Pediatr. Nephrol. |volume=24 |issue=12 |pages=2361–8 |date=December 2009 |pmid=19685083 |doi=10.1007/s00467-009-1287-6 |url=}}</ref><ref name="pmid19615554">{{cite journal |vauthors=Reidy KJ, Rosenblum ND |title=Cell and molecular biology of kidney development |journal=Semin. Nephrol. |volume=29 |issue=4 |pages=321–37 |date=July 2009 |pmid=19615554 |pmc=2789488 |doi=10.1016/j.semnephrol.2009.03.009 |url=}}</ref>
- [[Agenesis]]
 
- [[Dysplasia]]
 
- [[Hypoplasia]]
 
- [[Polycystic]]
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* Elevated [[hematocrit]]
|
* Decreased GFR
|
* [[Hypocalcemia]]
* [[Hypophosphatemia]]
|
* [[Microalbuminuria]]
* [[Uricosuria]]
|<nowiki>-</nowiki>
|
* Genetic testing for ADPKD1 and ADPKD2
|
* Ultrasound is the gold standard for visualization of cysts
|
* More sensitive than ultrasound and can detect small cysts (0.5 cm)
|
* Useful for determining kidney size and progression
* Magnetic resonance [[angiography]] may determine intracranial aneurysms
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|-
|[[End stage renal disease]]<ref name="pmid20054047">{{cite journal |vauthors=Abboud H, Henrich WL |title=Clinical practice. Stage IV chronic kidney disease |journal=N. Engl. J. Med. |volume=362 |issue=1 |pages=56–65 |date=January 2010 |pmid=20054047 |doi=10.1056/NEJMcp0906797 |url=}}</ref><ref name="pmid28614683">{{cite journal |vauthors=Denic A, Mathew J, Lerman LO, Lieske JC, Larson JJ, Alexander MP, Poggio E, Glassock RJ, Rule AD |title=Single-Nephron Glomerular Filtration Rate in Healthy Adults |journal=N. Engl. J. Med. |volume=376 |issue=24 |pages=2349–2357 |date=June 2017 |pmid=28614683 |pmc=5664219 |doi=10.1056/NEJMoa1614329 |url=}}</ref><ref name="pmid15738453">{{cite journal |vauthors=Sarnak MJ, Greene T, Wang X, Beck G, Kusek JW, Collins AJ, Levey AS |title=The effect of a lower target blood pressure on the progression of kidney disease: long-term follow-up of the modification of diet in renal disease study |journal=Ann. Intern. Med. |volume=142 |issue=5 |pages=342–51 |date=March 2005 |pmid=15738453 |doi= |url=}}</ref><ref name="pmid16408129">{{cite journal |vauthors=Eriksen BO, Ingebretsen OC |title=The progression of chronic kidney disease: a 10-year population-based study of the effects of gender and age |journal=Kidney Int. |volume=69 |issue=2 |pages=375–82 |date=January 2006 |pmid=16408129 |doi=10.1038/sj.ki.5000058 |url=}}</ref><ref name="pmid16790511">{{cite journal |vauthors=Hallan SI, Coresh J, Astor BC, Asberg A, Powe NR, Romundstad S, Hallan HA, Lydersen S, Holmen J |title=International comparison of the relationship of chronic kidney disease prevalence and ESRD risk |journal=J. Am. Soc. Nephrol. |volume=17 |issue=8 |pages=2275–84 |date=August 2006 |pmid=16790511 |doi=10.1681/ASN.2005121273 |url=}}</ref><ref name="pmid15262664">{{cite journal |vauthors=Hsu CY, Vittinghoff E, Lin F, Shlipak MG |title=The incidence of end-stage renal disease is increasing faster than the prevalence of chronic renal insufficiency |journal=Ann. Intern. Med. |volume=141 |issue=2 |pages=95–101 |date=July 2004 |pmid=15262664 |doi= |url=}}</ref>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
|
* Elevated [[creatinine]]
* Elevated [[BUN]]
* Decreased GFR
|
* [[Hyperkalemia]]
|
* [[Hypoalbuminuria]]
|
* Low [[bicarbonate]]
|
* To determine renal bone disease, the following may be performed:
** Serum [[phosphate]]
** 25 - hydroxyvitamin D
** [[Alkaline phosphatase]]
** [[Parathyroid hormone]]
* To determine kidney function, C - cystatin may be measured
|
* May indicate [[hydronephrosis]]
* [[Retroperitoneal fibrosis]]
* Mass
* Enlarged or shrunken kidneys
|
* May demonstrate [[nephrolithiasis]]
* Retrograde pyelogram may determine obstruction
|
* May determine renal masses, stones,  and cysts
|
* Useful in those who are contraindicated for intravenous contrast
* May determine [[renal vein thrombosis]]
* Magnetic resonance [[angiography]] can diagnose [[[renal artery stenosis]]
|
* Percutaneous renal [[biopsy]] is also useful in diagnosis
|
|-
|Endogenous toxins<ref name="pmid20533382">{{cite journal |vauthors=Borowitz MJ, Craig FE, Digiuseppe JA, Illingworth AJ, Rosse W, Sutherland DR, Wittwer CT, Richards SJ |title=Guidelines for the diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria and related disorders by flow cytometry |journal=Cytometry B Clin Cytom |volume=78 |issue=4 |pages=211–30 |date=July 2010 |pmid=20533382 |doi=10.1002/cyto.b.20525 |url=}}</ref><ref name="pmid6282181">{{cite journal |vauthors=Knochel JP |title=Rhabdomyolysis and myoglobinuria |journal=Annu. Rev. Med. |volume=33 |issue= |pages=435–43 |date=1982 |pmid=6282181 |doi=10.1146/annurev.me.33.020182.002251 |url=}}</ref><ref name="pmid17338959">{{cite journal |vauthors=Giannoglou GD, Chatzizisis YS, Misirli G |title=The syndrome of rhabdomyolysis: Pathophysiology and diagnosis |journal=Eur. J. Intern. Med. |volume=18 |issue=2 |pages=90–100 |date=March 2007 |pmid=17338959 |doi=10.1016/j.ejim.2006.09.020 |url=}}</ref><ref name="pmid6645213">{{cite journal |vauthors=Coe FL |title=Uric acid and calcium oxalate nephrolithiasis |journal=Kidney Int. |volume=24 |issue=3 |pages=392–403 |date=September 1983 |pmid=6645213 |doi= |url=}}</ref><ref name="pmid15202612">{{cite journal |vauthors=Maalouf NM, Cameron MA, Moe OW, Sakhaee K |title=Novel insights into the pathogenesis of uric acid nephrolithiasis |journal=Curr. Opin. Nephrol. Hypertens. |volume=13 |issue=2 |pages=181–9 |date=March 2004 |pmid=15202612 |doi= |url=}}</ref>
- [[Hemoglobin]]
 
- [[Myoglobin]]
 
- [[Uric acid]]
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* May indicate [[anemia]] or [[thrombocytopenia]]
|
* Elevated [[BUN]]
* Elevated [[creatinine]]
* Decreased GFR
|
* [[Hyperkalemia]]
* [[Hypocalcemia]]  due to [[hyperphosphatemia]]
* [[Hyperuricemia]]
|
* [[Uricosuria]]
* [[Hematuria]]
* [[Myoglobinuria]]
* Casts
* Urinary sediment
|<nowiki>-</nowiki>
|
* Elevated [[creatine kinase]] > 1000 U/L
|
* Ultrasound may determine the following:
** Malignant or cystic lesions
** [[Hydronephrosis]]
** [[Hydroureter]]
** [[Nephrocalcinosis]]
** Urolithiasis
|<nowiki>-</nowiki>
|
* Spiral CT may determine the following:
** Urolithiasis
** [[Wilms tumor]]
** [[Polycystic kidney disease]]
|<nowiki>-</nowiki>
|
* Voiding cystourethrograms may detect ureter or bladder abnormalities
* Radionuclide studies may visualize calculi
|
|-
|[[Glomerulonephritis]]<ref name="pmid2915517">{{cite journal |vauthors=Ellis EN, Mauer SM, Sutherland DE, Steffes MW |title=Glomerular capillary morphology in normal humans |journal=Lab. Invest. |volume=60 |issue=2 |pages=231–6 |date=February 1989 |pmid=2915517 |doi= |url=}}</ref><ref name="pmid27373970">{{cite journal |vauthors=Dickinson BL |title=Unraveling the immunopathogenesis of glomerular disease |journal=Clin. Immunol. |volume=169 |issue= |pages=89–97 |date=August 2016 |pmid=27373970 |doi=10.1016/j.clim.2016.06.011 |url=}}</ref><ref name="pmid7955787">{{cite journal |vauthors=Trachtman H, Bergwerk A, Gauthier B |title=Isolated proteinuria in children. Natural history and indications for renal biopsy |journal=Clin Pediatr (Phila) |volume=33 |issue=8 |pages=468–72 |date=August 1994 |pmid=7955787 |doi=10.1177/000992289403300804 |url=}}</ref><ref name="pmid15910953">{{cite journal |vauthors=Chadban SJ, Atkins RC |title=Glomerulonephritis |journal=Lancet |volume=365 |issue=9473 |pages=1797–806 |date=2005 |pmid=15910953 |doi=10.1016/S0140-6736(05)66583-X |url=}}</ref><ref name="pmid8361123">{{cite journal |vauthors=Couser WG |title=Pathogenesis of glomerulonephritis |journal=Kidney Int. Suppl. |volume=42 |issue= |pages=S19–26 |date=July 1993 |pmid=8361123 |doi= |url=}}</ref><ref name="pmid10620563">{{cite journal |vauthors=Rodriguez-Iturbe B |title=Postinfectious glomerulonephritis |journal=Am. J. Kidney Dis. |volume=35 |issue=1 |pages=XLVI–XLVIII |date=January 2000 |pmid=10620563 |doi= |url=}}</ref><ref name="pmid333598">{{cite journal |vauthors=Sanjad S, Tolaymat A, Whitworth J, Levin S |title=Acute glomerulonephritis in children: a review of 153 cases |journal=South. Med. J. |volume=70 |issue=10 |pages=1202–6 |date=October 1977 |pmid=333598 |doi= |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Pleocytosis]]
* [[Anemia]]
* [[Leukocytosis]]
|
* Elevated [[BUN]] and [[creatinine]]
|<nowiki>-</nowiki>
|
* Specific gravity > 1.020
* [[Proteinuria]]
* [[Hematuria]]
* [[Red blood cell]] casts
* [[White blood cell]] casts
* Dysmorphic RBCs
* [[Acanthocytes]]
* Cellular casts
* Granular casts
* Oval fat bodies
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Elevated [[ESR]]
* Elevated complement C3, C4, CH50
* Streptozyme test to screen for streptococcal antigens
* Blood and tissue culture may aid diagnosis
* Other useful tests include:
** [[Antinuclear antibodies]]
** Anti-DNA antibodies
** [[Cryoglobulin]]s
** Serum [[albumin]]
** [[Triglyceride]] levels
** [[Hepatitis B]] and C serologies
** [[Antineutrophil cytoplasmic antibody]] ([[ANCA]])
|
* May determine the following:
** Kidney size
** Echogenicity of the renal cortex
** Obstruction
** Degree of [[fibrosis]]
|
* To exclude the following:
** [[Granulomatosis with polyangiitis]] (Wegener granulomatosis)
** [[Goodpasture syndrome]]
** Pulmonary congestion
|
* To exclude the following:
** [[Granulomatosis with polyangiitis]] (Wegener granulomatosis)
** [[Goodpasture syndrome]]
** Pulmonary congestion
* To visualize visceral abscesses
|<nowiki>-</nowiki>
|
* Renal [[biopsy]] may aid diagnosis
* Light and electron microscopy may have specific findings and determine pathology
* Immunofluorescence may also exhibit diagnostic findings
|-
|[[Goodpasture syndrome]]<ref name="pmid12969182">{{cite journal |vauthors=Pusey CD |title=Anti-glomerular basement membrane disease |journal=Kidney Int. |volume=64 |issue=4 |pages=1535–50 |date=October 2003 |pmid=12969182 |doi=10.1046/j.1523-1755.2003.00241.x |url=}}</ref><ref name="pmid8914046">{{cite journal |vauthors=Bolton WK |title=Goodpasture's syndrome |journal=Kidney Int. |volume=50 |issue=5 |pages=1753–66 |date=November 1996 |pmid=8914046 |doi= |url=}}</ref><ref name="pmid8589284">{{cite journal |vauthors=Kalluri R, Wilson CB, Weber M, Gunwar S, Chonko AM, Neilson EG, Hudson BG |title=Identification of the alpha 3 chain of type IV collagen as the common autoantigen in antibasement membrane disease and Goodpasture syndrome |journal=J. Am. Soc. Nephrol. |volume=6 |issue=4 |pages=1178–85 |date=October 1995 |pmid=8589284 |doi= |url=}}</ref><ref name="pmid12815141">{{cite journal |vauthors=Hudson BG, Tryggvason K, Sundaramoorthy M, Neilson EG |title=Alport's syndrome, Goodpasture's syndrome, and type IV collagen |journal=N. Engl. J. Med. |volume=348 |issue=25 |pages=2543–56 |date=June 2003 |pmid=12815141 |doi=10.1056/NEJMra022296 |url=}}</ref><ref name="pmid8621555">{{cite journal |vauthors=Kalluri R, Sun MJ, Hudson BG, Neilson EG |title=The Goodpasture autoantigen. Structural delineation of two immunologically privileged epitopes on alpha3(IV) chain of type IV collagen |journal=J. Biol. Chem. |volume=271 |issue=15 |pages=9062–8 |date=April 1996 |pmid=8621555 |doi= |url=}}</ref><ref name="pmid10027929">{{cite journal |vauthors=Leinonen A, Netzer KO, Boutaud A, Gunwar S, Hudson BG |title=Goodpasture antigen: expression of the full-length alpha3(IV) chain of collagen IV and localization of epitopes exclusively to the noncollagenous domain |journal=Kidney Int. |volume=55 |issue=3 |pages=926–35 |date=March 1999 |pmid=10027929 |doi=10.1046/j.1523-1755.1999.055003926.x |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Anemia]]
* [[Leukocytosis]]
|
* Elevated [[BUN]]
* Elevated [[creatinine]]
|<nowiki>-</nowiki>
|
* Low-grade [[proteinuria]]
* Gross or [[microscopic hematuria]]
* [[Red blood cell] casts
|<nowiki>-</nowiki>
|
* Anti– glomerular [[basement membrane]] antibody testing is positive by radioimmunoassays or enzyme-linked immunosorbent assays
* [[Antineutrophilic cytoplasmic antibody]] testing is positive for c- or p- ANCA
* Elevated [[ESR]]
|<nowiki>-</nowiki>
|
* Bilateral, basal, patchy parenchymal consolidations
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Pulmonary [[biopsy]] will demonstrate diffuse [[alveolar hemorrhage]]
|
|-
|[[Hemolytic uremic syndrome]]<ref name="pmid15728781">{{cite journal |vauthors=Noris M, Remuzzi G |title=Hemolytic uremic syndrome |journal=J. Am. Soc. Nephrol. |volume=16 |issue=4 |pages=1035–50 |date=April 2005 |pmid=15728781 |doi=10.1681/ASN.2004100861 |url=}}</ref><ref name="pmid27989322">{{cite journal |vauthors=Goodship TH, Cook HT, Fakhouri F, Fervenza FC, Frémeaux-Bacchi V, Kavanagh D, Nester CM, Noris M, Pickering MC, Rodríguez de Córdoba S, Roumenina LT, Sethi S, Smith RJ |title=Atypical hemolytic uremic syndrome and C3 glomerulopathy: conclusions from a "Kidney Disease: Improving Global Outcomes" (KDIGO) Controversies Conference |journal=Kidney Int. |volume=91 |issue=3 |pages=539–551 |date=March 2017 |pmid=27989322 |doi=10.1016/j.kint.2016.10.005 |url=}}</ref><ref name="pmid25859752">{{cite journal |vauthors=Loirat C, Fakhouri F, Ariceta G, Besbas N, Bitzan M, Bjerre A, Coppo R, Emma F, Johnson S, Karpman D, Landau D, Langman CB, Lapeyraque AL, Licht C, Nester C, Pecoraro C, Riedl M, van de Kar NC, Van de Walle J, Vivarelli M, Frémeaux-Bacchi V |title=An international consensus approach to the management of atypical hemolytic uremic syndrome in children |journal=Pediatr. Nephrol. |volume=31 |issue=1 |pages=15–39 |date=January 2016 |pmid=25859752 |doi=10.1007/s00467-015-3076-8 |url=}}</ref><ref name="pmid16932353">{{cite journal |vauthors=Noris M, Remuzzi G |title=Genetic abnormalities of complement regulators in hemolytic uremic syndrome: how do they affect patient management? |journal=Nat Clin Pract Nephrol |volume=1 |issue=1 |pages=2–3 |date=November 2005 |pmid=16932353 |doi=10.1038/ncpneph0018 |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* Severe [[anemia]]
* [[Thrombocytopenia]]
|
* Elevated [[BUN]]
* Elevated [[creatinine]]
|<nowiki>-</nowiki>
|
* Mild [[proteinuria]]
* [[Red blood cell]]s
* [[Red blood cell]] casts
|<nowiki>-</nowiki>
|
* Peripheral [[blood smear]] demonstrates [[schistocyte]]s
* Prolonged [[activated partial thromboplastin time]] 
* Elevated [[fibrinogen]] degradation product and [[D-dimer]]
* Elevated [[bilirubin]]
* Elevated [[lactate dehydrogenase]]
* Decreased [[haptoglobin]]
* Stool culture may be postive for [[E coli]] 0157:H7 or [[shigella]]
* ADAMTS-13 activity is severely decreased 
|
* Helpful in ruling out obstruction
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Renal [[biopsy]] may demonstrate the following:
** Diffuse thickening of the glomerular capillary wall
** Swelling of endothelial cells
** Fibrin [[thrombi]]
|
|-
|-
|[[Nephrolithiasis]]<ref name="pmid23283137">{{cite journal |vauthors=Fwu CW, Eggers PW, Kimmel PL, Kusek JW, Kirkali Z |title=Emergency department visits, use of imaging, and drugs for urolithiasis have increased in the United States |journal=Kidney Int. |volume=83 |issue=3 |pages=479–86 |date=March 2013 |pmid=23283137 |pmc=3587650 |doi=10.1038/ki.2012.419 |url=}}</ref><ref name="pmid26349951">{{cite journal |vauthors=Singh P, Enders FT, Vaughan LE, Bergstralh EJ, Knoedler JJ, Krambeck AE, Lieske JC, Rule AD |title=Stone Composition Among First-Time Symptomatic Kidney Stone Formers in the Community |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1356–65 |date=October 2015 |pmid=26349951 |pmc=4593754 |doi=10.1016/j.mayocp.2015.07.016 |url=}}</ref><ref name="pmid14960744">{{cite journal |vauthors=Teichman JM |title=Clinical practice. Acute renal colic from ureteral calculus |journal=N. Engl. J. Med. |volume=350 |issue=7 |pages=684–93 |date=February 2004 |pmid=14960744 |doi=10.1056/NEJMcp030813 |url=}}</ref><ref name="pmid7862980">{{cite journal |vauthors=Smith RC, Rosenfield AT, Choe KA, Essenmacher KR, Verga M, Glickman MG, Lange RC |title=Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography |journal=Radiology |volume=194 |issue=3 |pages=789–94 |date=March 1995 |pmid=7862980 |doi=10.1148/radiology.194.3.7862980 |url=}}</ref><ref name="pmid11743350">{{cite journal |vauthors=Williams JC, Paterson RF, Kopecky KK, Lingeman JE, McAteer JA |title=High resolution detection of internal structure of renal calculi by helical computerized tomography |journal=J. Urol. |volume=167 |issue=1 |pages=322–6 |date=January 2002 |pmid=11743350 |doi= |url=}}</ref><ref name="pmid14744345">{{cite journal |vauthors=Oehlschläger S, Hakenberg OW, Froehner M, Manseck A, Wirth MP |title=Evaluation of chemical composition of urinary calculi by conventional radiography |journal=J. Endourol. |volume=17 |issue=10 |pages=841–5 |date=December 2003 |pmid=14744345 |doi=10.1089/089277903772036109 |url=}}</ref>
!
|<nowiki>-</nowiki>
!
|<nowiki>-</nowiki>
!
|<nowiki>-</nowiki>
!
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Mild [[leukocytosis]]
|
* Elevated [[creatinine]]
* Elevated [[BUN]]
|
* [[Hypercalcemia]]
* Hyper or [[hyponatremia]]
* Hyper or [[hypokalemia]]
* [[Hyperuricemia]]
|
* Gross or [[microscopic hematuria]]
* [[Red blood cell]]s or [[white blood cell]]s
* [[Pyuria]]
* Urinary crystals of [[calcium oxalate]], [[uric acid]], or [[cystine]]
* [[Hypercalciuria]]
* Urinary pH > 7  may indicate an infection with urea-splitting bacteria such as:
** [[Proteus]]
** [[Pseudomonas]]
** [[Klebsiella]], and may lead to struvite stones
* Urinary pH < 5 indicates likely formation of [[uric acid]] stones
|
* Decreased serum [[bicarbonate]] with [[hypokalemia]] may indicate [[renal tubular acidosis]]
|
* Elevated [[CRP]]
|
* All types of stones are visible
* May demonstrate the following:
** [[Hydronephrosis]]
** Ureteral dilation
** [[Abdominal aortic aneurysm]]
** [[Cholelithiasis]]
* Safe in pregnancy but may miss small stones
|
* [[Calcium]] - containing stones are radio-opaque
* [[Uric acid]] or [[cystine]] stones are radiolucent
* Plain or KUB (kidney-ureter-bladder) radiograph may determine stone characteristics such as:
** Size
** Shape
** Composition
** Location
** Differentiate between a phlebolith and an obstructing calcific stone
* Stone movement may also be monitored
|
* Most sensitive modality for renal stones
* Can estimate stone density, size and composition
* CT is able to determine pathology secondary to renal stones, such as:
**  Ureteral dilation
** [[Hydronephrosis]]
** Nephromegaly
** Perinephric fat streaking
* No contrast needed and can diagnose other pathologies, such as:
** [[Abdominal aortic aneurysm]]
** [[Appendicitis]]
** [[Pancreatitis]]
** [[Cholecystitis]]
** Ovarian disorders
** [[Diverticular disease]]
** [[Renal cell carcinoma]]
|<nowiki>-</nowiki>
|
* Intravenous pyelography (IVP) visualizes entire urinary system and is gold standard for the diagnosis of ureterolithiasis
* Renal tomography can determine similar findings as CT, however has been largely replaced by CT
* Nuclear renal scan can determine renal function
|
|-
|-
|[[Nephrotic syndrome]]<ref name="pmid1996578">{{cite journal |vauthors=Praga M, Borstein B, Andres A, Arenas J, Oliet A, Montoyo C, Ruilope LM, Rodicio JL |title=Nephrotic proteinuria without hypoalbuminemia: clinical characteristics and response to angiotensin-converting enzyme inhibition |journal=Am. J. Kidney Dis. |volume=17 |issue=3 |pages=330–8 |date=March 1991 |pmid=1996578 |doi= |url=}}</ref><ref name="pmid9370176">{{cite journal |vauthors=Haas M, Meehan SM, Karrison TG, Spargo BH |title=Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976-1979 and 1995-1997 |journal=Am. J. Kidney Dis. |volume=30 |issue=5 |pages=621–31 |date=November 1997 |pmid=9370176 |doi= |url=}}</ref><ref name="pmid16968733">{{cite journal |vauthors=Malafronte P, Mastroianni-Kirsztajn G, Betônico GN, Romão JE, Alves MA, Carvalho MF, Viera Neto OM, Cadaval RA, Bérgamo RR, Woronik V, Sens YA, Marrocos MS, Barros RT |title=Paulista Registry of glomerulonephritis: 5-year data report |journal=Nephrol. Dial. Transplant. |volume=21 |issue=11 |pages=3098–105 |date=November 2006 |pmid=16968733 |doi=10.1093/ndt/gfl237 |url=}}</ref><ref name="pmid20947631">{{cite journal |vauthors=Hausmann R, Kuppe C, Egger H, Schweda F, Knecht V, Elger M, Menzel S, Somers D, Braun G, Fuss A, Uhlig S, Kriz W, Tanner G, Floege J, Moeller MJ |title=Electrical forces determine glomerular permeability |journal=J. Am. Soc. Nephrol. |volume=21 |issue=12 |pages=2053–8 |date=December 2010 |pmid=20947631 |pmc=3014018 |doi=10.1681/ASN.2010030303 |url=}}</ref><ref name="pmid15146236">{{cite journal |vauthors=Reiser J, von Gersdorff G, Loos M, Oh J, Asanuma K, Giardino L, Rastaldi MP, Calvaresi N, Watanabe H, Schwarz K, Faul C, Kretzler M, Davidson A, Sugimoto H, Kalluri R, Sharpe AH, Kreidberg JA, Mundel P |title=Induction of B7-1 in podocytes is associated with nephrotic syndrome |journal=J. Clin. Invest. |volume=113 |issue=10 |pages=1390–7 |date=May 2004 |pmid=15146236 |pmc=406528 |doi=10.1172/JCI20402 |url=}}</ref><ref name="pmid21110043">{{cite journal |vauthors=Gbadegesin R, Lavin P, Foreman J, Winn M |title=Pathogenesis and therapy of focal segmental glomerulosclerosis: an update |journal=Pediatr. Nephrol. |volume=26 |issue=7 |pages=1001–15 |date=July 2011 |pmid=21110043 |pmc=3624015 |doi=10.1007/s00467-010-1692-x |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|
|
* Serum [[creatinine]] is normal in uncomplicated [[nephrotic syndrome]]
* Serum [[albumin]] is decreased
|<nowiki>-</nowiki>
|
|
* [[Proteinuria]] > 3.5g/day
* The following may or may not be present
** [[Waxy casts]]
** [[Oval fat bodies]]
** [[Fatty casts]]
** Granular casts
** [[Microhematuria]]
** Dysmorphic RBCs
|<nowiki>-</nowiki>
|
|
* Genetic screening for NPHS1 and NPHS2 mutations
* Renal [[biopsy]] aids diagnosis
* Other useful tests:
** [[Hepatitis B]] and C
** [[HIV]]
** [[Syphilis]]
** [[Antinuclear antibody]]
** Anti–double stranded DNA antibodies
** Complement
* Absence of phospholipase A2 receptor may indicate secondary [[nephrotic syndrome]]
|
|
* Ultrasound scanning may demonstrate focal glomerulosclerosis
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|-
|-
|[[Thrombosis]]<ref name="pmid17606842">{{cite journal |vauthors=Scolari F, Ravani P, Gaggi R, Santostefano M, Rollino C, Stabellini N, Colla L, Viola BF, Maiorca P, Venturelli C, Bonardelli S, Faggiano P, Barrett BJ |title=The challenge of diagnosing atheroembolic renal disease: clinical features and prognostic factors |journal=Circulation |volume=116 |issue=3 |pages=298–304 |date=July 2007 |pmid=17606842 |doi=10.1161/CIRCULATIONAHA.106.680991 |url=}}</ref><ref name="pmid12761259">{{cite journal |vauthors=Scolari F, Ravani P, Pola A, Guerini S, Zubani R, Movilli E, Savoldi S, Malberti F, Maiorca R |title=Predictors of renal and patient outcomes in atheroembolic renal disease: a prospective study |journal=J. Am. Soc. Nephrol. |volume=14 |issue=6 |pages=1584–90 |date=June 2003 |pmid=12761259 |doi= |url=}}</ref><ref name="pmid3906225">{{cite journal |vauthors=Llach F |title=Hypercoagulability, renal vein thrombosis, and other thrombotic complications of nephrotic syndrome |journal=Kidney Int. |volume=28 |issue=3 |pages=429–39 |date=September 1985 |pmid=3906225 |doi= |url=}}</ref><ref name="pmid7967339">{{cite journal |vauthors=Rabelink TJ, Zwaginga JJ, Koomans HA, Sixma JJ |title=Thrombosis and hemostasis in renal disease |journal=Kidney Int. |volume=46 |issue=2 |pages=287–96 |date=August 1994 |pmid=7967339 |doi= |url=}}</ref><ref name="pmid15524054">{{cite journal |vauthors=Crew RJ, Radhakrishnan J, Appel G |title=Complications of the nephrotic syndrome and their treatment |journal=Clin. Nephrol. |volume=62 |issue=4 |pages=245–59 |date=October 2004 |pmid=15524054 |doi= |url=}}</ref><ref name="pmid15990160">{{cite journal |vauthors=Singhal R, Brimble KS |title=Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management |journal=Thromb. Res. |volume=118 |issue=3 |pages=397–407 |date=2006 |pmid=15990160 |doi=10.1016/j.thromres.2005.03.030 |url=}}</ref>
- [[Renal vein]]
- [[Renal artery]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|
* Elevated [[creatinine]]
* Elevated [[BUN]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Hypercholesterolemia]]
* [[Hypoalbuminemia]]
* Complementemia
|
|
* Ultrasound may demonstrate the following:
** Echo-poor medullary pyramids
|
|
* Visualizes the [[renal vein]]s and is the modality of choice
|
|
* Visualizes blood flow, vessel walls, and adjacent tissues
|<nowiki>-</nowiki>
|
* Renal [[biopsy]], inferior vena cavography, and renal arteriography may aid diagnosis
* IVP may reveal an enlarged kidney
|
|
|-
|-
|[[Transplant rejection]]<ref name="pmid28052609">{{cite journal |vauthors=Hart A, Smith JM, Skeans MA, Gustafson SK, Stewart DE, Cherikh WS, Wainright JL, Kucheryavaya A, Woodbury M, Snyder JJ, Kasiske BL, Israni AK |title=OPTN/SRTR 2015 Annual Data Report: Kidney |journal=Am. J. Transplant. |volume=17 Suppl 1 |issue= |pages=21–116 |date=January 2017 |pmid=28052609 |pmc=5527691 |doi=10.1111/ajt.14124 |url=}}</ref><ref name="pmid18337655">{{cite journal |vauthors=Opelz G, Döhler B |title=Influence of time of rejection on long-term graft survival in renal transplantation |journal=Transplantation |volume=85 |issue=5 |pages=661–6 |date=March 2008 |pmid=18337655 |doi=10.1097/TP.0b013e3181661695 |url=}}</ref><ref name="pmid11052270">{{cite journal |vauthors=Madden RL, Mulhern JG, Benedetto BJ, O'Shea MH, Germain MJ, Braden GL, O'Shaughnessy J, Lipkowitz GS |title=Completely reversed acute rejection is not a significant risk factor for the development of chronic rejection in renal allograft recipients |journal=Transpl. Int. |volume=13 |issue=5 |pages=344–50 |date=2000 |pmid=11052270 |doi= |url=}}</ref><ref name="pmid9210497">{{cite journal |vauthors=Vereerstraeten P, Abramowicz D, de Pauw L, Kinnaert P |title=Absence of deleterious effect on long-term kidney graft survival of rejection episodes with complete functional recovery |journal=Transplantation |volume=63 |issue=12 |pages=1739–43 |date=June 1997 |pmid=9210497 |doi= |url=}}</ref><ref name="pmid21511091">{{cite journal |vauthors=Martinu T, Pavlisko EN, Chen DF, Palmer SM |title=Acute allograft rejection: cellular and humoral processes |journal=Clin. Chest Med. |volume=32 |issue=2 |pages=295–310 |date=June 2011 |pmid=21511091 |pmc=3089893 |doi=10.1016/j.ccm.2011.02.008 |url=}}</ref><ref name="pmid26454740">{{cite journal |vauthors=Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Goldfarb SB, Levvey BJ, Lund LH, Meiser B, Rossano JW, Stehlik J |title=The Registry of the International Society for Heart and Lung Transplantation: Thirty-second Official Adult Lung and Heart-Lung Transplantation Report--2015; Focus Theme: Early Graft Failure |journal=J. Heart Lung Transplant. |volume=34 |issue=10 |pages=1264–77 |date=October 2015 |pmid=26454740 |doi=10.1016/j.healun.2015.08.014 |url=}}</ref>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Lymphcytosis]] may be present
* [[Eosinophilia]] may occur
|
* Acute elevation in serum [[creatinine]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|
* [[Proteinuria]] > 1g/day
* [[Pyuria]] may be present
|<nowiki>-</nowiki>
|
|
* Plasma levels of donor-derived cell-free DNA is elevated > 1% and is released from the dead cells of the graft
* Positive detection of complement split product C4d
* Elevated endothelial activation and injury transcripts 
|
|
* May demonstrate the following
** Increased graft (kidney) size
** Loss of corticomedullary boundary
** Hypoechoic pyramids
** Decreased echogenicity of renal sinuses
* May also demonstrate other pathologies:
** Ureteral obstruction
** [[Acute tubular necrosis]]
** Renal vein occlusion
** [[Pyelonephritis]]
** [[Cyclosporine]] toxicity
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|
* Acute antibody-mediated rejection will demonstrate the following on histology:
** Patchy mononuclear cell infiltrates
** Swollen endothelium
** [[Fibrinoid necrosis]]
** Presence of fibrin [[thrombi]]
** Cortical [[necrosis]]
|
* [[Chronic rejection]] does not usually manifest with [[oliguria]] and/or [[anuria]]
|-
|}
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 17:32, 14 January 2019


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

Tables

Diagnosis Lab findings

References

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