Acute tubular necrosis laboratory findings: Difference between revisions
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*** Limitations of the [[Fractional sodium excretion|fractional excretion of sodium]] percent: Some conditions include, [[Contrast media|radio contrast media]] induced nephropathy, acute tubular necrosis in the presence of cirrhosis and congestive heart failure, and rhabdomyolysis may have <1%. | *** Limitations of the [[Fractional sodium excretion|fractional excretion of sodium]] percent: Some conditions include, [[Contrast media|radio contrast media]] induced nephropathy, acute tubular necrosis in the presence of cirrhosis and congestive heart failure, and rhabdomyolysis may have <1%. | ||
** [[Urine]] [[osmolarity]]:<ref name="pmid666184">{{cite journal |vauthors=Miller TR, Anderson RJ, Linas SL, Henrich WL, Berns AS, Gabow PA, Schrier RW |title=Urinary diagnostic indices in acute renal failure: a prospective study |journal=Ann. Intern. Med. |volume=89 |issue=1 |pages=47–50 |date=July 1978 |pmid=666184 |doi= |url=}}</ref> <350 mosmol/kg | ** [[Urine]] [[osmolarity]]:<ref name="pmid666184">{{cite journal |vauthors=Miller TR, Anderson RJ, Linas SL, Henrich WL, Berns AS, Gabow PA, Schrier RW |title=Urinary diagnostic indices in acute renal failure: a prospective study |journal=Ann. Intern. Med. |volume=89 |issue=1 |pages=47–50 |date=July 1978 |pmid=666184 |doi= |url=}}</ref> <350 mosmol/kg | ||
* Serum electrolyte abnormalities: | * Serum [[Electrolyte disturbance|electrolyte abnormalities]]: [[Hypokalemia]], [[hypophosphatemia]], [[hyponatremia]], [[hypocalcemia]], and [[hypomagnesemia]] may be found.<ref name="pmid27267762">{{cite journal |vauthors=Satirapoj B, Kongthaworn S, Choovichian P, Supasyndh O |title=Electrolyte disturbances and risk factors of acute kidney injury patients receiving dialysis in exertional heat stroke |journal=BMC Nephrol |volume=17 |issue=1 |pages=55 |date=June 2016 |pmid=27267762 |pmc=4895821 |doi=10.1186/s12882-016-0268-9 |url=}}</ref> | ||
* Urine/plasma creatinine ratio: <20 | * Urine/plasma [[creatinine]] ratio: <20 | ||
* Urine/plasma urea nitrogen:<3 | * Urine/plasma urea nitrogen:<3 | ||
* Ratio of BUN/sr.creatinine: 10 to 15:1 | * Ratio of [[Blood urea nitrogen|BUN]]/[[Creatinine|sr.creatinine]]: 10 to 15:1 | ||
* Rate of creatinine serum | * Rate of [[creatinine]] concentration in serum rise: Serum [[creatinine]] levels are increased progressively at a rate greater than 0.3 to 0.5 mg/dL/day. | ||
* Urine dipstick test: Commonly performed for blood pigments, proteins, WBC, nitrites, and glucose in all patients with suspected renal failure to exclude certain etiologies such as infection, hemolysis, myoglobinuria, and rhabdomyolysis. | * [[Urine]] [[Dipsticks|dipstick]] test: Commonly performed for [[blood]] pigments, [[Protein|proteins]], [[White blood cells|WBC]], [[Nitrite|nitrites]], and [[glucose]] in all patients with suspected [[Renal insufficiency|renal failure]] to exclude certain [[Etiology|etiologies]] such as [[infection]], [[hemolysis]], [[myoglobinuria]], and [[rhabdomyolysis]]. | ||
==References== | ==References== | ||
Revision as of 16:17, 4 May 2018
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Acute tubular necrosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
OR
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
OR
[Test] is usually normal for patients with [disease name].
OR
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
There are no diagnostic laboratory findings associated with [disease name].
Laboratory Findings
- Complete blood count (CBC):
- Anaemia may be due to decreased erythropoietin production.
- Abnormal platelets
- Urinalysis:[1][2]
- Urine sediment microscopy may show muddy brown granular casts from necrotic tubular cells binds with tamm horsfall protein or epithelial cell casts, and renal tubular epithelial cells.
- Urine sodium concentration:[3] >40 mEq/L
- Urine fractional excretion of sodium concentration:[4] > 2%
- Limitations of the fractional excretion of sodium percent: Some conditions include, radio contrast media induced nephropathy, acute tubular necrosis in the presence of cirrhosis and congestive heart failure, and rhabdomyolysis may have <1%.
- Urine osmolarity:[3] <350 mosmol/kg
- Serum electrolyte abnormalities: Hypokalemia, hypophosphatemia, hyponatremia, hypocalcemia, and hypomagnesemia may be found.[5]
- Urine/plasma creatinine ratio: <20
- Urine/plasma urea nitrogen:<3
- Ratio of BUN/sr.creatinine: 10 to 15:1
- Rate of creatinine concentration in serum rise: Serum creatinine levels are increased progressively at a rate greater than 0.3 to 0.5 mg/dL/day.
- Urine dipstick test: Commonly performed for blood pigments, proteins, WBC, nitrites, and glucose in all patients with suspected renal failure to exclude certain etiologies such as infection, hemolysis, myoglobinuria, and rhabdomyolysis.
References
- ↑ Ostermann M, Joannidis M (September 2016). "Acute kidney injury 2016: diagnosis and diagnostic workup". Crit Care. 20 (1): 299. doi:10.1186/s13054-016-1478-z. PMC 5037640. PMID 27670788.
- ↑ Kanbay M, Kasapoglu B, Perazella MA (June 2010). "Acute tubular necrosis and pre-renal acute kidney injury: utility of urine microscopy in their evaluation- a systematic review". Int Urol Nephrol. 42 (2): 425–33. doi:10.1007/s11255-009-9673-3. PMID 19921458.
- ↑ 3.0 3.1 Miller TR, Anderson RJ, Linas SL, Henrich WL, Berns AS, Gabow PA, Schrier RW (July 1978). "Urinary diagnostic indices in acute renal failure: a prospective study". Ann. Intern. Med. 89 (1): 47–50. PMID 666184.
- ↑ Steiner RW (October 1984). "Interpreting the fractional excretion of sodium". Am. J. Med. 77 (4): 699–702. PMID 6486145.
- ↑ Satirapoj B, Kongthaworn S, Choovichian P, Supasyndh O (June 2016). "Electrolyte disturbances and risk factors of acute kidney injury patients receiving dialysis in exertional heat stroke". BMC Nephrol. 17 (1): 55. doi:10.1186/s12882-016-0268-9. PMC 4895821. PMID 27267762.