Acute tubular necrosis laboratory findings
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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 serum concentration 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.