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- Title
Urinary diagnostic indices in acute renal failure: a prospective study.
- Authors
Miller, Thomas R.; Anderson, Robert J.; Linas, Stuart R.; Henrich, William L.; Berns, Arnold S.; Gabow, Patricia A.; Schrier, Robert W.; Miller, T R; Anderson, R J; Linas, S L; Henrich, W L; Berns, A S; Gabow, P A; Schrier, R W
- Abstract
A prospective analysis of the value of urinary diagnostic indices in ascertaining the cause of acute renal failure was undertaken. Our results show that in the setting of acute oliguria a diagnosis of potentially reversible prerenal azotemia is likely with urine osmolality greater than 500 mosm/kg H2O, urine sodium concentration less than 20 meq/litre, urine/plasma urea nitrogen ratio greater than 8, and urine/plasma creatinine ratio greater than 40. Conversely, a urine osmolality less than 350 mosm/kg, urine sodium concentration greater than 40 meq/liter, urine/plasma urea nitrogen ratio less than 3, and urine/plasma creatinine ratio less than 20 suggest acute tubular necrosis. A significant number of oliguric patients will not have urinary indices that fall within these guidelines. In this setting, urine sodium concentration divided by the urine-to-plasma creatinine ratio (the renal failure index) and the fractional excretion of filtered sodium provide a reliable means of differentiating reversible prerenal azotemia from acute tubular necrosis.
- Subjects
ACUTE kidney failure; AZOTEMIA; DIAGNOSIS; UREA metabolism; COMPARATIVE studies; CREATININE; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; SODIUM; UREMIA; EVALUATION research; OSMOLAR concentration; ACUTE kidney tubular necrosis
- Publication
Annals of Internal Medicine, 1978, Vol 89, Issue 1, p47
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-89-1-47