Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • oliguria or anuria
  • hypotension
  • tachycardia

Other diagnostic factors

  • poor oral intake and anorexia
  • malaise
  • thirst
  • dizziness
  • orthopnoea/dyspnoea
  • oedema

Risk factors

  • underlying renal disease
  • low renal perfusion
  • diabetes mellitus
  • hypotension
  • excessive fluid loss
  • major surgery
  • cardiac arrest
  • mechanical ventilation
  • exposure to nephrotoxins
  • exposure to radiocontrast media
  • muscle trauma
  • haemolysis
  • hyperuricaemia
  • infection
  • advanced age
  • multiple myeloma
  • sepsis
  • pancreatitis

Diagnostic investigations

1st investigations to order

  • basic metabolic profile (including urea and creatinine)
  • urea-to-creatinine ratio
  • urine sodium concentration
  • urine osmolality
  • fractional excretion of sodium
  • fractional excretion of chloride
  • urinalysis for sediment
  • FBC
  • coagulation studies
  • urinary myoglobin
Full details

Investigations to consider

  • arterial blood gases (ABG)
  • platelet aggregation studies
  • ultrasound
  • ECG
  • central venous pressure
  • renal biopsy
  • serum and urinary biomarkers
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consulting Staff

Nephrology Department

FundaciĆ³ Puigvert

Barcelona

Spain

Disclosures

MJLL lectured for Abbvie and Sanofi sponsored scientific events and has links with Vifor Fresenius Medical Care Renal Pharma.

Dr Maria Jesus Lloret Cora would like to gratefully acknowledge Dr Roser Torra, the previous contributor to this monograph. RT declares that she has no competing interests.

Peer reviewers VIEW ALL

Medical Director

Blood Management

Cleveland Clinic

Cleveland

OH

Disclosures

AK has received a fee for speaking about perioperative blood management from Ortho-Biotech and has also received reimbursement from medscape.com for the education webcast of the same presentation.

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Disclosures

IM declares that he has no competing interests.

Associate Professor

Department of Family Medicine

University of Texas Health Science Center

Tyler

TX

Disclosures

RT declares that he has no competing interests.

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