Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- oligúria ou anúria
- hipotensão
- taquicardia
Other diagnostic factors
- pouca ingestão de alimentos e anorexia
- mal-estar
- sede
- tontura
- ortopneia/dispneia
- edema
Risk factors
- doença renal crônica (DRC)
- hipertensão crônica
- diabetes mellitus
- idade avançada
- estados de baixa perfusão
- sepse
- cirurgia de grande porte
- exposição a agentes nefrotóxicos
- exposição a meio de radiocontraste
- exposição a toxinas endógenas
Diagnostic tests
1st tests to order
- perfil metabólico básico (incluindo ureia e creatinina)
- relação ureia/creatinina
- concentração de sódio urinário
- osmolalidade urinária
- excreção fracionada de sódio
- excreção fracionada de ureia
- análise do sedimento urinário
- Hemograma completo
- exames de coagulação
- mioglobina urinária
Tests to consider
- gasometria arterial
- exames de agregação plaquetária
- ultrassonografia
- eletrocardiograma (ECG)
- diâmetro da veia cava inferior (VCI) medido por ultrassonografia
- biópsia renal
- biomarcadores séricos e urinários
Treatment algorithm
necrose tubular aguda (NTA)
Contributors
Authors
Maria Jesus Lloret Cora, MD, MSc
Consulting Staff
Nephrology Department
Fundació Puigvert
Barcelona
Spain
Disclosures
MJLC declares that she has no competing interests.
Leonor Fayos de Arizon, MD
Resident
Nephrology Department
Fundació Puigvert
Barcelona
Spain
Disclosures
LFA declares that she has no competing interests.
Acknowledgements
Dr Maria Jesus Lloret Cora would like to gratefully acknowledge Dr Roser Torra, the previous contributor to this topic.
Раскрытие информации
RT declares that she has no competing interests.
Рецензенты
Ajay Kumar, MD, FACP
Medical Director
Blood Management
Cleveland Clinic
Cleveland
OH
Раскрытие информации
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.
Irfan Moinuddin, MD
Assistant Professor
Chicago Medical School
Rosalind Franklin University
Lombard
IL
Раскрытие информации
IM declares that he has no competing interests.
Robert Tompkins, MD
Associate Professor
Department of Family Medicine
University of Texas Health Science Center
Tyler
TX
Раскрытие информации
RT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Gill N, Nally JV Jr, Fatica RA. Renal failure secondary to acute tubular necrosis: epidemiology, diagnosis, and management. Chest. 2005 Oct;128(4):2847-63. Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Azotemia pré-renal
- Azotemia renal intrínseca
More DifferentialsGuidelines
- KDIGO clinical practice guideline for acute kidney injury
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer