Urinary diagnostic indices in acute renal failure. A prospective study

T. R. Miller, R. J. Anderson, S. L. Linas, W. L. Henrich, A. S. Berns, P. A. Gabow, R. W. Schrier

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271 Scopus citations

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 >500 mosm/kg H2O, urine sodium concentration <20 meq/liter, urine/plasma urea nitrogen ratio >8, and urine/plasma creatinine ratio >40. Conversely, a urine osmolality <350 mosm/kg, urine sodium concentration >40 meq/liter, urine/plasma urea nitrogen ratio <3, and urine/plasma creatinine ratio <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.

Original languageEnglish (US)
Pages (from-to)47-50
Number of pages4
JournalUnknown Journal
Volume89
Issue number1
DOIs
StatePublished - Jan 1 1978

ASJC Scopus subject areas

  • Internal Medicine

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    Miller, T. R., Anderson, R. J., Linas, S. L., Henrich, W. L., Berns, A. S., Gabow, P. A., & Schrier, R. W. (1978). Urinary diagnostic indices in acute renal failure. A prospective study. Unknown Journal, 89(1), 47-50. https://doi.org/10.7326/0003-4819-89-1-47