ACUTE KIDNEY INJURY (AKI)-PRE RENAL AKI INX

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SUMMARY

1. BUN:Cr ratio is typically increased to > 20.
2. Urine is very concentrated with osmolality > 400, and often > 700.

3. Urine Na+ is < 20, indicating normal tubular function (and avid reabsorption of Na+ to increase glomerular pressure).

4. AKl with an FENa < 1% and a normal urine sediment +/- few granular or hyaline casts => prerenal azotemia.

5. Urine-analysis - bland U/A; occasionally granular and/or hyaline casts.


Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].

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