Urine Diagnostic Indices in Differentiation of Prerenal Versus Intrinsic Renal Azotemia
Diagnostic Index | Typical Findings | |
---|---|---|
Prerenal Azotemia | Intrinsic Renal Azotemia | |
Fractional excretion of sodium (%)a UNa × PCr/PNa × UCr × 100 | <1 | >1 |
Urine sodium concentration (mmol/L) | <10 | >20 |
Urine creatinine to plasma creatinine ratio | >40 | >20 |
Urine urea nitrogen to plasma urea nitrogen ratio | >8 | <3 |
Urine specific gravity | >1.018 | <1.015 |
Urine osmolality (mosmol/kg H2O) | >500 | <300 |
Plasma BUN/creatinine ratio | >20 | <10-15 |
Renal failure index UNa/UCr/PCr | <1 | >1 |
Urinary sediment | Hyaline casts | Muddy brown granular casts |
aMost sensitive indices.
Abbreviations: PCr, plasma creatinine concentration; PNa, plasma sodium concentration; UCr, urine creatinine concentration; UNa, urine sodium concentration.