Distinguishing Acute Kidney Injury From Chronic Kidney Disease
Finding | Comment |
|---|---|
Decreased kidney function (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2) for ≥ 3 months | Most reliable evidence of CKD |
Renal sonogram showing small kidneys | Usually CKD |
Renal sonogram showing normal or enlarged kidneys | May be AKI or some forms of CKD (diabetic nephropathy, acute hypertensive nephrosclerosis, polycystic kidney disease, myeloma, rapidly progressive glomerulonephritis, infiltrative diseases [eg, lymphoma, leukemia, amyloidosis], obstruction) |
Oliguria, daily increases in serum creatinine and BUN | Probably AKI or AKI superimposed on CKD |
No anemia | Probably AKI or CKD due to polycystic kidney disease |
Severe anemia, hyperphosphatemia, and hypocalcemia | Possibly CKD but may be AKI |
Subperiosteal erosions on radiography | Probably CKD |
Chronic symptoms or signs (eg, fatigue, nausea, pruritus, nocturia, hypertension) | Usually CKD |
AKI = acute kidney injury; CKD = chronic kidney disease; BUN = | |