Emergency Medicine International / 2012 / Article / Tab 2

Review Article

Care of the Critically Ill Emergency Department Patient with Acute Kidney Injury

Table 2

Diagnostic work-up of patients with AKI.

InvestigationsComments

Essential tests
UrinalysisProteinuria and/or haematuria represent an active urinary sediment suggestive of glomerular disease
Serum creatinine, urea and electrolytes
Full blood count and blood filmTo rule out thrombotic mircoangiopathy and haemolysis; eosinophilia may be present with interstitial nephritis
C-reactive proteinelevated in inflammatory diseases and/or infections
Arterial or venous bicarbonate
Investigations to be considered depending on history and/or clinical signs
Creatine kinaseTo rule out rhabdomyolysis
Serum and urine protein electrophoresisTo rule out myeloma
Antinuclear antibody (ANA)In case of possible diagnosis of SLE or connective tissue disease
Antineutrophil antibody (ANCA)In case of possible systemic vasculitis
Anti-streptolysin O titresTo rule out post streptococcal glomerulonephritis
Anti-glomerular basement membrane antibodyTo rule out Goodpasture’s disease
Complement levelsReduced in SLE, infectious endocarditis and cryoglobulinaemia
Hep B, Hep C and HIV serologyTo rule out renal disease caused by viral infections
Renal ultrasoundTo assess renal size; to rule out obstruction and chronic kidney damage

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