Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Abbreviations: ABG = Arterial blood gases, BUN = Blood urea nitrogen, CBC = Complete blood count, CT = Computed tomography, CRP = C - reactive protein, ECG = Electrocardiogram, ESR = Erythrocyte sedimentation rate, IVP = Intravenous pyelography, KFT = Kidney function test, GI = Gastrointestinal, GFR = Glomerular filtration rate, MRI = Magnetic resonance imaging, PT = Prothrombin time
Etiology | Clinical manifestations | Paraclinical findings | Comments | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms and signs | Lab findings | Imaging | ||||||||||||||||||||
Fatigue/
Lethargy |
Thirst | Dizziness/
Confusion |
Muscle weakness/
cramp |
Somatic/
visceral pain |
Vomiting | Diarrhea | Tachypnea | Edema | Blood indices | Renal Funtion test | Electrolytes | Urine analysis | ABG | Other | Ultrasound | X-ray | CT | MRI | Other | |||
Prerenal causes | Aspergillosis[1][2] | +/- | - | - | - | - | - | - | +/- | - | Not applicable | Not applicable | Not applicable | Not applicable | Not applicable | Allergy test, ↑IgE (>1000 IU/dl), Direct visualization of fungal hyphae | Not applicable | Pulmonary infiltrates, Mucus plug, Mass in the upper lobe surrounded by a crescent of air, Solitary or multiple cavities | Halo sign, Wedge-shaped pulmonary infarction, Granuloma | Not applicable | - | Polymerase chain reaction (PCR) |
Drugs/toxins[3][4] | +/- | +/- | +/- | +/- | +/- | +/- | +/- | +/- | +/- | Not applicable | ↑BUN, ↑Cr, ↑CK | ↑K, ↓Mg, ↓Ca, ↓P | Ingested drug, Glucose, Aminoacid, Phosphate, Ketone, Hyaline cast, RBC | ↑Lactate, Metabolic acidosis | Toxicology, Rapid immunoassay | Nephropathy | Radioopaque substances, Ingested drug packets | Not applicable | Not applicable | - | - | |
Heart disease[5][6] | +/- | - | - | - | - | - | - | +/- | +/- | ↑ESR and CRP | ↑BUN, ↑Cr | Not applicable | Not applicable | Not applicable | Throat culture, Rapid streptococcal antigen test, Hyperoxia test, Pulse oximetry | Not applicable | Cardiomegaly, Dextrocardia | Not applicable | Not applicable | Ventricular dysfunction, Left and right ventricular hypertrophy, Valvular disease in echocardiography | - | |
Ischemic cardiomyopathy[7][8] | +/- | - | - | - | - | - | - | +/- | +/- | Anemia | ↑Cr | ↓Na, ↓K, ↓Mg | Not applicable | Not applicable | Troponin, Creatine kinase, Creatine kinase - MB, BNP | Not applicable | Abnormal cardiac silhouette | Biventricular volume, Wall motion abnormality, Myocardial perfusion, Hypertrophic cardiomyopathy | Mid-wall fibrosis in MRI | Ejection fraction ≤35%, Pulmonary embolism, Right ventricular dilation or pericardial effusion with tamponade in echocardiography | - | |
Malignant hypertension[9][10] | +/- | - | + | - | - | +/- | - | +/- | +/- | Microangiopathic hemolytic anemia | ↑BUN, ↑Cr | ↑Na, ↑K, ↑P | Proteinuria, Microscopic hematuria | Acidosis | Cardiac enzymes, Urinary catecholamines, TSH, ↑Renin | Not applicable | Cardiomegaly, Pulmonary edema, Rib notching, Aortic coarctation, Mediastinal widening, Aortic dissection | Not applicable | Not applicable | Left atrial enlargement and left ventricular hypertrophy in echocardiography | - | |
Myocarditis[11] | +/- | - | - | - | +/- | - | - | +/- | - | Leukocytosis (eosinophilia),↑ESR and CRP | Not applicable | Not applicable | Not applicable | Not applicable | Cardiac enzymes, Viral antibodies | Not applicable | Not applicable | Not applicable | Inflammatory edema, Degree of scarring | Endomyocardial biopsy, Echocardiography, Scintigraphy | Not applicable | |
Polycythemia[12][13] | +/- | - | - | - | - | - | - | +/- | - | ↑RBC, ↑HCT, ↑HGB, Thrombocytosis, Leukocytosis, ↑PT and aPTT | ↓Erythropoietin | Not applicable | Not applicable | Not applicable | Hyperuricemia | Splenomegaly | Not applicable | Not applicable | Not applicable | - | Phlebotomy is the usual treatment | |
Respiratory distress syndrome[14] | + | - | +/- | - | - | - | - | + | - | Not applicable | Not applicable | Not applicable | Not applicable | Metabolic and respiratory acidosis | Pulse oximetry | Not applicable | Bilateral, diffuse, reticular granular or ground-glass appearance +/- Cardiomegaly | Not applicable | Not applicable | Patent ductus arteriosus in echocardiography | - | |
Shock[15] | +/- | +/- | +/- | +/- | +/- | +/- | - | +/- | - | ↑HCT, ↑PT and aPTT, Eosinophilia, Leukocytosis | ↓GFR, ↑BUN, ↑Cr | Not applicable | Not applicable | ↑Lactate | LFT, ↑BNP, ↑Troponin, D-dimer, Fibrinogen | Pulmonary embolism, Pericardial effusion, Cardiac tamponade, Pneumothorax, Thoracic or abdominal aortic aneurysm in RUSH (Rapid Ultrasound for Shock and Hypotension) | Pneumonia, Pneumothorax, Pulmonary edema, Widened mediastinum, Free air under the diaphragm | Traumatic brain injury, Stroke, Spinal injury, Pneumonia, Pneumothorax, Ruptured aneurysm, Aortic dissection, Pulmonary embolism | Not applicable | - | - | |
Renal causes | Acute interstitial nephritis[16][17] | +/- | - | +/- | - | +/- | +/- | +/- | +/- | +/- | Eosinophilia | ↑BUN, ↑Cr, ↑FENa | Not applicable | Eosinophiluria, Sterile pyuria, Microscopic hematuria, Proteinuria | Not applicable | ↑Total IgG, ↑IgG4 | Normal-sized kidneys | Not applicable | Not applicable | Not applicable | - | History of long term analgesic use |
Goodpasture syndrome[18][19][20] | +/- | - | - | - | - | - | - | +/- | +/- | Anemia, Leukocytosis, ↑ESR | ↑BUN, ↑Cr | Not applicable | Low-grade proteinuria, Gross or microscopic hematuria, RBC casts | Not applicable | Anti– glomerular basement membrane antibody Antineutrophilic cytoplasmic antibody | Not applicable | Bilateral, basal, patchy parenchymal consolidations | Not applicable | Not applicable | Diffuse alveolar hemorrhage in pulmonary biopsy | - |