Diagnosis Of Possible Postrenal Causes Of Acute Renal Failure

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History

Examination

Laboratory/Other

Very young or very old age

Distended bladder

Abnormal urinalysis

Nocturia

Enlarged prostate

Elevated BUN-creatinine ratio

Decreased size or force of urine stream

Abnormal pelvic examination

Elevated postvoiding

Anticholinergic or alpha-adrenergic

residual volume

agonist medications

Abnormal renal ultrasound,

Bladder, prostate, pelvic, or

CT or MRI findings

intra-abdominal cancer

Improvement after drainage

Fluctuating urine volume

Oligoanuria

Suprapubic pain

Urolithiasis

Medication known to produce

crystalluria (sulfonamides, acyclovir,

methotrexate, protease inhibitors)

Diagnosis of possible postrenal causes of acute renal failure (ARF). Postrenal causes of ARF are less common (5% to 15% of ARF population) but are nearly always amenable to therapy. This figure depicts the historical, physical examination and tests that can lead to an intrarenal (crystal deposition) or extrarenal (blockade of the collecting system) form of obstructive uropa-thy [1, 6, 9, 10]. BUN—blood urea nitrogen; CT—computed tomography; MRI—magnetic resonance imaging.

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