How to differentiate Acute from chronic renal failure ?

This is a guide to defferentiate between a casee of Acute Renal Failure and Chronic Renal failure , clinically and through routine investigations .

1. A rapid rate of change of serum urea & creatinine suggesting an acute
process.
2. Small kidneys with increased echogenisity diagnostic of chronic
process.
3. Evidence of renal osteodystrophy is indicative of chronic disease.
4. Measurment of carbamylated Hb(a product of non enzymatic reaction
between urea & Hb) if high suggesting a chronic disease.
5.Low Hb, Low  Ca, High  P  may suggest a chronic disease.
6. Low fixed specific gravity of urine (1010) and presence of broad casts in urine
analysis indicates chronic renal failure.

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