Ancillary Tests

Microscopic examination of urine is very useful in establishing the differential diagnosis of ARF ( TabJe.88-6). While changes in urine output are poorly correlated with changes in GFR, the categories of anuria, oliguria, and nonoliguria can be useful in the differential diagnosis of ARF ( Table.88:Z). Approximately 50 to 60 percent of all causes of ARF is nonoliguric.

TABLE 88-6 Differential Diagnosis of Acute Renal Failure (ARF) According to Urinalysis

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TABLE 88-7 Differential Diagnosis of Acute Renal Failure (ARF) According to Urine Volume

To help differentiate prerenal failure from ATN, chemical analysis of the urine may provide important clues 19 (Iab!§88:8). The fractional excretion of sodium (FeNa) is a test that is commonly used but, unfortunately, fails to distinguish prerenal causes of ARF from other causes of ARF 20 (IaM§J8§:9)-

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