Harter H R, Martin K J
Postgrad Med. 1982 Dec;72(6):175-81. doi: 10.1080/00325481.1982.11716292.
Urinalysis and urine chemistries are most helpful in determining whether acute renal failure is due to a prerenal, renal, or postrenal cause. A plain film of the abdomen should be obtained, with ultrasound or computed tomography also being done if obstruction is suspected. When prerenal and postrenal causes have been excluded, the cause should be considered to be acute tubular necrosis, which progresses through initiating, oliguric (or sometimes nonoliguric), diuretic, and recovery phases. Acute tubular necrosis can produce a variety of clinical consequences affecting the entire body, including hyperkalemia, acidosis, hypocalcemia, anemia, and infection, as well as various cardiovascular, neurologic, and gastrointestinal problems.
尿液分析和尿生化检查对于确定急性肾衰竭是由肾前性、肾性还是肾后性原因引起最为有用。应拍摄腹部平片，如果怀疑有梗阻，还应进行超声或计算机断层扫描。当排除肾前性和肾后性原因后，应考虑病因是急性肾小管坏死，其病程会经历起始期、少尿期（或有时为非少尿期）、利尿期和恢复期。急性肾小管坏死可产生影响全身的各种临床后果，包括高钾血症、酸中毒、低钙血症、贫血和感染，以及各种心血管、神经和胃肠道问题。
