Blood and urine tests that detect chronic and acute kidney disease are commonly performed by clinicians in both ambulatory and hospital settings. Thresholds for these tests have been established that signal the presence and severity of kidney injury or dysfunction. In the appropriate clinical context of a patient's history and physical examination, an abnormal test result should trigger specific actions for clinicians, including review of the patient's medication use, follow-up testing, prescription of lifestyle modifications, and specialist referral. Tests for kidney disease can also be used to determine the prognosis with regard to future risk for kidney failure as well as cardiovascular death.
Use this article to:
- Review the differential diagnosis of abnormal kidney test results.
- Describe history and physical examination findings that are helpful in determining the cause of abnormal kidney test results.
- When would you order imaging studies in a patient with abnormal kidney test results?
- If able, consult with a nephrologist to review indications for subspecialty referral for a patient with abnormal kidney test results.
Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.