A Review to Differentiate Acute Kidney Injury from Chronic Kidney Disease

Abstract

The symptoms and signs of kidney disease are generally nonspecific to the underlying kidney disease. A considerable amount of these patients admit only with elevation in serum urea and creatinine. It is essential to first determine whether the disease is acute, subacute, or chronic for the differential diagnosis in a patient who presents with an elevated serum creatinine. The distinction between acute kidney injury (AKI) and chronic kidney disease (CKD) may be difficult in cases with no recent measurements of serum creatinine.Herein, we discussed the role of anamnesis, physical exam, routine laboratory tests, carbamylated hemoglobin, parathyroid hormone, hyaluronic acid, levels of 1,5-anhydroglucitol (AG), two-dimensional analysis of urinary dipeptidase, versus serum creatinine, creatinine levels of fingernails, and ultrasound in differential diagnosis of uremic subjects. The combination of data from medical anamnesis, physical exam, and routine laboratory test will be sufficient for diagnosis in most of the cases. Adding data from other markers in selected subjects may be useful in differential diagnosis of challenging cases admitted with uremia for the first time.