Prerenal Kidney Failure: Likelihood Ratios

Introduction: Acute kidney failure is generally divided into 3 categories: renal, pre-renal, and post-renal causes. Pre-renal causes are those that result from hypoperfusion of the kidneys, principally hypovolemia and cardiogenic shock.

The most common causes of ARF are prerenal failure and ATN.

Another reference study is Ann Intern Med. 1978 Jul;89(1):47-50 PMID: 666184.

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The likelihood ratios of findings for Prerenal Kidney Failure are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Fractional Excretion of Urea	22.4	0.1	FEurea < 35% including patients on diuretics. Patients with diuretics only had sens = 88.9%; without diuretics sens = 90%. Study: Kidney Int. 2002 Dec;62(6):2223-9. PMID: 12427149
Fractional Excretion of Sodium	19.2	0.2	ratio < 1% including patients on diuretics. Patients with diuretics only had sens = 48%; without diuretics sens = 92%. Study: Kidney Int. 2002 Dec;62(6):2223-9. PMID: 12427149
Urine Creatinine to Plasma Creatitine Ratio	6.7	0.2	including patients on diuretics. Patients with diuretics only had sens = 63%. Study: Kidney Int. 2002 Dec;62(6):2223-9. PMID: 12427149
Elevated BUN to Creatinine Ratio	4.4	0.2	ratio >15 including patients on diuretics. Patients with diuretics only had sens = 85%. Study: Kidney Int. 2002 Dec;62(6):2223-9. PMID: 12427149
Urine Sodium to Potassium Ratio	8.3	0.4	ratio < 1 including patients on diuretics. Patients with diuretics only had sens = 41%. Study: Kidney Int. 2002 Dec;62(6):2223-9. PMID: 12427149