Elevated Urea and Creatinine

CLINICAL DIAGNOSTIC MANUAL

Urea and creatinine are metabolic waste products eliminated from the body by the kidneys. Urea is produced in the liver from protein metabolism, while creatinine is generated from muscle metabolism.

Elevated levels of these compounds in the blood indicate decreased kidney function and can result from various conditions affecting renal perfusion, intrinsic renal damage, or urinary flow obstruction. Identifying the underlying cause is crucial for appropriate treatment and the prevention of complications.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Secondary increased protein load	Fatigue, weakness, nausea, vomiting, hypertension	History of high protein intake, catabolic diseases	Serum urea and creatinine measurement, dietary evaluation
Prerenal failure	Hypotension, tachycardia, oliguria, fatigue, dizziness	History of hypovolemia, bleeding, dehydration	Serum urea and creatinine measurement, renal function tests, renal ultrasound
Chronic renal failure	Fatigue, weakness, edema, hypertension, nausea, vomiting, oliguria, mental changes	History of chronic kidney disease	Serum urea and creatinine measurement, renal function tests, urinalysis, renal ultrasound
Acute tubular necrosis	Oliguria, edema, nausea, vomiting, confusion	History of toxin exposure or renal ischemia	Serum urea and creatinine measurement, urinalysis, renal biopsy if necessary
Severe hypotension	Dizziness, syncope, oliguria, fatigue, confusion	History of severe hypotension, shock	Serum urea and creatinine measurement, hemodynamic monitoring, renal ultrasound
Nephrotoxic medications	Nausea, vomiting, fatigue, weakness, decreased urine output	History of nephrotoxic medication use	Serum urea and creatinine measurement, medication review, renal function tests
Postrenal obstructive failure	Lower back pain, abdominal distension, oliguria, anuria	History of obstructive urinary symptoms, renal stone history	Serum urea and creatinine measurement, renal ultrasound, CT/MRI of the urinary tract