Key messages

• Glomerular filtration rate is the best test of renal function.

• Urinalysis is often the most useful test available for detecting early renal abnormalities.

• Serum creatinine level is probably the most widely used indirect measure of glomerular filtration rate. Unfortunately, correct interpretation in the critical care setting is a problem.

• A normal urinalysis in the setting of acute renal failure suggests the presence of either prerenal or obstructive renal failure.

• Red blood cells and red blood cell casts suggest the presence of glomerular or vascular inflammatory disease and are rarely seen in acute interstitial nephritis.

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