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1. BUN:Cr ratio is 10-15:1.

2. Urine osmolality is usually < 350 because tubules cannot concentrate the urine.

3. Urine Na+ is > 40 (however, if reabsorption of water is significantly affected, the urine Na+ becomes dilute).

4. FENa is > 2%. However, FENa can be low in contrast­ induced nephropathy.

5. Casts in the urine are the hallmark finding: muddy brown, "dirty" granular casts (nonspecific but very sensitive) and epithelial cell casts.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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