Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (536 page)

   Who Should Be Suspected?

   Patients with liver cirrhosis and ascites, especially following fluid loss (e.g., GI hemorrhage, diarrhea or forced diuresis) or an intercurrent infection.

   Patients with other liver conditions that are associated with portal hypertension such as severe alcoholic hepatitis.

   Laboratory Findings

   Progressive increase in serum creatinine (>1.5 mg/dL) and decrease in GFR.

   No improvement in serum creatinine after volume expansion with intravenous albumin.

   Urinalysis

   Oliguria: concentrated urine with high specific gravity

   Protein excretion <500 mg/day

   Less than 50 RBCs per high-power field

   Decreased urine sodium (<10 mEq/L)

   Hyponatremia.

   Markedly abnormal liver function tests.

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