Clinical features differentiating acute kidney injury from chronic kidney disease in children

Finding	Acute kidney injury	Chronic kidney disease
Serum BUN and Cr	Progressive rise in BUN and Cr	Stable elevated BUN and Cr
Historical clues	Positive history for acute kidney injury etiology (eg, recent streptococcal infection: poststreptococcal glomerulonephritis)	History of chronic hypertension
Growth	Normal growth	Impaired growth
Bone status	Normal bones	Evidence of renal osteodystrophy – History of fractures, abnormal tibial torsion
Urine sediment	No broad urinary casts	Broad, waxy urinary casts
Hematocrit	Anemia usually mild	Anemia usually severe
Kidney ultrasound	Normal or enlarged kidney size	Small, shrunken kidneys

BUN: blood urea nitrogen; Cr: creatinine.

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