Which laboratory tests are essential for the initial assessment and diagnosis of AKI in primary care?

Essential laboratory tests for the initial assessment and diagnosis of acute kidney injury (AKI) in primary care include:

• Measurement of serum creatinine to detect a rise indicating AKI, by comparing with baseline values if available.
• Estimation of glomerular filtration rate (eGFR) to assess kidney function and identify any significant decline.
• Urine dipstick testing for blood, protein, leucocytes, nitrites, and glucose to help identify possible causes such as infection or nephritis.

These tests should be performed promptly when AKI is suspected, especially in patients with risk factors such as chronic kidney disease, heart failure, liver disease, diabetes, or recent use of nephrotoxic drugs.

Additional investigations like ultrasound of the urinary tract are not routinely required unless there is suspicion of urinary tract obstruction or pyonephrosis.

Regular monitoring of serum creatinine is advised to track progression or resolution of AKI.

References: NICE NG148,NICE CKS,NICE CKS