Causes of Chronic Kidney Disease - Differential Diagnosis Algorithm

Decreased kidney function (eGFR < 60 ml/min/1.73 m2) persistent over at least 3 months

Pre-Renal (Evidence of Renovascular disease)

 • Atheroemboli

 • Renal artery stenosis

 • Drugs

 • Chronic hypoperfusion

Post-Renal (Obstruction/hydronephrosis on U/S)

 • Reflux nephropathy

 • Benign prostatic hyperplasia

 • Constipation

 • Prostate cancer

Tubular (Family history, ultrasound)

 • Polycystic kidney disease

 • Medullary cystic disease

 • Nephronophthisis

Vascular (Other small vessel disease)

 • Atherosclerosis 

Glomerular (Proteinuria)

 • Diabetes

 • Hypertension

Interstitial (Sterile pyuria, WBC casts, eosinophiluria)

 • Drugs (NSAlDs, analgesics)

 • Infections (chronic pyelonephritis)

 • Immune (sarcoid, Sjögren)

 • Multiple myeloma

 • Hyperoxaluria

 • Hypercalcemia

 • Hyperphosphatemia



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