Question

Mr. K. G. is a thin 60-year-old man admitted to the hospital for cardiac catheterization for recurrent angina. Past medical history includes hypertension, type 2 diabetes mellitus, and a previous myocardial infarction 2 years ago. Current medications are metformin (Glucophage), glipizide (Glucotrol), enteric-coated aspirin (Ecotrin), and lisinopril (Zestril). Laboratory tests on admission revealed the following: normal electrolyte levels; blood urea nitrogen (BUN), 40 mg/dL; and serum creatinine, 2.0 mg/dL. A complete blood cell count and urinalysis were unremarkable. Mr. K. G. receives intravenous fluids at a KVO (keep vein open) rate (20 mL/hr) on the morning of the procedure. He successfully undergoes the catheterization and returns to the telemetry unit. The day after the procedure, Mr. K. G.’s urine output decreases to less than 10 mL/hr. Mr. K. G. is given a fluid bolus of ¬normal saline without any increase in urine output. Furosemide is administered intravenously, with a slight increase in urine output to 15 mL/hr for several hours. Laboratory studies reveal the following: potassium, 5.9 mEq/L; BUN, 70 mg/dL; serum creatinine, 7.1 mg/dL, and carbon dioxide total content, 16 mEq/L. The next day Mr. K. G. has 2+ edema and basilar crackles, and he complains of feeling short of breath. A preliminary diagnosis of acute renal failure is made. Questions 1. What is Acute Kidney Injury? 2. Identify the three class of Acute Kidney injury and give 3 examples of each. 3. What are the stages of Acute Kidney Injury? 4. . What are possible factors predisposing Mr. K. G. for acute renal failure? 5. What laboratory studies would be useful to assist in the diagnosis of acute renal failure and explain the rationale for each? 6. What medical interventions do you anticipate for Mr. K. G.? 7. Discuss the advantages and disadvantages of using diuretic therapy in. patients with acute renal failure.

Answer 1

O nhat is Acute kidney Lnjuzy/ It is a condition n which the kidneys suddenly can't filter waste from the blood. Acuti kidneg friluse develaps nepidy Over a few houss or days It may be fatal It's most common 9 thase who are Giticaly ill and already hospituliBed. 2) Thoree dassifications of Acuite kid ney Injury2 Obstoultion in blood flaw to kidng •> Prerenal ) Intaí nsic - Da mayı to kidnei /Galomenb •> Post renal / obstouction of uninury Flow. nephiifis

* stuges of Aulte G onset phaye kid ny Inŷury 1 -Houn to duys CG) olligusic phase 8to 14 days 7 to 14 day DIuretic Phase (3) J several month to 1Ir CA) Recovery phase Forr A RE for mo, K.H * Predisposing felctors Hypertennon -> -> Diabetes → Advanced age. -) Being hopituliz ed, especidly for a Sesious condation thut require întenve Cerme (MI) > Healt fai ure,