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Chapter 25. Acute Kidney Injury

A 71-year-old man is transferred to the ICU with pneumonia and sepsis. His baseline serum creatinine upon admission to the hospital was 0.9 mg/dL (80 μmol/L). Two days later, his serum creatinine has increased to 2.1 mg/dL (186 μmol/L). His urine output is 1800 mL in the past 24 hours.

His acute kidney injury would best be classified as which of the following based on the KDIGO staging system?

A. Stage 1

B. Stage 2

C. Stage 3

D. Loss

E. End stage

A 71-year-old man is transferred to the ICU with pneumonia and sepsis. His baseline serum creatinine upon admission to the hospital was 0.9 mg/dL (80 μmol/L). Two days later, his serum creatinine has increased to 2.1 mg/dL (186 μmol/L). His urine output is 1800 mL in the past 24 hours.

His urine output would be classified as which of the following?

A. Anuria

B. Oliguria

C. Normal

D. Polyuria

E. Unable to assess

A 66-year-old woman (weight 140 pounds [63.5 kg], height 5’4” [163 cm]) is admitted to the hospital for a GI bleed. She has a history of diabetes mellitus and baseline Scr 1.4 mg/dL (124 μmol/L). Laboratory work today reveals BUN 65 mg/dL (23.2 mmol/L) and SCr 2.8 mg/dL (248 μmol/L).

Chronic medications include metoprolol, atorvastatin, and glyburide.

What of the following statements is true regarding assessment of kidney function in this patient?

A. MDRD equation should be used to estimate GFR

B. Cockcroft-Gault equation should be used to estimate GFR

C. 24-hour urinary data should be used to estimate GFR

D. Equations that estimate ClCr with a single SCr are not accurate in this patient

E. Her renal function is similar to baseline

A 66-year-old woman (weight 140 pounds [63.5 kg], height 5’4” [163 cm]) is admitted to the hospital for a GI bleed. She has a history of diabetes mellitus and baseline Scr 1.4 mg/dL (124 μmol/L). Laboratory work today reveals BUN 65 mg/dL (23.2 mmol/L) and SCr 2.8 mg/dL (248 μmol/L).

Chronic medications include metoprolol, atorvastatin, and glyburide.

Based on the patient’s BUN and SCr concentration, ...

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