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Chapter 25. Acute Kidney Injury

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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.

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

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A. Stage 1

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B. Stage 2

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C. Stage 3

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D. Loss

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E. End stage

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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.

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

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A. Anuria

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B. Oliguria

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C. Normal

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D. Polyuria

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E. Unable to assess

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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).

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Chronic medications include metoprolol, atorvastatin, and glyburide.

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

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A. MDRD equation should be used to estimate GFR

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

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

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

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E. Her renal function is similar to baseline

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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).

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Chronic medications include metoprolol, atorvastatin, and glyburide.

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

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