The following patient has been admitted to ICU with suspected renal injury. Base
ID: 3520159 • Letter: T
Question
The following patient has been admitted to ICU with suspected renal injury. Based on the results in the table below, which of the following conditions does patient 4 probably have?
Parameter
Normal range
Patient 4
Plasma
Albumin
35-50 g/L
48
Urea (BUN)
2.5-7.1 mM
18.2
Creatinine
61-107 uM
331
Potassium
3.5-5.0 mM
5.1
pH
7.35-7.45
7.32
osmolality
275-299 mOsMol/kg
318
Urine
Protein
Negative
Negative
Glucose
Negative
Negative
Osmolality
50-1200 (>500 if excretion rate lower than normal)
402
Urine: plasma osmolality ratio
>1.3
1.28
Urine sodium
<10 mM
11.1
Fractional clearance sodium
1%
1.21
Urine output
>0.5 ml/kg per hour
0.1 ml
a.
Risk of renal injury
b.
Pre-renal injury
c.
Intra-renal injury
d.
Intra-renal failure
e.
Pre-renal failure
Explanation / Answer
As there are no proteins in the urine and the amount of urine is decreased due to decreased GFR which has resulted from obstruction of blood filteration, this patient has pre-renal failure.
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