The following patient is thought to be at risk of developing acute tubular necro
ID: 3520189 • Letter: T
Question
The following patient is thought to be at risk of developing acute tubular necrosis having been exposed to a nephrotoxin. Based on the results below, which of the following conditions are they likely to have?
Parameter
Normal range
Patient 1
Plasma
Albumin
35-50 g/L
38
Urea (BUN)
2.5-7.1 mM
10.2
Creatinine
61-107 uM
161
Potassium
3.5-5 mM
4.1
pH
7.35-7.45
7.36
osmolality
275-299 mOsMol/kg
272
Urine
Protein
Negative
negative
Glucose
Negative
negative
Osmolality
50-1200 (>500 if excretion rate lower than normal)
660
Urine output
>0.5 ml/kg per hour
0.52 ml
a.
Nephrotic syndrome
b.
The prodromal phase of acute tubular necrosis
c.
Nothing, the patients blood results do not indicate a compromise of renal function
d.
Acute glomerulonephritis
e.
The oliguric phase of acute tubular necrosis
Explanation / Answer
b. Prodromal hase of acute tubular necrosis. In prodromal phase urea and creatinine increases suddenly. In nephrotic syndrome, albumin value decreases and in glomerulonephritis, urea and creatinine value decreases.
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