Question

J. S. is 23 years old. He was brought to the emergency department after an auto accident. He suffered a concussion and a deep laceration of his right thigh. He lost about 4 units of blood prior to effective control of bleeding and closure of the wound. Fluid resuscitation is initiated, and a urinary catheter is inserted post operation to monitor his urine output. However, he continues to have significant oozing from his sutured wound. His 24-hour urine volume is 350 ml with a high urine osmolality and low urine sodium. A coagulation screen results indicate the following: platelet count 250,000, bleeding time and a PTT time are both extended.

1. If J. S.’s renal function continues to be diminished without any improvement, what could be the subsequent stages of his renal disorder?

Answer 1

The urine output measures about 350ml/24 HR which means approximately 14ml/hr. Which is an extremely lower GFR indicating the kidneys are shutting down. This is probably because of volume depletion .The patient is in oliguria stage as the urine output is less than 400ml/day.The subsequent stage which can be expected after treatment are diuretic (happens after proper fluid resuscitation) .Then the convalescent or recovery phase happens for the renal system to repair and regain its normal functioning .The overall time period to recover takes about 4-6weeks in whole .