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. What type of renal failure is J. S. developing? Why is this type of renal failure developing?

Answer 1

Low urine sodium is a stage which detects whether a person is having insufficient or more amount of water.This low sodium levels is called hyponatremia and high urine osmolality means concentrated urine.In such cases J.S may develop postrenal (caused by inadequate drainage of urine distal to the kidneys) renal failure type.

Postrenal acute kidney injury , which used to be called acute renal failure, occurs when an obstruction in the urinary tract below the kidneys causes waste to build up in the kidneys . It is not as common as intrinsic acute kidney injury (AKI) or acute tubular necrosis.

Postrenal Acute Kidney Injury

• Kidney stones . Kidney stones most often develop in the ureters .
• An enlarged prostate ( benign prostatic hyperplasia, or BPH ).
• A bladder that doesn't empty properly.
• Blood clots in the ureters or urethra.
• Cancer of the prostate, cervix, or colon.