Question

Paul Wheat is a 23 y/o male who suffered a hit-and-run auto-pedestrian accident and sustained multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency room [ER]. Paul’s initial diagnostic workup, vital signs and lab work reveal a 2500 mL blood loss. A urinary catheter is inserted to monitor urine output. Currently, Paul’s urine output is 15 mL/hr and is clear but dark amber in color.

1. What type of renal failure is Paul likely developing? What is the underlying cause?
2. In addition to urine output, what laboratory data should be monitored to assess changes in Paul’s renal function?
3. Identify 3 other clinical problems (adverse outcomes) that may develop if Paul’s renal function does not return to normal but continues to decline?

Answer 1

#. Paul is developing Acute kidney failure. It has an abrupt onset and is potentially reversible.

#. The cause is blood loss ( less blood supply to kidney )

#. In addition to urine output, other laboratory data should be monitored to assess changes in Paul’s renal function are :-

Blood tests. A sample of your blood may reveal rapidly rising levels of urea and creatinine

Imaging tests. Imaging tests such as ultrasound and computerized tomography

Removing a sample of kidney tissue for testing.

Urine output measurements. Measuring how much you urinate in 24 hours may help your doctor determine the cause of your kidney failure.

Urine tests. Analyzing a sample of your urine (urinalysis) may reveal abnormalities that suggest kidney failure

#. Adverse effects :-

- high potassium and fluid buildup

- permanent kidney injury

- heart disease