Acute Kidney Injury and Kidney Replacement Therapy in the Critically Ill Patient
Patient Case
Questions 1β3 pertain to the following case.
F.B. is a 68-year-old male patient (weight 70 kg) admitted to your ICU with fever, elevated WBC, respiratory
failure requiring mechanical ventilation, and norepinephrine to support his blood pressure. His medical history
is significant for chronic back pain, diabetes, and hypertension. He takes both enalapril and glipizide once daily,
as well as acetaminophen as needed. Before this admission, he had otherwise been healthy. He saw his primary
care provider about 1 week ago. At that time, his blood pressure was 140/80 mm Hg, and his hemoglobin A1C
was 5.2%. His laboratory workup was also unremarkable: WBC 5.0 x 103 cells/mm3, BUN 7 mg/dL, and SCr 0.9
mg/dL. Today, his WBC is 24 x 103 cells/mm3, BUN is 38 mg/dL, and SCr is 3.2 mg/dL, with 325 mL of UOP
since his admission 24 hours ago.
Which best describes F.B.βs AKI?
When evaluating F.B.βs potential causes of AKI, which additional information or test would be most impor-
tant to consider or obtain?
Once injury has occurred, therapy consists of providing supportive care and limiting additional insults,
including nephrotoxin exposure.
without producing volume overload.
No specific pharmacologic therapy is effective in treating or reversing AKI.
Metabolic derangements and volume status should be followed closely, and KRT should be initiated
when other approaches have failed.