AKI

Question 1

A 24 year old man is brought to the emergency department having been found semi-conscious in the park. Toxicity with alcohol and drugs is suspected.

Question 2

A urinary catheter is inserted and 280mL of brown urine is drained over 12 hours. His weight is 75kg making his urine output 0.31ml/kg/hr. Urinalysis shows blood 4+. The doctor suspects an AKI.

Please stage the AKI.

Answer 2

AKI is staged with urine output and creatinine.
Stage 2

Question 3

Describe the patient’s acid-base status and suggest why this has occurred in this patient.

Answer 3

Acute metabolic and respiratory acidosis.
Hypoventilation- secondary for opiate drug overdose, dulled his CNS
Tissue hypoxia and necrosis causing metabolic acidosis.

Question 4

Have another look at the patient’s blood results. What is one very important investigation to do.

Answer 4

ECG due to high potassium levels

Question 5

Please describe the findings of the ECG

Answer 5

Question 6

What would you expect from this patient’s anion gap and what would it indicate?

Answer 6

High anion gap
Increase organic acid in the bloodstream due to ketoacidosis.
Decrease in bicarbonate to neutralize the acid.