Question 411 · LEK · Chronic kidney disease
A 60-year-old man with a long history of arterial hypertension with comorbid type 2 diabetes mellitus was admitted to Emergency Dept. because of massive oedema, dyspnoea, malaise, weakness, nausea and vomiting. Laboratory tests showed creatinine 8 mg/dl, urea 220 mg/dl, gasometry: pH 7.2, pCO₂ 30 mmHg, pO₂ 280 mmHg, HCO₃ 16 mmol/l, abdominal ultrasound revealed both kidneys with a longitudinal axis of 6 cm, with decreased corticomedullary differentiation. Indicate appropriate measures to be taken:
- A. intravenous Solu-Medrol pulse dosing.
- B. insertion of dialysis catheter and permanent dialysis.
- C. insertion of dialysis catheter and management of acute renal failure.
- D. kidney biopsy and taking relevant measures according to biopsy findings.
- E. intravenous fluid therapy.
Hint
Look at the kidney size on ultrasound: it tells you whether the renal failure is recent or long-standing and reversible or not.
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