Acute Tubular Necrosis

Acute Tubular Necrosis

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Acute Tubular Necrosis

A lady in her mid-40s was admitted to the emergency room. She had been involved in road carnage. She had suffered abdominal injuries, and her femur was fractured. Surgery was the first thing she done because her liver had been laceratedand her ileum perforated. Two blood units were transfused during surgery, and other two while in the recovery room. While in the surgical intensive care, she developed a transfusion reaction that led to the discontinuation of the transfusion. Her laboratory result during the day of surgery showed decline in urine output to 10-20ml/hr, an elevation in urinary sodium, levels of serum creatinine of 4mg/dl and BUN levels of 70mg/dl. Her output of urine never improved upon administration of plasma expanders.

On the third day her urine output stabilized at levels of 20-25ml/hr. this was a clear sign of acute tubular necrosis(Fogo, 2006).

Serious hypertension (BP 190/120) combined with hyperkalemia called for hemodialysis by t.............