A patient admitted with sepsis has had several episodes of severe hypotension. Laboratory results indicate a BUN 50 mg/dl (10.7 mmol/L), serum creatinine 2.0 mg/dl (177 µmol/L), urine sodium 70 mEq/L (70 mmol/L), urine specific gravity 1.010, and cellular casts and debris in the urine. The nurse knows these findings are consistent with

Question

Quizplus · Accepted Answer

The specific gravity and presence of casts and debris in the urinalysis suggest intrarenal failure and acute tubular necrosis. The sudden onset indicates that the renal failure is acute, not chronic. In prerenal failure, there would not be casts or debris in the urine. The patient does not have risk factors for postrenal failure.

A Patient Admitted with Sepsis Has Had Several Episodes of Severe