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You are here: Home / 03. Intensive Care / Oliguria and Urinary Electrolytes

Oliguria and Urinary Electrolytes

November 17, 2013 by CrashMaster

Post from Nickson on Life in the Fast Lane

USES

Oliguria

  • UNa+ low (<10mmol/L) – extravascular volume depletion
  • UNa+ high (>20) – tubular damage

Hyponatraemia

  • UNa+ low (<10) – extra-renal losses
  • UNa+ high (>20) – renal salt losing states, SIADH, diuretic therapy
  • Fractional excretion of Na+ = 100 x UNa+ x PCr / PNa+ x UCr
    -> < 1% implies pre-renal cause, limited by Na+ intake and diuretics therapy

Hypokalaemia

  • UK+ high (>20) – renal loss of K+
  • UK+ low (<20) – extrarenal loss of K+

Normal Anion Gap Acidosis

  • UCl- can be used
  • UCl- low (<10) – RTA from impaired urinary acidification (decreased ammonium excretion)
    -> also present = positive urinary anion gap and an inappropriately high pH (>6)
  • if acidosis is due to an extra-renal loss of bicarbonate, in the absence of renal failure the kidneys will excrete ammonium and chloride
    -> negative urinary anion gap (UCl > Na + K)

 

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Excellent Powerpoint

Oliguria by Raimund Pichler M.D

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Filed Under: 03. Intensive Care, renal

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  • Excellent Powerpoint

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