Renal

Some Lab Values to remember

1. Acute Renal Failure:  When Cr starts increasing at a rate > 0.3mg/dl/ 48 hrs...or increase in s.Cr by 25% from baseline..
2. BUN/ Cr ratio:   10-15-----------------Intrarenal etiology,     <10 ------------------Pre renal
3. Normal Cr-  0.7 to 1.2 mg/dl ( but in pregnance it never goes more then 1mg/dl)
4. Normal BUN  = 20 to 24
5. Normal GFR = 120 ml/ min

• Whne pt is having ARF dont forget to check serum k+ level..give keyxalate and insulin+ d50.
• In diabetic patient keep checking Urine protein, microalbumiuria--------if present suggest low protein, Low salt diet and Give ACE inhibitors...maintain blood glucose level...also check for retinopathy which is uaually associated with diabetic nephropathy
• In hypertensive patient also check for proteinuria...
• in chronic renal failure pt, donr forget to prescribe Vit D and Iron.
• The fractional excretion of sodium (FENa) is useful in diagnosing pre-renal ARF. FENa is less than 1 % in many patients with prerenal ARF. Intravenous hydration is the mainstay of treatment.