62 year old female presented with vomiting since 3 days. Lab values given below What is the lab diagnosis? What additional parameters(with relevance) are required to further analyse the lab data?



The lab values are suggestive of a chronic kidney diseas, as evidenced by a Urea of 74 and creatinine of 4.4 mg/dl. However, it needs to be seen whether there is any acute injury in the background of CKD Complete blood count - the total count will reveal whether there is any underlying infection or not, which may have precipitated AKI on CKD FBS, PPBS - Diabetes is an important cause of CKD. Diabetic ketoacidosis can precipitate AKI on CKD. Arterial blood gas analysis - this is important to know the extent of acidosis and base deficit, since metabolic acidosis with a pH<7.1 is one of the indications to initiate haemodialysis.

How can you say its CKD on the basis of urea, creat, Na, K ?

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Kindly calculate creatinine clearance and ultrasound abdomen to rule out CKD . Repeat urea , creatinine too . Bcos if it's ARF due pre renal causes like gastro enteritis may have decremental values on subsequent days. But if it's CKD , creatinine clearance to be estimated along with kidney size. Uremia itself can cause nausea , vomitting.. In the mean while, assess blood sugar levels too for Diabetes mellitus , as It itself can cause diabetic nephropathy leading to CKD or DKA causing acute on chronic kidney disease. DKA itself can cause pain abdomen and vomitting..

Vommiting ----> dehydration-----> pre-renal azotemia---> ARF. Rehydration with electrolyte monitoring. Find the cause of vommiting....usg abd,routine inv ,cbc ,crp,esr, rue,lft,etc

CRF, refer to Nephrologist.

Incomplete case

Acute Renal Failure .

Hydronephrosis? Ckd

Pre renal Acute kidney injury, possible background of chronic kidney disease

CKD, treat with antibiotic if any sign of urosepsis or if creatinine goes above 5 with very low urine output, then dialysis is the only choice


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