Constipation & decreased urine output

Chief Complaint A 69 y/o male presents with constipation & decreased urine output, along with SOB. History No relevant past medical/surgical or family history. Vitals BP: 125/85 mmhg, RR: 20 Breaths/min, Pulse: 87 Beats /min, Temp: 98.5 degree F Investigations BUN:Cr was 120mg/dL and 19.5 mg/dL, GFR of 4mL/min. CT showed bilateral renal masses and a right colon mass. Colonoscopy was done afterward which showed a circumferential fungating mass in the mid-ascending colon, & multiple polyps in transverse colon. Diagnosis What next investigations should be performed? Treatment What do you say?

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A case of an advanced CA colon with metastasis to kidneys which is rare with secondary acute kidney injury and shut down Considering a BUN - 120 , Creatinine 19.4 and GFR - 4 - Patient needs an urgent dialysis till the s.urea and creatinine fall to manageable levels. The metastatic colon cancer just needs targeted immuno and chemotherapy and an ileostomy - Prognosis remains poor

Colonoscopy suggestive 9f mass lesion of colon is likely adenocarcinoma colon Decreased renal functions as abundant rise in bul and sr creatinine eGFR is only 4ml So urgent dialysis to reduce bul and sr creatinine Increase output Biopsy of lesion for confirmation At this stage chemotherapy and targeted panetrating radiotherapy would be better choice

Do serum electrolyte pt will require dailysis once pt settles then nephrologist gasentrologist opinion


Biopsy for mass and ABG and give soda bicarb accordingly...urgent dialysis

CKD 5 stage because GFR is 4ml/ Hr with CA colon & metastasis to kidney urgent dialysis done immediately Prognosis is very poor

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