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ACUTE RENAL FAILURE AND CHRONIC RENAL FAILURE

I. ROC

Part I

Name: Julie Marrow

Age: 24

Gender: Female

History:

-2 days post partum

-underwent Cesarean section

-had Lupus Erythematosus for 3 years

Complaints:

- 34 weeks pregnant

- Pregnancy induced Hypertension (HTN)

Upon admission:

-diagnosed with HELLP syndrome

H -- hemolysis (the breakdown of red blood cells)

EL -- elevated liver enzymes

LP -- low platelet count

Upon delivery:

-hypovolymic

-suffered hypovolymic shock

- massive bleeding

several hrs after delivery :

-remained hemodynamically unstable inspite of blood, blood products and fluid replacement

-dopamine @ 3-10 mcg/kg/min

-levophed @ 4 mcg/min

For the past 2 days:

- BP ranges from 60/48 to 98/58

For the last 12 hours:

- urine output in minimal (0-30 cc/hour *

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SaO2 (Oxygen saturation) 90% [normal 90-95 %]

BUN 145 [normal 7-20 mg/dl]

Creatinine- 9.4 [normal 0.5-1.4]

K-6.4 U/L

Ca-8.0 U/L

Alk P- 154 U/L

SGOT (serum glutamic-oxaloacetic transaminase; or AST aspartate transaminase) 34 mcg/L [normal