GENITOURINARY / RENAL
		PLAN Daily Renal Check-list Ensure adequate volume Urine output should be 0.5 cc/kg/hr Monitor nephrotoxic drugs Avoid NSAID abuse Renal dose dopamine Remove foley early Decrease drugs when renal insufficiency present Other Problems OLIGURIA: Urine output less than 400 ml/day Increased serum Creatinine of 0.5 mg/dL above baseline. An increase in serum creatinine of at least 50% over baseline. Causes 1. Pre-Renal 2. Intrinsic Renal 3. Post-Renal FeNa <1% Una+ < 20 meq/L values FeNa+ >2% Una+ > 40 meq/L acute-pre-renal values chronic-intrinsic renal values Hypovolemia Acute Glomerular Nephritis Foley Obstruction Cardiac failure/dysfunction Acute Tubular Necrosis Bilateral Renal Obstruction Loss of vascular tone Acute Interstitial Nephritis Drugs -cause renovascular constriction Drugs that reduce GFR Post-operative VOLUME OVERLOAD: Situation occurs when the total body water and sodium is elevated but patient is intravascularly depleted and the kidneys are not being perfused to make urine. Ie. Pre-renal. Best to limit volume and carefully manage diuretics. No right way and is usually discussed thoroughly with team.

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