Question

A 55-year-old man with chronic kidney disease is admitted with sepsis and becomes oliguric. His creatinine rises from 150 µmol/L to 320 µmol/L over 48 hours. His blood pressure is 85/50 mmHg, lactate 4 mmol/L, and he is tachycardic. What is the best immediate management regarding fluids?

Accepted Answer

Give a 30 mL/kg bolus of crystalloid as part of sepsis resuscitation, reassessing response

Answer

Restrict fluids to avoid overload

Answer

Give a 500 mL bolus of 0.9% sodium chloride over 4 hours

Answer

Start diuretics to increase urine output

Answer

Delay fluids until a nephrologist reviews him

Practice question

A 55-year-old man with chronic kidney disease is admitted with sepsis and becomes oliguric. His creatinine rises from 150 µmol/L to 320 µmol/L over 48 hours. His blood pressure is 85/50 mmHg, lactate 4 mmol/L, and he is tachycardic. What is the best immediate management regarding fluids?