Post-Cardiac Surgery AKI — ESENeph MCQ

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ModerateAcute Kidney InjuryPost-Cardiac Surgery AKIESENeph

A 42-year-old man develops AKI after cardiac surgery. He is oliguric (<200 mL/day) despite fluid resuscitation and has K+ 6.5 mmol/L, pH 7.18, bicarbonate 10 mmol/L, and urea 38 mmol/L. Chest X-ray shows pulmonary oedema. What is the most appropriate form of renal replacement therapy?

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Correct answer: A — Continuous renal replacement therapy (CRRT)

In the ICU setting post cardiac surgery, CRRT (continuous venovenous haemofiltration or haemodiafiltration) is preferred for haemodynamically unstable patients. KDIGO 2012 AKI guideline suggests using CRRT rather than standard intermittent RRT for haemodynamically unstable patients (2B). CRRT provides gradual fluid and solute removal, better haemodynamic stability, and is the standard approach in post-cardiac surgical AKI with fluid overload.

Reference: KDIGO 2012 – AKI Guideline