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PD vs HD Survival Comparison — ESENeph MCQ

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HardPeritoneal DialysisPD vs HD Survival ComparisonESENeph

A pregnant patient with CKD develops vomiting, postural hypotension and a creatinine rise from 62 to 91 micromol/L. What is the best initial kidney approach?

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Correct answer: ECorrect volume depletion with coordinated obstetric and renal assessment

The best answer is “Correct volume depletion with coordinated obstetric and renal assessment”. Pregnancy-associated acute kidney dysfunction requires direct creatinine interpretation, prompt assessment and correction of reversible haemodynamic causes with obstetric–renal coordination. “Use eGFR to stage acute kidney dysfunction during pregnancy” is unreliable because standard eGFR equations are not validated in pregnancy. “Defer kidney assessment until the early postpartum period” risks progression of an acute problem. “Start an ACE inhibitor for kidney protection during pregnancy” introduces fetotoxic risk. “Attribute rising creatinine to normal physiological hyperfiltration” is incorrect because physiological hyperfiltration lowers rather than raises creatinine.

Reference: UK Kidney Association pregnancy and renal disease guideline: https://www.ukkidney.org/health-professionals/guidelines/pregnancy-and-renal-disease