Managing a patient on dialysis

Abstract

A 65-year-old diabetic and hypertensive male patient, with a history of coronary artery bypass grafting a year ago, was admitted to the ITU, with pneumonia and septic shock. Previous records show that he had poor cardiac systolic function (LVEF 30%) and was on an angiotensin receptor blocker-neprilysin inhibitor (ARNI). ARNI was stopped. He was resuscitated with fluids and started on vasopressors. He remained oliguric (urine output <30 mL/h) for more than 12 h, with serum creatinine 3 mg/dL, potassium 6.5 mEq/L, and pH 7.1. He was commenced on continuous renal replacement therapy (CRRT).