MRCP2-4082

MRCP2-4082

A 16 year old male patient presents to the acute medical unit with a seizure. He has no past medical history of note. On assessment, he is post-ictal but maintaining airway, breathing, circulation independently. His capillary blood glucose is 5.8.

CT brain reveals no bleed, no infarct and no space occupying lesion.
ECG: normal sinus rhythm

Bloods are as follows:

Hb 135 g/dl
Plt 70 x10^9/l
WCC 15.0 x10^9/l
Na+ 132 mmol/l
K+ 5.7 mmol/l
Ur 42 mmol/l
Cr 980 µmol/l

Blood gas analysis:

pH 7.35
pCO2 4.2 kPa
pO2 12.8 kPa
BE -3 mmol/l
HCO3- 17 mEq/l

You note his renal function and arrange for further investigation by booking a renal ultrasound and performing immunology bloods to assess for the underlying cause. You catheterise the patient – urine dipstick shows PRO +++, BLD ++. Therefore, a mid-stream sample of urine is sent for microscopy, culture and sensitivity(results awaited). Following discussion with the renal team, the decision is made to dialyse the patient.

What is one of the indications for dialysis in this patient?