問題詳情

29.一位40歲病人原本腎功能正常，現其血清creatinine在48小時內上升至2.5 mg/dL，下列何種狀況最可判斷此病人傾向內生性急性腎損傷（intrinsic acute kidney injury）？
(A)尿鈉排出比例（fractional excretion of sodium, FeNa）＜1%
(B)尿液滲透壓＞500 mOsm/L
(C)血液尿素與肌酸酐比率（BUN-to-creatinine ratio）＞20
(D)尿沉澱物可見顆粒性圓柱體（granular cast）

參考答案

答案：D

統計：A:59,B:47,C:62,D:359,E:0

難度：簡單

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TABLE 52-2 Laboratory Findings in Acute Renal FailureIndex Prerenal AzotemiaAcute Tubular NecrosisBUN/PCr ratio >20:1 10–15:1Urine sodium U Na, meq/L <20 >40Urine osmolality, mosmol/L H2O>500 <350Fractional excretion of sodium<1% >2%Urine/plasma creatinine UCr/PCr>40 <20Urinalysis (casts) None or hyaline/granular Muddy brownFENa may be >1% in prerenal AKI associated with diuretic use and/or the setting of bicarbonaturia or chronic kidney disease; FENa often <1% in acute tubular necrosis caused by radiocontrast or rhabdomyolysis