Renal Failure & Fluid Balance

Clinical Scenario 1

A 41 year old female with ovarian carcinoma is admitted to intensive care with respiratory failure. On examination she has bilateral pleural effusions and a distended abdomen, with shifting dullness to percussion. She is intubated and ventilated, on instructions of the attending physician. 36 hours after admission she gradually becomes oliguric, unresponsive to fluid and diuretic challenges and ultimately becomes anuric. Her creatinine over this time rises to 3.3

How do you diagnose the cause of her renal failure?

Please note: these tutorials are for personal study purposes only.  They are not currently peer reviewed, and no responsibility will be taken for mistakes or inaccuracies. Reproduction of information is forbidden. All material is copyrighted by the GasWorks Group.