A patient with acute kidney injury has creatinine 6 mg/dL, K 6.8 mmol/L with ECG changes and pulmonary oedema unresponsive to diuretics. What is the definitive treatment?
Answer and explanation
Correct answer: C. Emergency renal replacement therapy using haemodialysis
- Step 1: Refractory hyperkalaemia, pulmonary oedema and severe uraemia are indications for dialysis. Step 2. Medical measures can buy time but do not remove potassium or fluid reliably. Answer: Haemodialysis. Why not the others: Oral calcium is not definitive. Saline worsens pulmonary oedema. Diuretics have already failed.
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