A 1 month-old girl is admitted to the hospital with new onset acute renal failure in the setting of newly diagnosed obstructive uropathy. Which of the following pathophysiologic changes are LEAST likely to be observed?

a) Hypernatremia and hyperglycemia

b) Hyperphosphatemia and hypocalcemia

c) Metabolic acidosis and low pCO2

d) Hyperkalemia and platelet dysfunction

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Answer

Answer a. Common findings in renal failure include hyperkalemia, hyperphosphatemia, hypocalcemia, metabolic acidosis (with compensatory respiratory alkalosis) and hyperkalemia. In addition, there is a qualitative defect in platelet function caused by uremia; transfusing platelets in the absence of correction of uremia will not improve function. Hypernatremia would be unusual, as most patients develop hyponatremia due to free water overload.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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