Clinical Case Scenario
A 60-year-old male with a history of hypertension and diabetes mellitus is admitted to the hospital with a three-day history of vomiting, decreased oral intake, and reduced urine output. On initial assessment, he appears lethargic, with dry mucous membranes, poor skin turgor, and cool extremities. His blood pressure is 85/60 mmHg, heart rate is 110 bpm, and respiratory rate is 22 breaths per minute. The patient’s laboratory results reveal elevated serum creatinine (2.8 mg/dL, baseline 1.0 mg/dL), elevated blood urea nitrogen (BUN) of 45 mg/dL, and electrolyte imbalances.
The clinical team is concerned about acute kidney injury (AKI) in the context of hypovolemia and discusses the importance of accurate volume status assessment to guide resuscitation and prevent further kidney damage. Appropriate fluid resuscitation is considered to optimize renal perfusion.
Question: Which of the following methods is most appropriate for assessing intravascular volume status in this patient with AKI?
