Clinical Case Scenario
A 68-year-old male is admitted to the intensive care unit with septic shock due to severe community-acquired pneumonia and hypoxemic respiratory failure. He is hemodynamically stabilized on norepinephrine at 0.15 mcg/kg/min and has received an initial 30 mL/kg of crystalloid fluids, followed by an additional 3 liters of crystalloid over the next 24 hours, guided by pulse pressure variation monitoring. After 24 hours, the following data is available:
- Serum Creatinine: 0.9 mg/dL (baseline: 0.8 mg/dL)
- Urine Output: 1.2 mL/kg/hr over the past 6 hours
- Arterial Blood Gas: pH 7.38, PaO₂ 85 mmHg, PaCO₂ 39 mmHg, HCO₃⁻ 24 mmol/L, lactate 2.2 mmol/L
- NGAL (Neutrophil Gelatinase-Associated Lipocalin): 220 ng/mL (normal: <150 ng/mL)
- TIMP2·IGFBP7 (combined value): 0.9 (high-risk threshold >0.3)
Based on above information, tick one best response from each question:
Question 1a. What is the most appropriate interpretation of this patient’s renal profile?
