Approach to postoperative acute kidney injury Quiz: Ace Your Exams

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A 68-year-old man is evaluated in the post-anesthesia care unit following open repair of an abdominal aortic aneurysm that was complicated by moderate blood loss. Urine output from the foley catheter has decreased to 20 mL/hour over the past 4 hours. Past medical history is significant for benign prostatic hyperplasia (BPH), hypertension, and type 2 diabetes. Temperature is 37.0°C (98.6°F), heart rate is 112/min, blood pressure is 100/62 mm Hg, respiratory rate is 18/min, and oxygen saturation is 98% on room air. Physical examination is significant for dry mucous membranes and decreased skin turgor. The abdomen is soft with a clean surgical incision. Laboratory findings are significant for a rise in serum creatinine from 1.1 mg/dL to 3.1 mg/dL and a blood urea nitrogen level of 68 mg/dL. Which of the following is the best next step in management?  

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