MEDizzy - A patient presents with a twofold-elevated serum creatinine

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Renal and Urinary Systems

A patient presents with a twofold-elevated serum creatinine level compared to baseline for 12 hours. In order to prevent worsening azotemia, the patient’s glomerular filtration rate must be increased. Which of the following is an appropriate manipulation?

ExplanationDilating the afferent arteriole increases hydrostatic glomerular capillary pressure (PGC). This increases the force that drives plasma from the capillary into the capsule and increases the glomerular filtration rate (GFR). (A, C) Constricting the afferent arteriole or dilating the efferent arteriole decreases PGC and thus decreases GFR. (D) Increasing the glomerular capillary colloid oncotic pressure will draw fluid from Bowman’s capsule into the capillary, hence decreasing GFR.