CKD and I&O

[Firewood, RN]

I had a GIB pt the other day who had a hx of CKD. His creatinine and BUN were normal. His Gfr was >60. His uop for the shift was ~ 1000cc. He had an IV of NS at 100cc/hr and his 24 hr total was positive ~1.5 L. My question is that how much does intake factor in to ckd with these lab values? If uop remains at a decent constant and the lab values are normal, can the pt be positive this much and not be considered to be renal impaired?

[KatieMI, BSN, MSN, RN]

Not enough details to decide but generally NS stays in bloodstream (so being available for renal excretion) for about an hour at the best, then it goes either intracellular or third space where it can stay for a while. Also, 1 l of NS has 9 grams of salt (NaCl), and 100 cc/h means almost 20 g of salt/6.5 grams of sodium/24 h. It is D*** whole lot of sodium and will keep a lot of water from being excreted, especially for CKD patient whose distal tubules function might be altered alrwady.