Following surgery to correct a massive hemorrhage, a 55-year-old patient exhibits oliguria and edema. Blood test results indicate increasing azotemia and electrolyte imbalance. The glomerular filtration rate is 20 mL/min. Urinalysis results are as follows: COLOR: Yellow KETONES: Negative CLARITY: Cloudy BLOOD: Moderate GRAVITY: 1.010 BILIRUBIN: Negative pH: 7.0 UROBILINOGEN: Normal PROTEIN: 3+ NITRITE: Negative GLUCOSE: 2+ LEUKOCYTE: Negative Microscopic:    50–60 RBCs/hpf 2–3 granular casts/lpf  3–6 WBCs/hpf 2–3 RTE cell casts/lpf 3–4 RTE cells/hpf 0–1 waxy casts/lpf 0–1 broad granular casts/lpf What diagnosis do the patient’s history and laboratory results suggest? What is the most probable cause of the patient’s disorder? Is this considered to be of prerenal, renal, or postrenal origin?

Following surgery to correct a massive hemorrhage, a 55-year-old patient exhibits oliguria and edema. Blood test results indicate increasing azotemia and electrolyte imbalance. The glomerular filtration rate is 20 mL/min. Urinalysis results are as follows:

COLOR: Yellow

KETONES: Negative

CLARITY: Cloudy

BLOOD: Moderate

GRAVITY: 1.010

BILIRUBIN: Negative

pH: 7.0

UROBILINOGEN: Normal

PROTEIN: 3+

NITRITE: Negative

GLUCOSE: 2+

LEUKOCYTE: Negative

Microscopic:    50–60 RBCs/hpf

2–3 granular casts/lpf

 3–6 WBCs/hpf

2–3 RTE cell casts/lpf

3–4 RTE cells/hpf

0–1 waxy casts/lpf

0–1 broad granular casts/lpf

1. What diagnosis do the patient’s history and laboratory results suggest?
2. What is the most probable cause of the patient’s disorder? Is this considered to be of prerenal, renal, or postrenal origin?