Renal, Urology and Electrolytescommon
A 74-year-old man is on day 2 after an emergency Hartmann procedure for perforated diverticulitis. He takes spironolactone and perindopril for heart failure. He has passed 250 mL of urine in the last 12 hours. Results this morning: sodium 136 mmol/L, potassium 7.1 mmol/L (3.5–5.0), urea 24 mmol/L, creatinine 268 µmol/L (60–110, was 98 pre-operatively). An electrocardiogram shows tall peaked T waves in the chest leads and a QRS duration of 0.16 seconds.
Which one of the following is the most appropriate immediate management?