DISCUSSION

Medical Students and Interns:

* Based on the history and physical be able to establish that this patient has congestive heart failure and be able to determine that it is from acute renal failure.

* Be able to list the three major categories of causing acute renal failure.

* For each of the three major categories of acute renal failure be able to list the major causes of each.

* Be able to take a directed history to help clarify the cause of a patient's acute renal failure.

* Be aware of the basic findings in the urine that suggests the etiology of a patient's renal comprimise.

Junior Residents:

* Be able to answer the goals and objectives for students and interns.

* Be aware of the information provided by urine electrolytes and urine osmolarity.

* Be able to calculate FENa and understand what the results of this calculation indicate.

* Be familiar with the value, if any, of radiographic procedures such as intravenous pyelograms, ultrasound, and CT scans.

* Be familiar with the major causes of acute tubular necrosis and be aware of the ways in which it differs from prerenal and renal causes of acute renal failure.

* Be aware of the basic approach to managing patients with acute renal failure.

Senior Residents:

* Be able to answer the goals and objectives for junior residents.

* Be aware of the most common complictions that may need to be addressed in patients with acute renal failure.

* Be able to establish the cause of a patient's renal failure and treat it appropriately depending on that etiology.

* Be familiar with some of the more common medications that cause acute tubular necrosis.

* Be familiar with the indications for dialysis in a patient in acute renal failure.