The case: a 60 year-old woman with a history of metastatic ovarian cancer who presents with a markedly tense, distended abdomen and acute-on-chronic kidney injury, with a Cr which had risen from 1.4 mg/dL to 4.5 mg/dL and a drop in her urine output. An initial urine Na was <10>20mmHg (which can be easily measured via a Foley catheter with a device similar to that shown above) may result in altered renal hemodynamics and reduced GFR.Treatment of ACS involves relief of the pressure, which is generally achieved by either surgical decompression or paracentesis. Diuretics may also be helpful.
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