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A 68-year-old man with multiple myeloma presents with lethargy and markedly reduced urine output.
Vitals: HR 118 bpm, BP 78/44 mmHg, RR 30/min, SpO₂ 94% RA
Labs: K⁺ 7.2 mmol/L, pH 7.18, bicarbonate 13 mmol/L, creatinine 410 µmol/L (baseline 95)
Urine output: 50 mL in 12 hours
Which of the following represents the most appropriate indication for urgent renal replacement therapy?

Oliguria <0.5 mL/kg/h for 12 h alone

Stage 3 AKI by criteria alone

Refractory hypokalemia with metabolic acidosis and oliguria

Creatinine >400 µmol/L alone

eGFR <15 mL/min/1.73 m²

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