A 61-year-old woman with a history of hyperlipidemia, hypertension, stage 1 chronic kidney disease, and a baseline creatinine level of 1.5 mg/dL (132.6 μmol/L) presented yesterday with acute hypoxic respiratory failure from multilobar pneumonia. She underwent intubation last night, after which she developed mild shock, and she currently is receiving a 0.15 μg/kg/minute norepinephrine infusion. This morning, her ventilator settings have stabilized with assist control volume control with tidal volume of 350 mL, PEEP of 10 cm H₂Ο, and FiΟ₂ of 0.6. Her urine output has decreased, and she has been making only 5 to 10 mL of urine an hour for the last 12 hours. Her laboratory tests are notable for the results shown in Figure 1. Enteral feeding was started this morning at a trophic rate of 10 mL/hour.