Case Discussion

56 year male , ex smoker with significant history of Ischemic heart disease

Presented in emergency with the complaint of Generalized weakness, Short

Of breath and decreased urine output for last 2 weeks.

He was already investigated outside in cardiology services which he often

Visisted for his chronic heart ailment. His serum creatinine jumped from 0.7

Mg/dl to 4.1 mg/dl in 1 week period.

His past history entails stent placement 8 year back after angiography. Since  then

He was on heart medication including anti hypertensive agent s whose is prescription

Was not brought by him and he does not  know the names for all medications.

On examination he was conscious , well oriented and mobile with regular pulse

96 bpm and BP 80/6o with diminished perepheral pulses. He pale , not icteric

Not cyanosed with dry peripheries and flat neck veins.

Systemically he was ok except slight tenderness on right hypochondrial region.

Discussion:

Now this middle age guy has developed acute kidney injury. And the reason for

This is quit well infromed for his low blood pressure with significand heart disease

With medication whose names are not described. Well we can presume medication

In this scenario would be diuretic , ace inhibitors, anti platelets, Beta blockers etc.

This could cause volume depletion and AKI. ACE inhibitors can cause AKI.

He might have developed unstabel angina/MI which has cused AKI. He may have atherembolic disease.