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.
