A 71 year old man is admitted for septic shock due to pneumonia. He remains hypotensive for several hours despite fluid resuscitation. Two days later his serum creatinine rises sharply. Urinalysis shows muddy brown granular casts. Fractional excretion of sodium is elevated. Which of the following is the most likely cause of his acute kidney injury?
- A)Acute tubular necrosisGABARITO
- B)Acute interstitial nephritis
- C)Prerenal azotemia
- D)Postrenal obstruction
- E)Rapidly progressive glomerulonephritis
Explicação
Acute tubular necrosis is correct. Ischemic injury from prolonged hypotension damages tubular epithelial cells, leading to intrinsic renal failure with elevated fractional excretion of sodium and muddy brown granular casts. ATN commonly follows shock, sepsis, ... Ver explicação completa e trilha adaptativa →