A 74 year old man presents with suprapubic discomfort, nocturia, and weak urinary stream. Over the last day he has had difficulty voiding. Laboratory studies show rising BUN and creatinine. Bedside ultrasound reveals bilateral hydronephrosis and a distended bladder. Which of the following is the most likely cause of his acute kidney injury?
- A)Autoimmune injury to the renal interstitium
- B)Increased hydrostatic pressure proximal to urinary tract obstructionGABARITO
- C)Acute ischemic necrosis of tubular epithelium
- D)Selective efferent arteriolar vasodilation
- E)Immune complex deposition in the glomeruli
Explicação
This patient has postrenal acute kidney injury from bladder outlet obstruction, most likely due to benign prostatic hyperplasia. Obstruction raises hydrostatic pressure in the tubules and Bowman space, which lowers net filtration pressure and decreases GFR. Ver explicação completa e trilha adaptativa →