A 55-year-old man with type 2 diabetes and hypertension develops acute kidney injury after 2 days of vomiting and diarrhea. Physical exam shows decreased skin turgor and orthostatic hypotension. Serum creatinine is 3.2 mg/dL (baseline 1.1 mg/dL). Urinalysis is normal. FENa is 0.4%. Which of the following is the most likely diagnosis?

  1. A)Acute interstitial nephritis
  2. B)Prerenal acute kidney injuryGABARITO
  3. C)Diabetic ketoacidosis
  4. D)Acute glomerulonephritis
  5. E)Acute tubular necrosis

Explicação

Clear case of prerenal AKI from volume depletion (GI losses, orthostatic vital signs). FENa <1% confirms intact tubular function with appropriate sodium conservation. Normal urinalysis rules out intrinsic renal disease. The large creatinine elevation relative ... Ver explicação completa e trilha adaptativa →

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