A 75 year old nursing home resident is brought in for confusion after several days of poor oral intake. Blood pressure is 88/54 mm Hg. Creatinine is mildly elevated. His urine sodium is very low and his calculated fractional excretion of sodium is 0.4 percent. Which of the following is the most likely diagnosis?
- A)Acute tubular necrosis
- B)Acute interstitial nephritis
- C)Prerenal azotemiaGABARITO
- D)Rapidly progressive glomerulonephritis
- E)Postrenal obstruction
Explicação
An FeNa below 1 percent strongly supports prerenal azotemia because the tubules are intact and avidly reabsorb sodium in response to hypoperfusion. The clinical setting of dehydration and hypotension fits this diagnosis. Ver explicação completa e trilha adaptativa →