A 67-year-old man with hypertension and type 2 diabetes presents with acute onset oliguria after undergoing coronary angiography for unstable angina. Serum creatinine increased from 1.2 to 3.8 mg/dL within 48 hours. Urinalysis shows muddy brown casts and minimal proteinuria. Urine osmolality is 350 mOsm/kg and urine sodium is 65 mEq/L. Which of the following is the most likely diagnosis?
- A)Prerenal acute kidney injury from dehydration
- B)Acute tubular necrosis from contrast-induced nephropathyGABARITO
- C)Acute glomerulonephritis from lupus nephritis
- D)Postrenal acute kidney injury from ureteral obstruction
- E)Acute interstitial nephritis from medication exposure
Explicação
Contrast-induced nephropathy causes acute tubular necrosis (ATN), the most common intrinsic renal cause of AKI in hospitalized patients. Key features include: temporal relation to contrast exposure, muddy brown casts (characteristic of ATN), high urine sodium ... Ver explicação completa e trilha adaptativa →