Approach to acute kidney injury Quiz: Ace Your Exams
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A 68-year-old man presents to the primary care clinic for a routine follow-up visit. He has no acute complaints and no fever, chills, chest pain, shortness of breath, abdominal pain, or dysuria. Past medical history is significant for heart failure with reduced ejection fraction, coronary artery disease, benign prostatic hyperplasia (BPH), and osteoarthritis. Vital signs are within normal limits. Cardiopulmonary exam is within normal limits. The abdominal exam shows no distension or tenderness. There are no signs of fluid overload, jugular venous distension, or peripheral edema. Laboratory results are shown below. Renal ultrasound reveals normal kidney size and no evidence of hydronephrosis bilaterally. Which of the following is most likely to be present in this patient's history?
| Laboratory test | Result |
| Sodium | 138 mEq/L |
| Potassium | 4.3 mEq/L |
| Serum creatinine | 2.4 mg/dL (baseline 1.1 mg/dL 4 weeks ago) |
| Blood urea nitrogen (BUN) | 45 mg/dL |
| Urinalysis with microscopy | 1+ protein, 1+ blood |
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