medication-induced acute kidney injury

Etiology

• fluid loss from a febrile illness, in combination with an ACE inhibitor, a diuretic, & an NSAID (triple whammy) may result in acute kidney injury

Clinical manifestations

• uremia may result in fatigue, anorexia, & confusion Labatoratory:
• increased serum creatinine & eGFR
• increased serum urea nitrogen (uremia)
• urinalysis: granular casts

Differential diagnosis

• acute interstitial nephritis
  • mean time from beginning NSAID to initial signs of renal failire is 10 days
    • may be faster if patient has taken the NSAID previously
  • fever, rash, eosinophilia, pyuria, & WBC casts may be seen

More general terms

• acute renal failure (ARF)

Additional terms

• triple whammy