83 year old man

Introduction

• An 83 year old man with a history of hypertension & dyslipidemia managed with lisinopril, hydrochlorothiazide & atorvastatin presents for evaluation.
• Eight days ago, he had symptoms of rhinorrhea, myalgia & fever that he self-treated with naproxen & acetaminophen.
• He also had limited oral intake & anorexia, all of which started to improve until he began to develop fatigue, nausea & anorexia 2 days ago.
• At today's visit, he is found to have a serum creatinine of 4.6 mg/dL increased from his baseline of 1.6 mg/dL.
• A CBC is normal & urinalysis shows granular casts.
• What is the most likely cause of his increased serum creatinine?

More general terms

• case presentation