Coronary artery disease and chronic kidney disease

Reference no: EM133731146

Question

A 58-year-old patient with hypertension, type 2 diabetes mellitus, coronary artery disease, and chronic kidney disease presents with fatigue. Two weeks ago, they developed left knee pain, for which they started taking celecoxib 200 mg twice daily. They also report some nausea and decreased urinary frequency. Vitals are notable for a blood pressure of 140/84 mm Hg and a temperature of 98.6° Fahrenheit. A physical exam is unremarkable. Labs are notable for a blood urea nitrogen (BUN) of 83 mg/dL (normal 6-24 mg/dL) and serum creatinine of 2.6 mg/dL (baseline 1.9 mg/dL). Complete blood counts are normal, and there is no eosinophilia. Urinalysis is negative for leukocyte esterase, nitrites, and blood. Urine microscopy reveals bland sediment. Which of the following is the most likely underlying etiology of this patient's acute kidney injury?

A. Altered renal hemodynamics B. Renal papillary necrosis C. Allergic interstitial nephritis D. Acute tubular necrosis.

Reference no: EM133731146

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