Pre-renal azotemia mimicking chronic renal failure in a hypotensive patient.
A 56-year-old Samoan man with a documented history of hypertension, who presented with atrial fibrillation and hypotension, quickly developed renal failure with a serum urea nitrogen of 1.370 g/L and a serum creatinine of 92 mg/L. After hydration of the patient, the creatinine value became normal in two days, the urea nitrogen in four days. The urinary creatinine output during the first 24 h of hospitalization was 3.7 g. This case illustrates the rapidity with which unusually large amounts of creatinine (more commonly seen in chronic renal failure) can accumulate and be excreted in pre-renal failure. It also reaffirms the usefulness of the urea nitrogen/creatnine ratio in evaluating the causes of azotemia.
D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000652:urine; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014511:Uremia / Q000150:complications / Q000175:diagnosis*
D003404:Creatinine