ACUTE KIDNEY INJURY (AKI)-POST RENAL AKI CAUSES

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SUMMARY

1. In males: prostatic hypertrophy and stones are the usual causes. History (males/females): urinary urgency, frequency, poor stream, post void dribbling, incontinence. Supra-pubic pain (severe if acute). Examination: distended bladder.

2. Intratubular obstruction can be caused by uric acid precipitation, oxalate depositions, hypercalcemia with intrarenal deposits (remember Type 1 distal RTA!).

3. Multiple myeloma with light chains, myeloma cast nephropathy.

4. Drugs: methotrexate, indinavir, acyclovir, ganciclo­vir, and sulfa antibiotics (which can crystallize in the urine).


Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].

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