When the Well Runs Dry

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Author: Dena Al-waidh, Faisal Faruqi / Editor: Sarah Edwards / Codes: / Published: 14/04/2025

An 80-year-old woman presents to the emergency department (ED) after an unwitnessed fall at home. She has a history of hypertension and type 2 diabetes but no previous kidney issues.

On examination and investigation, the following findings are noted:

Key Features:

  • Haemoglobin: 52 g/L (severe anaemia).
  • Creatinine: 350 mol/L (baseline: 80 mol/L; AKI stage 3).
  • Potassium: 5.4 mmol/L
  • WCC: 15 x 10/L; CRP: 120 mg/L.
  • Urine Output: Oliguria, <0.3 mL/kg/hour over 8 hours.
  • Blood Pressure: 100/70 mmHg; irregular heart rate at 130 bpm.
  • Chest: Clear; no pulmonary oedema
  • Examination: Abdo SNT. No signs of urinary infection or overt bleeding

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