A 40-year-old woman presented to the emergency department due to bloody vomiting. The patient was resuscitated, and she underwent upper gastrointestinal endoscopy, which shows bleeding gastroesophageal gastric ulcer. While she was hospitalized, the patient started having decreased urine output. Serum creatinine rises to 3.2 mg/dL from a baseline of 1.3 mg/dL. Microscopy reveals patchy epithelial necrosis of the tubules, tubulorrhexia, and intratubular casts. One week later, urine output significantly started increasing and serum creatinine levels declined. Over the next few days, this patient is at the highest risk for which of the following complications?

Question

Quizplus · Accepted Answer

Eductional Objective: Acute tubular necrosis results from either ischemia affecting the tubules or direct toxic injury to the tubular cells. Acute tubular necrosis has 3 stages, initiation, maintenance, and recovery. The recovery period leads to an increase in the glomerular filtration rate compared to the initial damage. Therefore, patients present with polyuria and electrolyte wasting especially hypokalemia.

A 40-Year-Old Woman Presented to the Emergency Department Due to Bloody