Case 3: A 81-Year-Old Man Presented With Abnormal Serum Creatinine Levels

Sojung Youn, Jung Wook Kim, Eun Sil Koh, Bum Soon Choi, Tae Hyun Ban

Research output: Contribution to journalArticlepeer-review

Abstract

Dr. Jung Wook Kim: A 81-year-old man under medication with hypertension and dyslipidemia was hospitalized with general weakness, dyspnea, and elevated blood urea nitrogen (BUN) and serum creatinine (Cr) levels. The patient had regular health check-ups, but he had never heard of abnormal renal function until the last examination, which was done 6 months ago. His prescribed agents were valsartan, rosuvastatin, and aspirin for many years. He denied alcohol abuse, smoking, or intake of herbal medications. Vital signs were stable without fever (blood pressure was 127/77 mmHg, heart rate 66 beats per minute, respiratory rate 18 breaths per minute, body temperature 36.9°C). He had no symptoms other than general weakness and dyspnea on the review of systems. Although he complained of dyspnea, physical examination revealed clear breath sounds without rales. Laboratory findings were BUN level of 74.8 mg/dL and serum Cr level of 3.92 mg/dL, spot urine protein-to-Cr ratio 1.42 g/g Cr suggesting the possibility of kidney injury. In addition, inflammatory markers, such as white blood cell count and c-reactive protein increased. Acute kidney injury (AKI) combined with infection, rather than chronic kidney disease (CKD), was highly suspected. The patient started antibiotics treatment.

Original languageEnglish
Article numbere298
JournalJournal of Korean Medical Science
Volume37
Issue number38
DOIs
StatePublished - 2022

Bibliographical note

Funding Information:
The Case Conference section is prepared from monthly case conference of Department of Internal Medicine, the Catholic University of Korea College of Medicine, Seoul, Korea

Publisher Copyright:
© 2022 The Korean Academy of Medical Sciences.

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