Case Studies

Case 8: A 75-year-old man with acute kidney injury (AKI) (Part 10 The urinary system)

Mr Hong is a 75-year-old man who goes to see his GP with a 48-hour history of passing small amounts of urine and complaining of painful micturition. He also thinks he may have seen some blood in his urine but isn't sure. He informs his GP that he finds it difficult to pass urine and it appears cloudy. He also complains of a chill and a fever. Mr Hong states that: 'I have been suffering painful urination for about a week and it has progressively got worse. I tried all kinds of remedies but nothing helped and it may have made things worse.' Mr Hong states that he was treated with antibiotics before, and at the time it gave him some relief, but still the problem persists. His GP decides to send him to the local hospital to see the urologist.

Mr Hong sees the urologist who informs him that he would like to admit Mr Hong for further investigations and that he suspects he may be suffering from acute kidney injury.

• 1. Discuss the causes of AKI. Think about the pre-, intra- and post-renal causes.

• 2. Discuss the test and investigations the urologist may carry out to confirm diagnosis.

• 3. Discuss the immediate care for Mr Hong on admission to the hospital.

• 4. What advice would you give Mr Hong on discharge from the hospital?