Today we heard a case of a patient post ETOH binging who presented with acute anuric renal failure. We briefly discussed hepatorenal syndrome and then abandoned this diagnosis.We discussed an approach to renal failure.
We then discussed the possibility of interstitial nephritis, and the role (or lack therof) of testing for urine eosinophils which I have blogged about here.
Some speculations included undiagnosed/untreated pancreatitis or rhabdomyolysis leading to pre-renal azotemia and subsequent acute tubular necrosis (review here).
A nature review of the value of the competant microscopy urinalysis is available here.
Ultimately this patient will have a renal biopsy to make a more definitive diagnosis.
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