AKI with blurred vision post cardiac cath
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Published on Jun 27, 2021
A 77-year-old patient, with a high load of atherosclerotic risk factors (hypertension, smoker, hyperlipidemia, and diabetes mellitus) presented with an acute renal failure , creat of 7 ‘ K 6.5 , 3 weeks after undergoing coronarography to investigate a dyspnea on effort. His had acute on chronic systolic chf with EF of 25 %. HE was treated with aggressive diuresis prior to this and lost 10 pounds with iv lasix . He was started on statin post cath . Serum creatinine before coronarography was 0.7.also 1 week post cath he had a creat of 1.1 range -he has positive pulses on arterial Doppler bedside in both extr and CPK level is 450 range.
WHAT IS THE MOST LIKELY CAUSE FOR RENAL FAILURE ?
A. Cardiorenal syndrome
B. Cholesterol emboli
C . Rhabdomyolysis from muscle ischemia - arterial emboli
D. Contrast nephropathy
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Answer is B
delayed reaction 2-3 weeks with eosinophilia and livedo reticularis is typical of cholesterol emboli
Contrast nephropathy and cardiorenal syndrome would be occurred mouth earlier is course of disease . CPK of 450 do not cause such severe AKI
Also he has normal pulses which is not typical for arterial ischemia
