In this week’s noon report, we reviewed our approach to weakness and delved into our differential for acute kidney injury. We took the time to understand when we should be concerned about renal AKI and discussed our approach to GNs!
Case Overview:
A 69-year-old female presented with generalized weakness, atrial fibrillation, and AKI. The progression of her kidney function deterioration, along with her urinalysis and microscopy findings, raised concerns about a possible renal AKI. After thorough investigation, she was diagnosed with lupus nephritis
Please see didactic slides for the report here
Key takeaway points:
- Understanding Weakness:
- Weakness can stem from various causes. When assessing a patient with weakness, start by:
- Clarifying what the patient means by “weakness.”
- Differentiating between neuromuscular and non-neuromuscular causes.
- Weakness can stem from various causes. When assessing a patient with weakness, start by:
- Recognizing Renal AKI:
- Learn when to be concerned about renal AKI and interpret the significance of blood and casts in urinalysis and microscopy.
- Causes of renal AKI
- Glomerular causes:
- Nephrotic vs. Nephritic syndrome
- Within nephritic syndrome, we further divide our differential based on histopathology patterns
- Linear pattern, Pauci-immune and Immune-complex
- Within nephritic syndrome, we further divide our differential based on histopathology patterns
- Nephrotic vs. Nephritic syndrome
- Tubular causes such as ATN
- Interstitial causes such as AIN
- Vascular causes such as TMA or embolic phenomenon
- Glomerular causes:
Vancouver IM LMR 
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