Mr. Thompson is 60 yo and has been unusually tired for several weeks. He occasio

Question

Mr. Thompson is 60 yo and has been unusually tired for several weeks. He occasionally feels dizzy and lately finds it increasingly difficult to sleep at night. He has swollen ankles and feet and his face looks puffy. He experiences a burning pain in his lower back, just below the rib cage. He also notices that his urine is dark in color. He goes to see his physician who finds that he has elevated blood pressure, and that the kidney region is sensitive to pressure.

What diagnosis would you give Mr. Thompson? What type of casts might be found in his urine?

Explanation / Answer

The diagnosis would be acute renal failure. This usually develops in elderly people with high blood pressure. The swollen ankles and puffy face indicate that the kidneys are not working properly. The burning pain in his lower back show that the problem is with his kidneys. The fatigue is another symptom of kidney failure. ------------------- The casts seen would be hyaline cast brown and granular with cellular debris.

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