5th July 2024

A 38-year-old man was admitted with fatigue, poor urinary output and profuse watery diarrhoea for the last 3 days

A 38-year-old man was admitted with fatigue, poor urinary output and profuse watery diarrhoea for the last 3 days. He recently returned from a holiday in India. He is normally fit and well and does not take any regular medications.

Blood tests showed the following: Hb 160g/L (115-165), WBC 10.5×10⁹/L (4-11), Neutrophils 9.1×10⁹/L (2-8), Platelets 200×10⁹/L (150-400), Na 130 mmol/L (135-145), K 4.8 mmol/L (3.5-5), Urea 12 mmol/L (2.5-7.5), Creatinine 235 μmol/L (60-110).

Urine Dipstick is negative for protein and blood. He is started on IV fluids and hyponatremia screening tests were sent. They showed a urinary sodium of 48 mmol/L and urine osmolality of 300 mOsm/kg. What is the most likely cause of his AKI?

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