Renal Case

A healthy 26-year-old woman sustained a significant crush injury to her right upper
extremity while on the job at a local construction site. She was brought to the emergency
department and subsequently underwent pinning and reconstructive
surgery and received perioperative broad-spectrum antibiotics. Her blood pressure
remained normal throughout her hospital course. On the second hospital day, a medical
consultant noted a marked increase in her creatinine, from 0.8 to 1.9 mg/dL. Her urine
output dropped to 20 mL/h. Serum creatine kinase was ordered and reported as 3400
units/L.