66 year old man comes to ED with: -Nausea, vomiting, malaise He was hospitalized four weeks ago for MI on background of longstanding hypertension. He was started on new BP medications. Recently he developed community acquired pneumonia and is currently under outpatient treatment. Pulse is 110/min, respirations are 22/min bp is 130/65. Physical examination reveals and epigastric bruit 4 cm lateral to midline. Lab studies show creatinien of 4.8 mg/dl. Review of his reecords shows serum creatinine of 1.1 mg/dl two months earlier. 1. Which drug is likely responsible for his lab results and why? 2. What is the significance of the epigastric bruit heard? 3. What lab value suggests an acute kidney injury?

How do you remember renal physiology?
Use the mnemonic, A WET BED: A) maintenance of ACID-base balance; W) maintenance of WATER balance; E) balance of ELECTROLYTES; T) removal of TOXINS; B) control of BLOOD pressure; E) production of ERYTHROPOIETIN; and D) metabolism of vitamin D.