Ahealthy 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.
questions
what are the primary causes of this patient’s acute kidney injury? how should her kidney injury be categorized (as prerenal, intrarenal, or postrenal)?
how should she be treated?