26/05/2026
March 2026 – Day 5: Recall 45
A 68-year-old man is admited following an acute ischaemic stroke. He has a history of hypertension, dyslipidaemia, and known Stage 3 chronic kidney disease (baseline eGFR 50 mL/min). Thrombolysis was not administered due to a recent major surgical procedure. On admission, his serum creatinine was 70 μmol/L (0.8 mg/dL). He is commenced on Aspirin 300 mg, prophylactic Enoxaparin, and IV maintenance fluids. An indwelling urinary catheter is placed to monitor output. On day 2 of admission, his serum creatinine rises sharply to 200 μmol/L (2.3 mg/dL). His blood pressure remains stable at 130/80 mmHg.
What is the most likely cause of this acute kidney injury (AKI)?
A. Dehydration
B. Aspirin-induced nephrotoxicity
C. Enoxaparin-induced AKI
D. Urinary retention
E. Contrast-induced Nephropathy
