Apparent AKI in a Patient with Ascites Following Laparoscopic Hysterectomy

A 39-year-old woman with a history of menorrhagia who underwent laparoscopic hysterectomy presented to the emergency department 4 days after surgery with abdominal pain and distention. Her vitals revealed the following: blood pressure 98/62 mm Hg, heart rate 110 beats/minute, oxygen saturation 99% on room air, and temperature 37.1 °C. Initial basic laboratory values were as follows: white blood counts 18.0×109/L with neutrophil predominance, hemoglobin 15.2 g/dl, platelets 190×109/L, sodium 134 mmol/L, potassium 4.9 mmol/L, chloride 101 mmol/L, bicarbonate 17 mmol/L, BUN 45 mg/dl (9–24), serum creatinine 7.4 mg/dl, calcium 9.0 mg/dl, albumin 3.7 g/dl, aspartate aminotransferase 20 U/L, alanine aminotransferase 25 U/L, alkaline phosphatase 90 U/L, total bilirubin 0.6 mg/dl, lipase 62 U/L, and lactate 2.4 mmol/L. Urinalysis was remarkable …