一位70 歲男性過去有糖尿病、高血壓、高血脂及常年抽菸的病史。4 週前因冠狀動脈狹窄,接受經femoral artery 之PTCA(percutaneous transluminal coronary angioplasty)治療。目前主訴尿量減少,全身倦怠,輕微發燒住院。檢查結果顯示血壓偏高180/100 mmHg,下肢有網狀斑(livedo reticularis)及水腫,血中creatinine 由4 週前之1.2 mg/dL 上升到5.7 mg/dL。則其初步診斷是:
contrast nephropathy
systemic vasculitis
atheroembolic renal disease(cholesterol emboli syndrome)
acute interstitial nephritis