51yof. lost 63lb in 5 mo. got kenalog (triamcinolone) cerv.block 7 days before lab. bun 26h, creat.1.1ok, bun/creat ratio 23.6h, alb 4.6, gfr 56-l. got kidney prob?

ARF: Has decrease GFR from medication, or dehydration, thus needs to stop nephrotoxic medications, and increase fluid intake.Re-check laba in 7-10 days.

Probably not: We would need to take a history to assess other medications in use as well as perform a physical exam to assess the state of hydration. The high bun/creat ratio and the slightly high Albumin suggest volume depletion. A urinalysis would be helpful in screening this patient for renal disease. The patient's current weight would also be needed. Cystatin c testing and a GFR nuclear scan could help.