Case 11-1996: A 69-year-old man with progressive renal failure and the abrupt onset of dyspnea

Presentation of Case A 69-year-old man was admitted to the hospital because of increasing dyspnea in the course of one day. The patient had a 12-year history of hypertension. He had had hyperlipidemia, with pancreatitis, five years before admission. During the year before admission, the creatinine concentration ranged between 1.3 and 1.7 mg per deciliter (110 and 115 μmol per liter). Six months before admission, the urea nitrogen concentration was 24 mg per deciliter (8.6 mmol per liter), and the creatinine concentration was 2.7 mg per deciliter (240 μmol per liter). “Nephrotic-range” proteinuria was noted; the results of serum protein . . .