Chapter 19 - 19 Acute Kidney Injury

Chapter 19: Chapter 19 Acute Kidney Injury

At night, inside a bar that wasn't particularly noisy, Kube Rokuro was sitting alone at the counter, sipping his drink in a somewhat gloomy manner with his head down, seemingly deep in thought.

When Chen Yu walked into the bar, he spotted Kube Rokuro at a glance and walked over, slapping him on the shoulder, "Hey, Kube!"

"Ah! Chen-san!" Startled by the slap on his shoulder, Kube Rokuro suddenly jumped, quickly turned around to see it was Chen Yu, and then relaxed, "Don't suddenly slap me from behind! You nearly scared me to death."

"Inviting me for a drink and here you are brooding over a solo drink, what's up? Work not going smoothly, or did something happen, little Kube? Let me guess, it couldn't be that you've fallen for one of those female forensic doctors at your institute and got rejected when you confessed, could it?" Chen Yu sat down next to Kube Rokuro, looking at his troubled face, he couldn't resist teasing him.

"That's not it!" Kube Rokuro hurriedly denied it, but after he did, he seemed a bit embarrassed, adding unnecessarily as he explained to Chen Yu, "There ARE two very beautiful female forensic doctors at UDI, but I haven't confessed to them."

"Oh~!" Chen Yu responded with a meaningful "oh," his gaze full of teasing as he looked at Kube Rokuro, "So it's not that there are no female forensic doctors, but that you haven't confessed, is that it?"

However, faced with Chen Yu's teasing, Kube Rokuro wasn't in the mood to joke around this time, and just shook his head saying, "Those female forensic doctors are really..."

Perhaps finding the topic too heavy, Chen Yu promptly moved on, asking about something else, "Rokuro, you said earlier that a body was brought in for an autopsy at your place, but it involved another deceased person. What's that all about?"

"Oh, it was commissioned by a pair of parents whose son was found dead in his own home. The police concluded that the cause of death was ischemic heart disease. His parents didn't believe that their son could die of such a cause, so they sent him to our UDI for a forensic autopsy, wanting to know the true cause of their son's death. But after the autopsy, the creatinine levels were three times the normal, leading to a diagnosis of acute kidney injury, suspected to be poisoning." Perhaps also wanting to divert from the previous subject, Kube Rokuro explained the case he encountered in detail, perhaps seeking the opinion of his senior colleague, Rokuro was very thorough.

"Poisoning? That's not necessarily the case!" After hearing Kube Rokuro's explanation, Chen Yu disagreed with the judgment of the UDI autopsy doctor, "While toxins are indeed a primary cause of acute kidney injury, they are not the only cause. Acute kidney injury refers to the sudden onset and persistence of a rapid decline in kidney function, defined as at least a 0.5mg/dl increase in serum creatinine, presenting with azotemia, disorders of the water, electrolyte and acid-base balance, as well as symptoms affecting various systems throughout the body, possibly accompanied by oliguria or anuria."

"As for the causes..." Chen Yu said, seeming quite unsatisfied with Kube Rokuro's bewildered look, "Mr. Kube, how can you not know this? You attended medical school after all, albeit a third-rate one, but as a clinical doctor, shouldn't you understand these things?"

"Sorry! I wasn't paying attention in class." Chastised by Chen Yu, Kube Rokuro knew he had embarrassed himself and quickly apologized, but he was more concerned about the causes Chen Yu had mentioned, "But what are the causes of acute kidney injury, senior brother? Why do you say it might not be poisoning?"

Chen Yu gave Kube Rokuro a speechless look, clearly even more dissatisfied with this medical student's ignorance of the causes of acute kidney injury, but proceeded to explain, "The pathogenesis of acute kidney injury includes prerenal factors leading to acute kidney injury, kidney parenchymal or vascular disease-related acute kidney injury, and postrenal acute kidney injury caused by urinary tract obstruction."

"Acute kidney injury from toxic poisoning comes from nephrotoxins causing tubular necrosis, which belongs to kidney parenchymal or vascular disease-related acute kidney injury. Potential toxins include aminoglycosides, contrast agents, heavy metals, organic solvents, or other antibiotics. As for what specifically caused the deceased's acute kidney injury, I think you should investigate further. It's very likely to be another disease and not poisoning."