54-year-old man with a history of type 2 diabetes and coronary artery disease is admitted to the cor

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54-year-old man with a history of type 2 diabetes and coronary artery disease is admitted to the coronary care unit with worsening angina and hypertension. His pain is controlled with intravenous nitroglycerin, and he is treated with aspirin, beta-blockers to lower his heart rate, and angiotensin-converting enzyme (ACE) inhibitors to lower his blood pressure. Cardiac enzymes are normal. He undergoes coronary angiography, which reveals no significant stenosis. By the next day, his urine output has diminished to 200 mL over 24 hours.

 Patient found in NAD with decreased urine output. Na 140 mEq/L, K 5.3 mEq/L, Cl 104 mEq/L, CO2 19 mEq/L, and blood urea nitrogen (BUN) 69 mg/dL. His creatinine (Cr) level has risen to 2.9 mg/dL from 1.6 mg/dL on admission

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