1. Presented by Mark Haas, M.D. and prepared by Carol Allan, M.D.

A 59 year old African-American man presented to the emergency room in August, 2000 with a three day history of fatigue, nausea, and headaches. His symptoms started the day after doing extensive and strenuous work in his yard. He has also noted a decrease in his urine output. In the ER, he was found to have a serum creatinine of 14.5 mg/dL. Urinalysis showed only trace protein (by dipstick) with rare RBCs. Medical history is remarkable for a five year history of hypertension, well controlled with medication. He also occasionally takes Advil for "arthritis". He was admitted to the hospital and underwent a renal biopsy.

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