Musfasa from the Lion King speaks to you.

He asks you to remember who you are.

He asks you to specifically remember you are the renal SHO who knows nephritic syndrome inside out:

• Haematuria / red cell casts
• Hypertension (mild)
• Oliguria
• Uraemia

Proteinuria (<3g/24 hours i.e. less than nephrotic syndrome)

You also realise that to define AKI in the first place, changes in creatinine and/or changes in urine output are used, not changes in urea. And that increases in urea without corresponding increases in creatinine happen in GI bleeds (and to some extent in dehydration).

You go to see the patient, who has meanwhile died in sheets stained with brown/red/black gunk.